Abortion Pill Goes to the Supreme Court ***Update!

M.A. Dworkin

Washington, D.C. - A ruling by the Fifth Circuit Court of Appeals on Friday, May 1, 2026, which temporarily blocked the ability to prescribe and ship the abortion pill mifepristone nationwide - the most common way of terminating pregnancies - requiring it to be obtained in person at a clinic instead, has now been presented for a ruling by the U.S. Supreme Court

***Update.**************************

On Monday, May 4, 2026, the U.S. Supreme Court restored telehealth and mail access to the abortion pill mifepristone, responding to an emergency appeal that warned of potential chaos for patients who had appointments to access the drug. The "administrative stay" is far from a final decision but rather maintains the status quo for a few days while the Court reviews emergency appeals filed on Saturday May 2, 2026, by the drug's manufacturer and the maker of the generic version. The order puts on hold a decision from the conservative 5th U.S. Circuit Court of Appeals.

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Danco Laboratories and GenBioPro have asked the U.S. Supreme Court to restore mail-order access to the medication. The drugmakers are seeking an emergency stay of the Appeals Court’s decision. 

“The resulting chaos for patients, providers, pharmacies, and the drug-regulatory system is quintessential irreparable harm that underscores the need for emergency relief from the Court.” Danco lawyers wrote, arguing that it “injects immediate confusion and upheaval into highly time-sensitive medical decisions, and causes irreparable damage.” 

The Fifth Circuit’s, lower court, decision sided with a challenge from the state of Louisiana, aimed at stopping the distribution of pills via telehealth and mail, which critics argue subverts state abortion bans.

Since the 2022 overturning of Roe v. Wade, mail-order access has been a critical way for patients to obtain medication abortion, particularly in states with strict bans. Medication abortion accounts for roughly two-thirds of all abortions in the U.S. 

In 2023, the Food and Drug Administration (FDA) had previously allowed Doctors to send the pills without seeing patients in person, giving women the ability to receive the pills at a pharmacy or via telehealth and mail delivery of the pills, a practice that the Appeals Court’s temporary ruling has now disrupted.

“Every abortion facilitated by FDA’s action cancels Louisiana’s ban on medical abortions and undermines its policy that every unborn child is a human being from the moment of conception and is, therefore, a legal person,” the Appeals Court wrote in the order.  

Mifepristone is the first of a two-pill regimen recommended by the FDA to end a pregnancy. It is widely available in states where abortion is legal. It works by blocking a hormone called progesterone, which is necessary for a pregnancy to continue. The second drug, misoprostol, empties the uterus. In 2016, the approved use of the drug was extended from seven weeks to ten weeks of pregnancy. 

In 2024, the U.S. Supreme Court unanimously rejected an effort to restrict access to mifepristone. But the decision left the door open to other attempts to limit the availability of the drug. 

“This decision defies clear science and settled law and advances an anti-abortion agenda that is deeply unpopular with the American people,” said Julia Kaye, an attorney with the American Civil Liberties Union (ACLU).