The US Supreme Court on Thursday upheld nationwide access to mail-order mifepristone, blocking a lower court's attempt to ban the practice while an appeal proceeds [1, 2, 3]. The decision allows patients across the country to continue receiving the abortion pill through mail delivery.
Louisiana sued the Food and Drug Administration in October 2025 seeking to restrict mail-order access to mifepristone, citing the state’s abortion ban [1, 2]. The Fifth Circuit Court of Appeals sided with Louisiana on May 1, ordering a nationwide halt to mail-order distribution of mifepristone pending further litigation [1, 2].
Two manufacturers of mifepristone, Danco Laboratories and GenBioPro, filed emergency requests with the Supreme Court. The high court granted a stay against the lower court’s ban on May 4, temporarily allowing mail-order access to continue while the case moved through appeals [2]. On Thursday, the Supreme Court extended that stay over a 7-2 vote, enabling the mailing of mifepristone to persist for now [1, 2, 3].
Justices Clarence Thomas and Samuel Alito dissented. Thomas described mailing mifepristone as a "criminal enterprise," citing the 1873 Comstock Act that bans sending abortion-related materials through the mail. He wrote, "Applicants are not entitled to a stay of an adverse court order based on lost profits from their criminal enterprise" and emphasized "The Comstock Act bans using 'the mails' to ship any 'drug . . . for producing abortion'" [1, 2].
Alito warned that the majority’s decision threatens the precedent set by the Dobbs v Jackson Women’s Health Organization ruling, which overturned Roe v Wade. He said, "What is at stake is the perpetration of a scheme to undermine our decision in Dobbs v Jackson Women’s Health Organization" [1, 3].
The Court also ruled Louisiana lacked standing to challenge the mail-order abortion access directly and remanded the case back to the Fifth Circuit for further consideration [1]. Medication abortion currently accounts for approximately two-thirds of abortions in the US, and the ability to receive mifepristone by mail has helped stabilize abortion rates amid mounting state restrictions [1].
The FDA eliminated the in-person prescription requirement for mifepristone in 2023, facilitating telehealth consultations and mail deliveries nationwide [1, 2, 3].
The extended Supreme Court stay will remain in effect until the full appeal is decided, allowing continued mail-order access to mifepristone across the US [1, 2, 3].
