The Supreme Court is being asked to restore access to an abortion pill
by mail. Here's what to know
[May 04, 2026]
By HANNAH SCHOENBAUM and GEOFF MULVIHILL
Two makers of the widely used abortion pill mifepristone asked the
Supreme Court on Saturday to block an appellate court ruling that cut
off mail-order access to the drug just a day earlier, in what was the
biggest jolt to abortion policy in the U.S. since the overturning of Roe
v. Wade.
Danco Laboratories asked the high court for an emergency pause on the
5th U.S. Circuit Court of Appeals decision, saying the appellate ruling
“injects immediate confusion and upheaval into highly time-sensitive
medical decisions.” GenBioPro, which makes a generic version of
mifepristone, made a similar request.
The New Orleans-based appeals court's unanimous ruling Friday marked a
substantial victory for abortion opponents seeking to stem the flow of
abortion pills prescribed online, which they view as subverting state
bans on the procedure. It requires that mifepristone be distributed only
in person and at clinics, overruling regulations set by the federal Food
and Drug Administration.
“We’re now going to see, I think in a way we haven’t before, what the
nation will look like when abortion bans are actually in effect,” said
Mary Ziegler, an expert on abortion law and a professor at University of
California at Davis School of Law.
Here's what to know:
Impact extends beyond states with abortion bans
Frustrated with a lack of federal action against medicated abortions,
Louisiana Attorney General Liz Murrill sued the FDA last year, saying
its rules allowing mifepristone to be dispensed through the mail
undermined the state’s ban on abortions at all stages of pregnancy.
Friday’s ruling is in effect while the case works its way through the
courts. It affects patients in all states, even those without abortion
restrictions.
“This is a huge access issue for patients that haven’t got providers
close by, or providers close by who are willing to prescribe,” said Josh
Thorburn, owner of Eddie’s Pharmacy in Los Angeles.
There is little precedent for a federal court overruling the scientific
regulations of the FDA, and it remains to be seen how the decision could
impact abortion access long-term.
Murrill, a Republican, celebrated the ruling as a “victory for life”
while other anti-abortion advocates cheered the reversal of rules
finalized under President Joe Biden that ended a longstanding
requirement that the pills be obtained at an in-person doctor’s visit.
Representatives for the FDA and the U.S. Department of Justice did not
immediately respond to requests for comment.
Mifepristone long considered safe and effective
Mifepristone was approved in 2000 as a safe and effective way to end
early pregnancies. It is typically used in combination with a second
drug, misoprostol, which is not affected by the ruling but is less
effective on its own.
Surveys have found that the majority of abortions in the U.S. are
administered using pills and that about one in four abortions nationally
are prescribed via telehealth. Providers have suggested that its
availability through telehealth is a reason why the number of abortions
in the U.S. has not fallen since Roe was overturned in 2022.
As a result, abortion pills and those who prescribe them out of state
have become key targets of abortion opponents.
Some Democratic-led states have adopted laws that aim to protect
providers who prescribe via telehealth and mail the pills to states with
bans. Those so-called shield laws are being tested through civil and
criminal cases in Louisiana and Texas.
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Attorney General Liz Murrill speaks with the news media, Oct. 15,
2025, in Washington. (AP Photo/Cliff Owen, File)
 One telehealth provider in a state
with a shield law, Dr. Angel Foster, was working with legal experts
to understand how the ruling would impact her organization, The
Massachusetts Medication Abortion Project.
“We will do everything in our power to continue providing care to
people in all 50 states,” she said.
Mini Timmaraju, president and CEO of Reproductive Freedom for All,
said providers are “in limbo” as they await further court decisions
but can pivot to using just misoprostol for abortion care.
“It’s got a chilling effect on providers across the country, and
it’s going to have a chilling effect on patients, who are already
having a hard time navigating the law state by state, and what they
can get and how they can get care,” she said.
Abortion policy could come into play in the midterms
The case could again make abortion a key issue in the midterm
elections as Democrats aim to take back control of the House and
Republicans fight to hold on to a narrow majority.
“This is going to be a pretty significant change in terms of how
people experience abortion access, probably as significant as
anything we’ve seen since Roe was overturned,” Ziegler said. “So
another big question mark is going to be the extent to which voters
feel that before they go to the polls."
Recent electoral results suggest that voters seeking to maintain
abortion access have the political momentum. Since Roe was
overturned, abortion has been on the ballot directly in 17 states.
Voters have sided with the abortion-rights side in 14 of those
questions.
Abortion-rights supporter Fatima Goss Graves, president and CEO of
the National Women’s Law Center, said the ruling is “deeply out of
step with both the public and fact-based science.”
Ziegler said the case also “sort of puts the president in the
position of having to get off the sidelines on this issue in a way
we haven’t seen before.”
Trump received criticism after the ruling from some anti-abortion
advocates who expressed frustration that he did not take action
himself to block distribution of the pill.
The FDA under Trump approved another generic version of mifepristone
last year, which peeved some allies of the Republican president.
“It’s shameful that the Trump administration’s inaction has forced
pro-life states to take their battle to the federal courts,” said
Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life
America, who also applauded the appellate ruling.
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This story has been updated to correct the name of drugmaker
GenBioPro and the timing of Louisiana's lawsuit against the FDA.
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