A federal judge in Louisiana on April 7 temporarily paused a lawsuit filed by the state seeking to reinstate in-person dispensing requirements for the abortion drug mifepristone, leaving telehealth and mail-order access in place for now while the Food and Drug Administration (FDA) conducts a safety review. At the same time, the judge suggested Louisiana is likely to succeed.
U.S. District Judge David Joseph granted the federal government’s request to stay the case, writing in his ruling, “It is the completion of FDA’s promised good faith, evidence-based, and expeditious review of the mifepristone REMS, not ‘government by lawsuit,’ that this Court finds to be in the public interest.”
The ruling keeps in place a 2023 FDA policy that allows abortion drugs to be prescribed via telehealth and mailed directly to patients, even in states that have abortion bans in some cases. The Justice Department, representing the FDA, argued in January that court action now could disrupt the agency’s promised safety review, which it said could take more than a year to complete, Zeale News previously reported. Mifepristone is used in roughly 60% of abortions in the U.S.
At the same time, Joseph indicated that Louisiana’s case could ultimately prevail. He wrote that the state is “likely to succeed” in arguing the FDA’s rule is unlawful but the agency should first complete its review.
The ruling ordered the FDA to provide an update within six months on its review of the drug’s Risk Evaluation and Mitigation Strategy (REMS), which governs how the drug is prescribed and distributed.
“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,” Joseph wrote.
Joseph — who was appointed by President Donald Trump — also concluded that Louisiana is suffering “ongoing” and “irreparable harm,” citing evidence that the 2023 rule may have been approved “at least in part, as part of an effort to circumvent anti-abortion states’ ability to regulate abortion.” His ruling leaves the motion open for Louisiana to refile after the FDA’s review is complete.
Citing Joseph’s finding that the state is likely to succeed, Louisiana Attorney General Liz Murrill said April 8 that the state will now ask the U.S. Court of Appeals for the 5th Circuit to vacate the FDA’s mail-order rules. If successful, the appeal would reinstate the in-person dispensing requirement for mifepristone nationwide.
“Judge Joseph concluded that Louisiana has standing to sue and is likely to succeed in showing that the 2023 REMS is unlawful,” Murrill said in a statement, according to The Center Square. “He also concluded that Louisiana suffers irreparable harm every day that the 2023 REMS remains in effect. Accordingly, under binding 5th Circuit precedent, the only thing left to do is vacate the 2023 REMS pending the outcome of this litigation. We will ask the 5th Circuit to do so.”
Pro-life leaders have long warned that the FDA’s current mifepristone policies increase health and safety risks to women, including cases of suspected abuse in which women were allegedly drugged without their consent. They have also urged the Trump administration to restore in-person safety requirements and provide updates on the safety review first promised in 2025.
The case is part of a broader wave of state-led challenges targeting the Biden-era expansion of telehealth access to abortion drugs. In one 2025 case, a Texas man who fathered an unborn child sued a California doctor for prescribing mifepristone to his ex-girlfriend through the organization Aid Access. The case, Rodriguez v. Coeytaux, remains ongoing. Another case brought by Missouri, Idaho, and Kansas seeks to reinstate safeguards for the abortion pill.