A panel of the New Orleans-based 5th U.S. Circuit Court of Appeals is requiring that the abortion pill Mifepristone be distributed only in person at clinics.
Groups in Illinois and the Chicago area spoke out after the ruling Friday.
"Every abortion facilitated by FDA's action cancels Louisiana's ban on medical abortions and undermines its policy that 'every unborn child is human being from the moment of conception and is, therefore, a legal person,'" the ruling states.
Judges have long deferred to the Food and Drug Administration's judgments on the safety and appropriate regulation of drugs. FDA officials under President Donald Trump have repeatedly stated the agency is conducting a new review of Mifepristone's safety, at the direction of the president.
The Friday court order undercuts 2023 FDA guidelines from the Biden administration that had eased access to the pill, citing an ongoing safety review by the Trump administration.
Friday's ruling sets up a likely appeal to the Supreme Court. The conservative-majority high court overturned abortion as a nationwide right in 2022 but unanimously preserved access to Mifepristone two years later. That 2024 decision sidestepped the core issues, however, by ruling that the anti-abortion doctors behind the case didn't have legal standing to sue.
Mifepristone is often is used in combination with another drug, misoprostol, to induce an abortion or to help manage an early miscarriage, up to 10 weeks' gestation.
Abortion opponents celebrated the court's order on Friday and expressed optimism it will be upheld.
In the aftermath of the Supreme Court's reversal of Roe v. Wade which legalized abortion, Illinois has become a destination for women seeking now-restricted abortions in their home states.
"Illinois is a national leader in reproductive health care, seeing more abortion patients traveling for services than any other state in the nation," Dr. Katie Sisco, Planned Parenthood of Illinois Chief Medical Officer, said in a statement. "As the experts we understand that abortion bans and restrictions do not stop people from needing access to care. This 5th court ruling will cause immediate and irreparable damage for those most at risk. Planned Parenthood of Illinois is prepared for the surge of patients who will now be forced to travel to Illinois for medication abortion care at our health centers."
There is little precedent for a federal court overruling the scientific regulations of the FDA.
It's not immediately clear how quickly or completely this decision will impact *mailing of the drug throughout the country.
The American College of Obstetricians and Gynecologists has previously said that Mifepristone is a "safe, effective, and necessary medication" and should remain available nationwide -- without medically unnecessary and burdensome restrictions. All eyes now on if and when the Supreme Court takes up the case.
"Thousands of people across the country may lose access to this essential health care, or be forced to travel hundreds of miles to seek care in-person," a statement from the Chicago Abortion Fund read in part. "This case is one of several on track for the Supreme Court, aimed at permanently restricting or banning mifepristone, a medication that has a 20+ year track record as a safe, effective, FDA-approved option for ending a pregnancy before 12 weeks. Mifepristone is safer than many over-the-counter medications, and all major medical associations approve of its use. In Illinois, we have built a strong ecosystem of abortion care and serve as a national model for access. Our providers, advocates, abortion funds, and elected officials are working in coordination to not only protect, but expand access to abortion."
The Associated Press contributed to this report.