Federal Judge Denies Request to Block Mail-Order Abortion Plan

A federal judge has decided not to prevent the Biden administration’s plan for mail-order abortion services. However, he emphasized that the U.S. Food and Drug Administration (FDA) is still evaluating the safety of mifepristone, the abortion medication.

U.S. District Judge David Joseph ruled against Louisiana Attorney General Liz Murrill, who sought to challenge an FDA ruling that allows mifepristone to be dispensed through the mail. Joseph issued a 37-page memorandum in which he accepted the Trump administration’s request to pause litigation while the FDA conducts what it describes as a “good faith, evidence-based, and expedited review” of the safety concerns surrounding abortion pills. He mentioned that Louisiana has the standing to sue and appears “likely to succeed” in its case.

Judge Joseph, appointed by President Donald Trump, stated, “Continuing to grant permission to the FDA will not remain open-ended.” He added that the FDA must act with urgency to thoroughly analyze its past decisions. A failure to complete this review and implement necessary changes will affect the court’s stance on the matter.

A case was brought forth by Rosalie Markesic in Louisiana, claiming her boyfriend forced her to take abortion pills that were ordered online from California. The lawsuit, filed against the FDA in October 2025, accuses the agency of acting illegally, violating the Administrative Procedures Act by easing regulations around mifepristone and permitting its mailing.

The allegations specifically reference changes made by the FDA in 2021, which altered the requirements for dispensing abortion pills and allowed them to be sent by mail. These rules, confirmed as permanent in 2023, along with supportive legislation in certain states, have enabled abortion providers to ship pills to states with stricter abortion laws. The state highlighted a troubling study from 2025 indicating that the health risks associated with mifepristone may be greater than previously indicated.

Louisiana asserts that the FDA’s actions undermine existing abortion restrictions and impose financial burdens on the state, especially concerning Medicaid costs for emergency treatments following medication abortions.

In light of the current regulatory landscape, Judge Joseph acknowledged that the Risk Evaluation and Mitigation Strategies (REMS) approved in 2023 did not receive adequate consideration, particularly as part of an apparent effort to bypass states opposed to abortion.

“There is evidence that the consequences of this action were predictable,” he wrote, mentioning that providers outside of Louisiana could expand access to mifepristone in ways that could harm the state.

In response, Attorney General Murrill stated she would seek a suspension of the FDA’s mail-order abortion regulation, noting that Judge Joseph recognized the ongoing harm Louisiana faces due to this rule.

Judge Joseph concluded that, even if the FDA admits procedural shortcomings, the agency should carry out its safety review without interference, but must do so swiftly. He has ordered the FDA to provide a complete record of safety decisions about mifepristone within 60 days and to submit updates every six months on the review’s progress.

Mifepristone, the first part of a two-drug abortion process, has been at the center of dispute since the Supreme Court overturned Roe v. Wade in 2022. In 2024, the court declined to halt Biden’s mail-order abortion initiative, ruling that the doctor involved lacked standing, without addressing the case’s merits.

While many pro-life states are working to restrict mail-order abortion services, FDA regulations permitting telemedicine abortions remain effective. Data indicates that medical abortions constitute about 63% of all abortions conducted within formal healthcare settings in the U.S. A report from 2025 found that telemedicine abortions accounted for a significant portion of the estimated 1.1 million abortions that occurred that year, including many in states with restrictive abortion laws.

Mifepristone acts by blocking progesterone, a hormone essential for maintaining pregnancy, leading to the deterioration of the uterine lining and subsequent loss of pregnancy. A second drug, misoprostol, is used to induce contractions and expel the pregnancy.