Fifth Circuit questions Louisiana’s bid to block abortion pill by mail
The Fifth Circuit questioned Louisiana’s attempt to ban mailing FDA-approved abortion pills.
Why it matters: This case highlights ongoing clashes between federal authority and state abortion restrictions, important for legal counsel navigating reproductive healthcare regulation. It will shape access to medication abortion across the U.S.
- September 9, 2026: Fifth Circuit heard arguments in Louisiana v. FDA over mailing mifepristone.
- Louisiana AG Liz Murrill sued in October 2025 to block FDA’s 2023 telehealth and mail distribution policy.
- May 2026: Fifth Circuit temporarily reinstated in-person dispensing of mifepristone, later stayed by Supreme Court.
- By December 2025, 29% of abortions in the U.S. were via telehealth, with 91,000 telehealth abortions in states with bans.
On September 9, 2026, the Fifth Circuit Court of Appeals revisited Louisiana v. FDA, a pivotal case challenging the FDA’s landmark 2023 decision allowing telehealth prescriptions and mail-order distribution of mifepristone, a medication used for abortions.
Louisiana Attorney General Liz Murrill filed the lawsuit in October 2025, arguing the FDA’s policy undermines the state’s abortion ban by facilitating mail-order abortions from out-of-state providers. "Until then, Louisiana’s efforts to protect mothers and their unborn children and to hold out-of-state abortion pill traffickers accountable for the harm they inflict will be all but futile," Murrill stated.
Earlier, in May 2026, the Fifth Circuit had temporarily blocked the FDA’s rule, reinstating the requirement that mifepristone be dispensed in person. However, the U.S. Supreme Court stayed that order on May 14, 2026, allowing continued mail distribution while the legal battle proceeds, according to The Guardian.
The use of telehealth in abortion care is significant. By December 2025, telehealth accounted for 29% of all U.S. abortions, including 91,000 abortions provided via telehealth in states with total abortion bans—roughly 9,350 in Louisiana alone. Medication abortions comprised 65% of all abortions nationally in 2023.
Kelly Baden, Vice President for Public Policy at the Guttmacher Institute, criticized restrictions that force patients to navigate "ever-changing restrictions that disregard evidence and established standards of care," highlighting the stakes for healthcare providers and patients.
This case spotlights federal-state tensions over reproductive healthcare regulation and could set precedents impacting abortion access nationwide.
By the numbers:
- 29% — U.S. abortions conducted via telehealth by December 2025
- 91,000 — Telehealth abortions provided in states with total bans in 2025
- 65% — Medication abortions out of all U.S. abortions in 2023
Yes, but: The FDA’s ongoing safety review of mifepristone initiated in 2025 has not yet concluded, potentially affecting the case’s outcome.
What's next: The Fifth Circuit’s final ruling in Louisiana v. FDA is still pending and will influence future abortion pill access laws.