The Supreme Court on Monday granted a temporary pause to an appeals court ruling that blocked the telehealth provision and mailing of the abortion pill mifepristone nationwide as litigation continues.
The court granted an administrative stay until May 11 at 5 p.m. ET to the ruling handed down by the Louisiana’s 5th Circuit Court of Appeals on Friday, which temporarily barred providers from virtually prescribing and mailing mifepristone — one of the two pills typically used in a medication abortion, as well as in miscarriage care — while the case over its broader availability continues to play out.
In a brief, one-page order issued Monday morning, Justice Samuel Alito, who was assigned to emergency requests out of the 5th Circuit, also ordered Louisiana to file a response to the emergency request by Thursday at 5 p.m. ET.
The temporary action, known as an administrative stay, will not prevent the court from reaching a different outcome when all the justices weigh in, but it halted the lower court ruling for now. Back in 2023, for example, Alito similarly issued a temporary stay blocking restrictions on mifepristone from taking effect in a separate case. A week later, the conservative justice dissented from the full court’s decision to keep those restrictions blocked.
“This doesn’t really tell us a lot — it just means they think it’s important enough that they don’t want to let the 5th Circuit cause all the chaos before they’ve had a chance to read the filings,” Mary Ziegler, a scholar of reproductive rights law based at the University of California, Davis, told MS NOW on Monday.
Rolling back the telehealth provision of abortion pills has been a major goal for anti-abortion Republicans as medication abortions have surged in popularity following the Supreme Court’s June 2022 overruling of Roe v. Wade. Medication abortions account for 63% of all abortions nationwide as of 2023, up from 53% in 2020, according to data from the Guttmacher Institute, a research and policy organization that supports abortion rights.
The Biden administration’s December 2021 decision allowing mifepristone to be permanently prescribed via telehealth and mailed to patients, coupled with the proliferation of so-called shield laws — intended to protect providers in blue states that mail pills into red states from criminal prosecutions — helped drive the popularity of medication abortion via telehealth. More than a quarter of all abortions in the first half of 2025 were provided via telehealth, up from 5% in the second half of 2022, according to the Society of Family Planning, which also supports abortion rights.
More than 100 scientific studies have shown that the two-pill medication abortion regimen is safe and effective in ending pregnancy, including when the pills are prescribed virtually and mailed to patients.
Nonetheless, abortion rights opponents have argued that the virtual prescribing and mailing of mifespristone endangers those who take it and could facilitate domestic abuse, though widespread evidence has not supported those claims, and providers have disputed them.
The administrative stay comes as the latest major shift in abortion access after the two Trump-appointed judges and one Bush-appointed judge who make up the 5th Circuit panel ruled Friday that the telehealth provision of mifepristone should be blocked while a broader case over its availability proceeds. That broader case was brought by Louisiana Attorney General Liz Murrill, a Republican, in October.
In the lawsuit, Murrill argued that the Biden administration violated the Administrative Procedure Act in making mifepristone permanently available by mail in 2021. Previously, an in-person doctor’s visit was required to receive mifepristone.
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Early last month, a federal judge determined the case should be paused until the Food and Drug Administration completed an ongoing safety review of mifepristone, which was prompted by demands from anti-abortion Republicans. Louisiana subsequently appealed that decision and asked the 5th Circuit to temporarily block telehealth provision of mifepristone while the case proceeded, which was the request the court granted Friday.
The Friday ruling generated swift pushback from manufacturers of mifepristone and abortion rights supporters.
Over the weekend, the two manufacturers of mifepristone, GenBioPro and Danco Laboratories, filed emergency requests with the Supreme Court, asking the justices to halt the 5th Circuit decision. Both companies have voluntarily joined the lawsuit as defendants. And on Monday morning, attorneys general representing nearly two dozen blue states filed an amicus brief with the Supreme Court asking them to stay the Friday ruling, arguing that blocking access to mifepristone would unleash chaos and was not supported by science.
The court battle does not affect the mailing or availability of misoprostol, the second pill used in conjunction with mifepristone for medication abortions, which providers may continue to mail to patients and can induce abortion on its own, Elisa Wells, co-founder of the abortion access information website Plan C, told MS NOW on Friday.
Research shows the use of misoprostol by itself to induce abortion is slightly less effective than using both pills together. But advocates have said misoprostol-only regimens are likely the most commonly used form of medication abortion globally due to its availability.
Ziegler said she thinks the recent rulings related to mifepristone will likely cause confusion among some people seeking out abortion pills by mail.
“I think fewer people are going to use telehealth until all of this is sorted out,” she said, “because they’re not going to know if they can.”
Wells said that expected confusion is intentional, telling MS NOW that “part of the goal of the lawsuit is to introduce doubt and chaos with respect to the safety of mifepristone.”
Fallon Gallagher and Jordan Rubin contributed reporting.
Julianne McShane is a breaking news reporter for MS NOW who also covers the politics of abortion and reproductive rights. You can send her tips from a non-work device on Signal at jmcshane.19 or follow her on X or Bluesky.