WASHINGTON — The Supreme Court will leave women’s access to the widely used abortion pill until at least Thursday, while the justices consider whether to allow restrictions on the drug mifepristone.
Justice Samuel Alito’s Monday order allows women seeking abortions to continue obtaining the pill at pharmacies or through the mail without having to visit a doctor in person. This prevents restrictions on mifepristone imposed by a federal appeals court from taking effect for the time being.
The court is grappling with the latest abortion debate four years after a conservative majority overturned Roe v. Wade, effectively banning abortion altogether in more than a dozen states.
The court case stems from a lawsuit filed by the state of Louisiana to overturn Food and Drug Administration rules on how mifepristone is prescribed. The state argues the policy undermines the state’s ban and calls into question the safety of the drug, which was first approved in 2000 and has been repeatedly found safe and effective by FDA scientists.
Lower courts concluded that Louisiana was likely to prevail, and a three-judge panel of the 5th Circuit Court of Appeals ruled that mail access and telehealth visits should be suspended while the case progresses.
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This drug is most often used for abortions in combination with another drug, misoprostol. In 2023, the last year for which statistics are available, medication abortions accounted for nearly two-thirds of all abortions in the United States.
The current dispute is similar to one that went to court three years ago.
Later, lower courts also sought to restrict access to mifepristone in a lawsuit brought by anti-abortion doctors. They filed the lawsuit months after the court overturned Roe’s decision.
The Supreme Court blocked the Fifth Circuit’s decision from taking effect over Alito and Justice Clarence Thomas’ dissenting votes. In 2024, the high court unanimously dismissed the doctors’ lawsuit on the grounds that they lacked the legal right or standing to sue.
In the current case, mainstream medical groups, the pharmaceutical industry and Democratic lawmakers are focused on warning courts against restricting access to the drug. Pharmaceutical companies said the ruling against abortion opponents would upend the drug approval process.
The FDA has eased many restrictions originally placed on the drug, including who can prescribe it, how it is compounded, and what types of safety complications must be reported.
Mifepristone court ruling makes drug development riskier for everyone
Despite this determination, abortion opponents have challenged the safety of mifepristone for more than 25 years. They have filed a series of petitions and lawsuits against the agency, alleging that the agency violated federal law by overlooking safety issues with the pills.
President Donald Trump’s administration has remained unusually silent on the Supreme Court. Even though federal regulations were at issue, the court declined to submit a brief recommending what to do.
This incident puts the Trump Republican administration in a difficult situation. Although President Trump relies on the political support of anti-abortion groups, he has also seen poll questions and polls showing that Americans generally support abortion rights.
Both sides took the silence as tacit support for the appellate court’s decision. Alito is the judge in charge of Louisiana’s emergency appeals process and author of the 2022 decision that declared abortion not a constitutional right and sent the issue back to the states.
— Mark Sherman, Jeff Mulvihill, Matthew Perrone
Mulvihill reported from Haddonfield, New Jersey.

