On Thursday the U.S. Supreme Court ruled to allow access by mail to the abortion drug mifepristone for now. The order effectively extends a previous stay issued by the Court on a lower court ruling that would have made it illegal nationwide to mail mifepristone. Only Justices Clarence Thomas and Samuel Alito dissented in Thursday’s ruling.
At the heart of the case is a disagreement over Louisiana state law and virtual abortion access. In 2025 Louisiana filed a suit against the U.S. Food and Drug Administration in which the state objected to the use of mail-order mifepristone—something the FDA first allowed during the COVID pandemic—on the grounds that the drug carried potential risks and that prescriptions issued by telehealth providers and mailed into the state undermined its abortion ban. Earlier this year, the U.S. Court of Appeals for the Fifth Circuit ruled in favor of Louisiana, prompting two companies that make the abortion pill to ask the Supreme Court to step in. If the lower court’s ruing had gone into effect, it would have required those seeking mifepristone to access the medication in person.
Mifepristone was approved by the FDA in 2000. It is typically used to induce abortion, often in combination with another drug called misoprostol. In the U.S., it can be used for pregnancies at up to 10 weeks of gestation. The overwhelming evidence suggests the drug is safe to use, but the Trump administration has opened a review into its safety and efficacy. Some experts say the review’s findings will likely be flawed at best and an exercise in cherry-picking data to support the administration’s views at worse.
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Editor’s Note (5/14/26): This is a developing story and may be updated.