Emma Richman, Global Writer
Additional reporting by Natalie Strain
For around a 65-hour period beginning May 1, a Louisiana lawsuit against the Food and Drug Administration (FDA) shut down nationwide access to an abortion pill by mail. The New Orleans-based 5th Circuit Court of Appeals banned access to the drug—mifepristone—by mail, and the Supreme Court responded by blocking the ban until the case resolves.
The history of abortion access in the US spans back to a landmark Roe v. Wade ruling in 1973. The Supreme Court granted a nationwide right to abortion before the point of fetal viability—meaning the point when a fetus has the ability to survive outside the uterus.
Another Supreme Court ruling in 2022, Dobbs v. Jackson, overturned the 1973 ruling, deciding that federal law does not guarantee the right to abortion. Abortion access is now determined at the state level due to this ruling, allowing states to place tighter restrictions or enforce outright bans.
Medication-induced abortions account for more than 60% of U.S. abortions, according to research from the Guttmacher Institute. Mifepristone is the most common drug used, typically alongside misoprostol, as is the clinical standard but is not required. Analysis from the Center for Reproductive Rights illustrates how this case directly targets how most Americans access abortions post-Roe era.
Gretchen Ely, program director at Stony Brook School of Social Welfare who studies reproductive health access, said mifepristone is a viable option for abortion seekers nationwide, especially in states with strict abortion laws where people have to travel across state lines for abortion care.
“Abortions are up, according to WeCount, despite that they’re illegal in large swaths of the U.S. now,” Ely said. “So, you know, if you lived in a place where you couldn’t access a facility and you…needed, you know, to have abortion care, that’s oftentimes the most practical way to get it.”
In anti-abortion states, abortion seekers can access the necessary medication by mail due to shield laws, which allow health care providers to prescribe and send the pills by mail to those states. However, multiple anti-abortion states have filed lawsuits to prevent licensed abortion pill providers in states where abortions are legal from shipping pills to their state.
Not only have abortions increased post-Roe, but they are cheaper and more accessible—a factor that David Cohen, a law professor at Drexel University, thinks is a main reason anti-abortion states like Louisiana targeted mifepristone.
To Cohen, who teaches constitutional law and reproductive rights, “Their goal was not to overturn Roe, their goal was to stop abortion.”
This is not the first time that abortion pill access has been challenged. In 2022, a group of doctors sued the FDA in a Texas federal district court over its approval of mifepristone, with the goal of making the pills unavailable nationwide. Cohen noted that this case shares similarities with the current Louisiana one, but when it was brought to the Supreme Court, the judges ruled unanimously against the doctors.
According to Cohen, this was not because they approved the drug’s usage, but because they determined the doctors did not have “legal standing” to sue—they could not prove sufficient injury, they were not the right people to bring the case to court.
Cohen views Louisiana’s legal standing as a stretch, and although there are differences between the cases, he said it’s very possible the Supreme Court will rule in favor of the FDA again.
Updates to abortion access in other countries
According to an abortion laws world map from the Center for Reproductive Health and Justice, 24 countries prohibit abortion under any circumstances, including when a person’s life is at risk.
In Kenya, a country where thousands of women die from unsafe abortions yearly, abortion is only permitted if there is need for emergency treatment. In April, a court of appeal challenged this law with a landmark judgement to reinstate criminal proceedings of a health care professional for providing emergency care for a 16-year-old girl after an abortion. The case—which is likely to be taken to Kenya’s supreme court—is pending investigation into whether the girl’s treatment was a medical emergency.
In late 2025, changes in policy in other African countries expanded reproductive healthcare.
Rwanda’s Parliament passed a law that lowers the age of consent for accessing reproductive healthcare to 15, and Malawi’s High Court granted an automatic right to abortion for victims of sexual violence. In June of 2025, the Federal High Court of Nigeria issued a “first-of-its kind ruling” declaring that pregnancy as a result of rape or incest is a violation of women’s and girl’s rights to both physical and mental health.
