Mifepristone is under attack. Again. Still.
Here’s what’s at stake in Louisiana v. FDA
Mifepristone is under attack.
Again.
Still.
Since the FDA approved mifepristone over 25 years ago, clinicians have used the drug as part of an extremely safe and effective regimen for abortion care. In 2023, the FDA eliminated the medically unnecessary in-person dispensing requirement on mifepristone, thereby improving access to care by allowing the medication to be mailed or picked up at a pharmacy.
While pills are not a panacea, medication abortion via the mail plays a critical role in ensuring access to abortion in a national landscape where many states have total bans or other restrictive policies. This makes the anti-abortion movement furious. Enter Louisiana.
Louisiana v. FDA
Louisiana v. FDA is one of several schemes through which the anti-abortion movement is attacking medication abortion.
In this case, Louisiana seeks to restrict access to the mifepristone through reinstatement of the medically unnecessary in-person dispensing requirement. Reinstating the in-person dispensing requirement would end mail and pharmacy distribution of mifepristone. This would hurt patient access to medication abortion across the United States, and especially impact patients living in states with abortion bans who rely on telehealth medication abortion.
You may remember this case already making its way through the courts. In Spring 2026 a lower court agreed with Louisiana and temporarily restricted access to mifepristone. However, the Supreme Court quickly stepped in and blocked that decision, allowing mifepristone to continue to be available via mail or pharmacy. The Court held that the current REMS on mifepristone will remain in place while this case proceeds, or until the case reaches Supreme Court again and the Court reaches a final decision.
Mifepristone has long history and track record as an extremely safe and effective medication. Despite research and data supporting this fact, anti-abortion policymakers and states are steadfast in their pursuit of gaslighting the public into believing otherwise. The truth is mifepristone is safe. Medication abortion is safe. And people will always access the care they need.
Unfortunately, that’s not the end.
On September 9, the Fifth Circuit heard full arguments in the case. Whatever the outcome, this case will almost certainly head back to the Supreme Court in 2027 for a final decision. That brings us to where we are now.
What’s At Stake
Mifepristone, and medication abortion broadly, is safe, effective, and widely relied on to help people control their reproductive futures. Medication abortion using mifepristone is incredibly common and accounts for over half of clinician provided abortions in states without total bans. For patients living in states with total abortion bans, telehealth medication abortion accounted for nearly all abortions in those states in 2025. Physicians know that mifepristone is an effective medication they can deliver without burdensome regulatory restrictions. The World Health Organization classifies mifepristone and misoprostol as “core” essential medications, a category comprising “the most efficacious, safe and cost-effective medicines for priority conditions” that should always be available in health care systems.
After Dobbs and the influx of state abortion bans, access to medication abortion via the mail and pharmacies became an essential part of retaining autonomy in an increasingly hostile environment. The option to receive medication abortion via mail or from a pharmacy—including an online pharmacy—is a critical lifeline for the millions that face barriers to in-clinic care. If Louisiana is successful in their challenge, people will lose access to abortion care, even in states where care is still legal. A win for Louisiana means that people seeking abortions must travel to a health center to receive abortion pills. Finding and traveling to a clinic is a progressively impossible task. Ninety percent of counties in the United States do not have an abortion provider and after the administration’s funding cuts in OBBBA, nearly 50 family planning clinics across the country were forced to stop services in 2025. This impending threat is so dire because the need to travel exacerbates the negative impact of other barriers that people experience when seeking care, especially Black, Indigenous, Latinx and other people of color, people with low incomes, immigrants, young people, and people living in rural and medically underserved communities. For example, with ICE enforcement at an all-time high, traveling carries a risk of family separation, detention, and surveillance.
No one should fear for their family’s safety, financial security, or future when seeking essential abortion care.
The Truth Is Out There
The attacks against mifepristone and abortion are rooted in disinformation–false or misleading information that is deliberately created and spread with the intent to deceive, manipulate, or cause harm. The anti-abortion movement believes that they can manipulate the truth to further their agenda of eliminating access to abortion care for everyone. Disinformation has given way to a rise in state legislation attempting to further restrict access to medication abortion, serving as a compounding barrier to care among existing restrictions and bans. False claims that mifepristone and misoprostol are dangerous have led states to the introduction of legislation to classify these medications as controlled substances. Attacks on the sale, distribution and transportation of the medications are attempts to limit patient access, particularly for patients in banned states who rely on telehealth medication abortion provided via shield laws. Escalating claims that mifepristone is contaminating waterways is a blatant co-opting of the environmental justice movement to require states test for the medications in drinking water. Hateful, false ideology must be countered with evidence-based science that is rooted in facts. No matter what the outcome is at the Fifth Circuit Court or the Supreme Court, the truth will stay the same. Abortion care is safe, essential, necessary health care that everyone deserves access to.
Mifepristone is safe and effective, including via telehealth.
The evidence is clear and has been around for decades: mifepristone is safe and effective, whether patients get their prescription in the mail, at a pharmacy, or a health center. Over 100 peer-reviewed studies have repeatedly proven that mifepristone is safe and effective. (Are you tired us saying safe and effective? We are tired of people claiming mifepristone isn’t!) Evidence also affirms that mifepristone is just as safe when patients get pills by mail or at a pharmacy after being evaluated and counseled through telemedicine. Telehealth medication abortion involves remote patient-provider interactions, delivery of pills by mail or local pharmacy pick up, and remote follow-up care. In addition to the proven safety for this model of care, patients are highly satisfied with telehealth medication abortion care because it offers greater privacy, convince, and lower costs.
Coercion Claims Are Rooted in Control
One legal theory in Louisiana v. FDA rests on the argument that people are tricked or forced to take abortion pills by their partners and therefore access to mifepristone by mail is dangerous and must be stopped. The anti-abortion movement is capitalizing on the reproductive coercion narrative to eliminate access to medication abortion. Abortion bans will not stop intimate partner violence. In fact, people and organizations who support survivors of domestic violence have told us that abortion bans increase the risk of intimate partner violence and can expose people experiencing abuse to more danger at home. Access to medication abortion through the mail or at a pharmacy can help survivors of intimate partner violence get care free from their abuser’s knowledge or control.
Reproductive coercion is any behavior or action that interferes with an individual’s decision-making around reproduction and reproductive health. Forcing a pregnancy decision on another person is never okay. Yet, everyday abortion bans interfere with people’s power to decide their own reproductive future in favor of the state’s ability to control their body. To realize reproductive freedom, we must be free from intimate partner violence and state control.
Conclusion
Abortion and autonomy are back in the courts. It was never about “leaving it up to the states.” The anti-abortion movement is determined to ban abortion care for everyone, and their current tactic is to attack mifepristone by any means necessary. Their reliance on pedaling fake science, spreading disinformation, and generating fear will not stop us. Our communities will always find ways to get the care they need and protect each other. And that makes the antis mad. The Court rescinded our national right to abortion with Dobbs and they want to send us back again. No matter what, our physician advocates will continue to fight to ensure patients in their community have access to the full spectrum of sexual and reproductive health care. Mifepristone is still available; telehealth is still available; the truth is out. Nothing will stop us from standing up for our communities.