Louisiana seeks temporary return of in-person abortion pill requirement

Louisiana has asked a court to temporarily reinstate the in-person requirement for dispensing abortion pills, in its federal lawsuit against the Department of Health and Human Services.

The state’s motion opposes the 2023 Risk Evaluation and Mitigation Strategy (REMS) rule, propagated under the Biden Food and Drug Administration, which permitted “remote prescription and mailing of the abortion drug mifepristone.”  

“Congress prohibits the use of ‘any express company or other common carrier or interactive computer service’ for ‘any drug, medicine, article, or thing designed, adapted, or intended for producing abortion,” the motion reads. 

“Because a federal agency cannot permit what federal law expressly prohibits, FDA lacked authority to permanently remove the in-person dispensing requirement,” the motion argues, in asking to re-establish the in-person requirement while the case is ongoing. 

Louisiana Attorney General Elizabeth Murril filed the motion Dec. 17 in an update to the original complaint filed Oct. 6. 

“We support the Trump administration which has acknowledged the flaws in the original rule,” Murril said in a post on X. “But unfettered and unsupervised access to these pills is dangerous. So the Biden-era rule should be enjoined.” 

Louisiana outlaws abortion in nearly all cases, but online companies still ship mifepristone, the chemical abortion pill, to residents of the state. In fact, mail-order abortion pills shipped to Louisianans accounted for more than 600 abortions a month from April to June 2024, according to the original lawsuit. 

The same database found more than 800 abortions in December 2024 in Louisiana resulted from out-of-state abortion drugs.  

“The 2023 REMS is the direct cause of extensive harm that Louisiana suffers every day that the REMS is in effect,” the complaint argues. 

“Indeed, this was the intended effect of the Biden Administration’s 2023 REMS: to permit ‘dispensing of mifepristone through the mail … or through a mail-order pharmacy’ – specifically to target those pro-life states like Louisiana where abortion is prohibited (with narrow exceptions) or narrowly circumscribed.” 

The lawsuit cites the additional risks for women with an Rh-negative blood type. If a woman with this blood type does not receive proper treatment during an abortion, her future pregnancies face an increased risk of stillbirth or brain injury. 

“In addition, beyond these physical risks, women have described their abortion-drug experiences as harming their mental health and leaving them feeling unprepared, silenced, regretful, or trapped,” the lawsuit argues. 

In some cases, women using an abortion pill must dispose of their fully formed, limp babies – too big to flush down the toilet, as the drug label instructs. Doctors have reassured women that disposing of the child is untraceable “as long as you don’t tell anybody,” the lawsuit notes.  

The lawsuit details the coercion, pressure and manipulation many women face because of the free access to abortion pills under the 2023 REMS guidelines. 

Indeed, in January a Louisiana grand jury indicted a New York doctor for inducing an unwanted abortion in a teenage girl whose mother ordered abortion pills against her wish. 

The pregnant girl was rushed to the emergency room after dire complications, and later the mother was also indicted. 

New York Gov. Kathy Hochul, however, protected the doctor under a shield law, refusing to extradite her. 

Moreover, joining Louisiana as a plaintiff in the lawsuit, Rosalie Markezich shares how her boyfriend manipulated her into taking abortion pills he ordered despite her wish to keep her baby. 

Markezich said she feared for her safety and took the pills in front of him, hoping to regurgitate them later. She was too late, and lost her baby.  

“The 2023 REMS caused Rosalie’s injuries, and her injuries are traceable to the 2023 REMS,” the complaint argues. “If FDA had required an in-person office visit, a medical professional would have screened Rosalie for coercion and abuse. … 

“But the 2023 REMS allowed abortion drugs to be provided through the mail – enabling abusers to order them in others’ names and coerce pregnant women like Rosalie to take them. Had FDA required in-person dispensing, Rosalie’s boyfriend would not have been able to access the drugs and compel Rosalie to take them. She could have told a doctor that she did not want them.“ 

A district court is scheduled to hear the plaintiffs’ motion Feb. 24 in Lafayette, Louisiana.