A federal judge declined to block the Biden administration’s mail-order abortion scheme last week — but he put the U.S. Food and Drug Administration (FDA) on notice as the agency continues its safety review of the abortion drug mifepristone.
U.S. District Judge David Joseph ruled against Louisiana Attorney General Liz Murrill, who asked the court to halt an FDA rule that allows mifepristone to be dispensed through mail as litigation challenging the rule continues. Joseph issued a 37-page memorandum ruling granting the Trump administration’s request to pause the case as the FDA continues its “good-faith, evidence-based and expeditious review” of the abortion drug’s safety risks, although he indicated the state has standing to sue and is “likely to succeed” in its challenge.
“…[T]he stay granted to FDA will not remain open-ended,” wrote Judge Joseph, a nominee of President Donald Trump. “FDA has an obligation to act with all deliberate speed to review its past actions and complete a thorough analysis that addresses the deficiencies it has acknowledged. The parties and the American public deserve nothing less. Should the agency fail to complete its review and make any necessary revisions to the REMS within a reasonable timeframe, the Court’s analysis – and the weight accorded to these factors – will inevitably change.”
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The State of Louisiana, along with Rosalie Markezich — a woman who alleges her boyfriend was able to order abortion drugs online from California and coerce her into taking the pills — filed a lawsuit against the FDA in October 2025. The lawsuit argues that the FDA acted unlawfully by loosening safeguards around mifepristone and allowing it to be sent via mail, including violating the Administrative Procedure Act (APA).
The lawsuit specifically points to the Biden FDA’s 2021 action that removed the in-person dispensing requirement for abortion pills and allowed them to be sent via mail — a rule that the agency made permanent in 2023. That action, combined with shield laws in blue states, have allowed abortionists to mail abortion pills into red states with laws protecting the unborn. The state also points to a shocking 2025 study suggesting that serious adverse health events from mifepristone are much higher than previously reported, along with the FDA’s 2016 action requiring prescribers to report only fatalities but not serious adverse events.
Louisiana argues those FDA actions have undermined its laws restricting abortion and have imposed financial burdens on the state, specifically from Medicaid costs associated with emergency care after medication abortions.
“[In a] post-Dobbs regulatory environment, there is evidence that the 2023 REMS [Risk Evaluation and Mitigation Strategies] was approved without adequate consideration, at least in part, as part of an effort to circumvent anti-abortion states’ ability to regulate abortion,” Judge Joseph acknowledged.
He continued:
Likewise, there is evidence that the consequences of this action were predictable – out-of-state providers and related entities would expand access to mifepristone in ways designed to reach into jurisdictions like Louisiana. These actions cause concrete and ongoing injury to Louisiana…
Attorney General Murrill said in a statement she would ask an appeals court to pause the FDA’s mail-order abortion rule, and pointed out that Judge Joseph “concluded that Louisiana suffers irreparable harm every day” the current rule is in effect.
Judge Joseph wrote that even though the FDA has “acknowledged” the shortcomings of its procedural decisions, the agency should finish its safety review “free from judicial interference” but with “deliberate speed.” He ordered the FDA to produce the entire administrative record of safety decisions related to mifepristone within 60 days, file a status report within six months, and notify the court within 14 days of completing the safety review.
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Mifepristone, the first drug taken in a two-drug medication abortion regimen, has been a battlefield since the Supreme Court overturned Roe v. Wade in 2022 with its Dobbs decision. In 2024, the high court declined to block Biden’s mail-order abortion scheme, ruling that the doctors who brought the case lacked standing. The Supreme Court did not address the merits of that case.
As the FDA rule allowing telehealth abortions continues to stand, along with blue state shield laws, many pro-life states are trying to pass legislation banning mail-order abortion pills.
Data suggest medication abortions make up 63 percent of all abortions within the formal U.S. healthcare system. A 2025 report indicated that telehealth abortions were a major contributor to the estimated 1.1 million abortions that occurred last year, with tens of thousands occurring in states that restrict abortion.
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In a medication abortion, mifepristone blocks the action of progesterone, which the mother’s body produces to nourish the pregnancy. When progesterone is blocked, the lining of the mother’s uterus deteriorates, and blood and nourishment are cut off to the developing baby, who then dies inside the mother’s womb. The drug misoprostol (also called Cytotec) then causes contractions and bleeding to expel the baby from the mother’s uterus.
Katherine Hamilton is a political reporter for Breitbart News. You can follow her on X @thekat_hamilton
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