In other parts of the world, social movements have influenced abortion policy.
A feminist movement sweeping Latin America called the “Green Wave” has caused significant advances in reproductive rights in recent years, according to the Center for Reproductive Health and Justice. Court rulings from Ecuador, Nicaragua, Mexico, El Salvador, Colombia and Argentina have decriminalized abortion, some ruling that denying abortion care is violating the plaintiff’s rights.
A woman’s death in Ireland caused the country to change their constitution’s Eighth Amendment in 2018, acknowledging “the right to life of the unborn” to include the right to an abortion up to 12 weeks gestation.
Savita Halappanavar was admitted to the hospital in 2012, where doctors determined that she was having a miscarriage. Though, they could not medically intervene—meaning inducing an abortion—because it would have infringed on the Eighth Amendment. After four days in intensive care, waiting for the miscarriage to progress naturally, Halappanavar died.
Although this wasn’t the only time a person died after being denied an abortion in Ireland, Ely explained this case’s publicity sparked a new wave of pro-choice activism across the country.
When countries treat abortion as a women’s health issue
The United Nations and the World Health Organization define abortion as an essential health care issue. Ely views a case in Ireland the same way.
“Because it seems they realized, you know, abortion is life saving health care,” Ely said. “It’s not just what, I think people perceive it as something that perhaps you do when you’ve had a misstep in your fertility planning, and it’s more than that.”
Ely believes abortion advocacy efforts across the U.S. can take the Ireland case as a lesson in advocacy and strategy to reverse abortion access restrictions.
For California residents, the case has sparked concern that the government is challenging the legitimacy of mifepristone out of political motivation and control over women’s reproductive rights.
“An overwhelming body of medical research proves that mifepristone is a safe, effective way to end a pregnancy, including when prescribed via direct-to-patient telehealth. Limiting access to this medication ignores decades of research and puts politics ahead of patient care,” President and CEO of Planned Parenthood of Orange and San Bernardino Counties (PPOSBC) Krista Hollinger said in a press statement.
The case has evoked fear in those looking towards the future of reproductive freedom in states with and without an abortion ban.
Nicole Ramirez is the Chief Communications Officer for PPOSBC and has been working for Planned Parenthood for 13 years. While abortion is legal and protected in California, Ramirez is concerned that the debate over abortion will impact future generations.
“There are a lot of female studies showing the complete negative impact of people who are essentially forced to carry to term when they’re not able to or want to. There’s going to be women who die,” Nicole Ramirez said.
What comes next for the US
The ruling didn’t come as a shock for Helen Gilbert, the coordinator at the National Mobilization for Reproductive Justice, a pro-choice grassroots coalition of organizations and activists.
“The clear direction of this government and the courts federally and in many states, has been to continually cut back access and try to make abortion illegal, [or] impossible to get if it is legal,” Gilbert said.
To circumvent this ruling, Gilbert’s team had to urge community members to order abortion pills while they remain available, and Planned Parenthood has begun offering abortion pills preemptively with the “Just in Case” Initiative in certain states with supportive laws, a practice that has been around since post-Roe.
Cohen, who has written a book on how abortion access has shifted post-Roe, noted that abortion providers have and will continue to employ creative ways to get around restrictions. Some of these include providing the other drug, misoprostol, which can induce an abortion by itself yet causes more discomfort. Cohen also mentioned there are international pharmacies which mail abortion pills to the US legally, and the possibility of doctors continuing to mail the drug to anti-abortion states regardless.
For now, mifepristone is still available nationwide by mail, and will continue to be as the 5th Circuit of Appeals continues its deliberations. Cohen expects the conservative-leaning court to again rule in favor of Louisiana, at which point the Supreme Court will likely revisit the case, with a resolution likely to be reached next summer.
While the decision remains in the hands of the Supreme Court, Ramirez urges Americans to vote to protect their rights.
“Vote. The number one thing is voting. You need to make sure you understand where these elected officials stand on things like women’s rights and reproductive rights, and vote accordingly,” Ramirez said.
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