WASHINGTON, D.C.: A U.S. appeals court has temporarily blocked a federal rule allowing the abortion drug mifepristone to be distributed by mail, limiting access nationwide, especially in states where abortion is banned.

The decision by the New Orleans-based U.S. Court of Appeals for the Fifth Circuit marks the most significant restriction on the drug in years. A three-judge panel ruled that the state of Louisiana is likely to succeed in its challenge to a 2023 rule introduced under former President Joe Biden that removed the requirement for in-person dispensing.

While the ruling is temporary, it could disrupt access to medication abortion, which has become more common since the U.S. Supreme Court overturned nationwide abortion rights in 2022.

Louisiana Attorney General Liz Murrill welcomed the decision, saying she would continue efforts to "defend women and babies" as the case proceeds.

Abortion rights advocates warned of widespread disruption. "Reimposing medically unnecessary in-person dispensing requirements for mifepristone will send shockwaves of chaos and confusion across the country and dramatically upend patients' ability to obtain abortion care," said Kelly Baden of the Guttmacher Institute.

Mifepristone is used in a two-drug regimen with misoprostol and accounts for about two-thirds of abortions in the United States. The U.S. Food and Drug Administration had eased access rules in recent years, citing studies showing the drug is safe and effective, with serious complications occurring in fewer than one percent of cases.

Republican-led states have increasingly targeted the drug, arguing that the FDA failed to consider potential risks, such as severe bleeding or infection, fully. Nearly half of U.S. states have banned or heavily restricted abortion since 2022, leading to a surge in medication-based procedures and legal battles over access.

Drugmakers, including GenBioPro and Danco Laboratories, have intervened in the case to defend the FDA's rule. GenBioPro CEO Evan Masingill criticized the ruling, saying the court had ignored decades of scientific evidence supporting the drug's safety.

Legal challenges over abortion pills are ongoing. In 2024, the Supreme Court dismissed a separate challenge to the mail-order rule, holding that the plaintiffs lacked standing. However, states including Missouri, Kansas, and Idaho have since taken up similar claims.

Friday's ruling could still be overturned. The federal government or drugmakers may ask the full Fifth Circuit to reconsider or appeal to the Supreme Court.