On May 2, the Fifth Circuit Court revived a pre‑existing rule that forces patients to see a provider in person to receive mifepristone, the first drug in the two‑drug abortion regimen. The order stops mail‑based prescriptions while the lawsuit, filed by Louisiana, proceeds. A manufacturer has now asked the Supreme Court to reverse the pause.

Medical groups and rights advocates slammed the ruling, saying it undermines evidence‑based care. The FDA had earlier allowed telemedicine and mailing of the pill, a practice that enabled nearly two‑thirds of U.S. abortions. Misoprostol, the second drug, remains available, but its standalone use is less effective and riskier.

Planned Parenthood of Greater New York pivoted to send misoprostol‑only kits by mail, citing the Fifth Circuit decision. Providers in shield‑law states, such as Massachusetts, say they will continue mailing the drug. The legal battle could reshape how abortion services are delivered across 20 states that ban or restrict the pill.

With the Supreme Court yet to rule, providers face uncertainty. If the Fifth Circuit’s order stands, access to mifepristone would shrink nationwide, affecting patients even in states with broad abortion rights. Stakeholders now await the Court’s decision, while advocacy groups mobilize legal and logistical strategies to preserve care.