The U.S. Supreme Court has ruled that the abortion pill can continue to be dispensed through mail as a Louisiana lawsuit against the Food and Drug Administration (FDA) continues.
The decision came after the court on May 4 granted a temporary pause on a Fifth Circuit Court of Appeals ruling, which had blocked abortion pill distribution by mail. Under the ruling, abortion by mail could resume until May 11, but the extension was later lengthened to May 14, when the temporary stay expired.
But the May 14 ruling extended the stay indefinitely as Louisiana’s suit against the FDA continues.
Louisiana first challenged the modification of the FDA’s drug safety program, Risk Evaluation and Mitigation Strategy, in October 2025. The modification, which occurred in 2023 under the Biden administration, removed the federal requirement to dispense abortion drugs in person.
In its suit, Louisiana claims that sending abortion drugs into the state “directly violates Louisiana’s abortion laws and prevents Louisiana from protecting the lives of unborn babies despite the promise of Dobbs” and has “directly generated medical emergencies that harm Louisiana women and emergency room visits that harm the State.”
Justices Samuel Alito and Clarence Thomas dissented from the Supreme Court decision.
Alito called the “unreasoned order granting stays” “remarkable.”
“What is at stake is the perpetration of a scheme to undermine our decision in Dobbs v. Jackson Women’s Health Organization, … which restored the right of each State to decide how to regulate abortions within its borders,” Alito said. “Some States responded to Dobbs by making it even easier to obtain an abortion than it was before, and that is their prerogative. Other States, including Louisiana, made abortion illegal except in narrow circumstances. … But Louisiana’s efforts have been thwarted by certain medical providers, private organizations, and States that abhor laws like Louisiana’s and seek to undermine their enforcement.”
The ruling has prompted alarm among pro-life advocates and advocacy groups.
Erin Hawley, an Alliance Defending Freedom (ADF) attorney representing Louisiana in its suit, said that ADF looks forward to litigating an appeal to the 5th Circuit.
“We are disappointed by this decision that allows the FDA and the abortion industry to continue nullifying Dobbs and its promise to return the issue of abortion to the people,” said Hawley. “It’s high time the Biden FDA be held accountable for the destruction it has caused with this high-risk drug.”
Erica Inzina, J.D., policy director for Louisiana Right to Life, responded to the ruling in a statement.
“We are deeply disappointed that the Supreme Court has allowed this dangerous mail-order abortion drug policy to continue while the case proceeds,” she said. “Nonetheless, this order should not be mistaken as the Supreme Court approving the FDA’s reckless decision to remove basic safeguards for abortion drugs. At this moment, it merely means the status quo will remain while the lower courts continue to consider the case.”
Carol Tobias, president of National Right to Life, called the decision “deeply troubling.”
“When abortion drugs can be ordered online with minimal medical oversight and shipped directly to homes, women become more vulnerable to coercion, manipulation, and exploitation,” Tobias said. “There have already been disturbing reports of abusive partners obtaining abortion drugs and administering them to women without their knowledge or consent. A regulatory system with weaker safeguards makes these crimes easier to commit and harder to prevent.”
