The Supreme Court on Monday temporarily restored nationwide access to the abortion pill mifepristone through telehealth and mail, blocking a lower court ruling that would have required in-person doctor visits for the medication used in most abortions.

Justice Samuel Alito issued a one-week administrative stay lasting until May 11 at 5 p.m., putting on hold a decision from the New Orleans-based 5th U.S. Circuit Court of Appeals. Alito handles emergency issues arising from that appeals court, which covers Texas, Louisiana and Mississippi.

The emergency action came after two companies that manufacture mifepristone, Danco Laboratories and GenBioPro, appealed directly to the Supreme Court on Saturday seeking “emergency relief” from a 5th Circuit order that reinstated requirements limiting how the drug can be dispensed.

The appeals court’s Friday decision was effective immediately for the whole country, meaning that mifepristone access would be significantly restricted. Alito’s order maintains current access protocols for one week while the court considers the matter.

The case stems from litigation challenging FDA regulations around mifepristone access. The legal challenge argues that expanded telemedicine access to mifepristone undermines state abortion restrictions and creates additional costs for states.

The 5th Circuit’s order was written by Judge Stuart Kyle Duncan, a Trump appointee. Duncan argued that expanded mifepristone access creates injuries to states “by undermining laws protecting unborn human life and also by causing expenditure of state funds on emergency care.”

The ruling would have restored more restrictive FDA requirements that were in place before recent expansions of telemedicine access to mifepristone. With no geographic limitations, the decision would have applied nationwide immediately.

The stakes in this case are significant for reproductive rights access. Medication abortions accounted for more than 60% of abortions in the U.S. in recent years, according to Guttmacher Institute research. The Guttmacher Institute reports that by 2020, medication abortions had grown to represent the majority of abortion procedures nationwide.

Telemedicine abortion access has expanded significantly in the approximately two and a half years since the Supreme Court overturned Roe v. Wade in June 2022. According to the Kaiser Family Foundation, telemedicine has become an increasingly important method for accessing abortion care, particularly in states where abortion remains legal.

The legal arguments center on whether expanded access creates undue burdens on states with restrictive abortion laws. Court documents reference costs associated with emergency care and enforcement of state abortion restrictions, though specific figures vary across different filings.

Reproductive rights advocates have strongly opposed the restrictions throughout the litigation. Organizations supporting abortion access argue that mifepristone has a well-established safety record and that additional restrictions would create unnecessary barriers to care.

The FDA’s safety data supports continued access under current protocols. The FDA has found mifepristone to be safe based on more than two decades of use since its initial approval in 2000. The agency has reported that more than 5 million women have used mifepristone in the United States.

Multiple medical studies have documented mifepristone’s safety profile. Research published in medical journals has consistently found that serious complications from medication abortion are rare, occurring in less than 1% of cases.

In combination with misoprostol, a medication that’s also used to treat ulcers and other conditions, mifepristone is approved in the U.S. to end pregnancies up to 10 weeks of gestation. According to FDA data, the combination successfully completes medical abortion in the vast majority of cases.

The current legal challenge represents one of several ongoing battles over abortion access since the Dobbs v. Jackson decision. Courts across the country have been weighing various aspects of abortion regulation, from state-level bans to questions about interstate commerce and telemedicine.

This particular case highlights the complex interplay between federal drug regulation and state abortion laws. The litigation raises questions about how federal agencies like the FDA should balance drug safety considerations with varying state policy approaches to abortion.

The temporary nature of Alito’s stay means the Supreme Court will need to decide quickly whether to hear the case fully or allow lower court decisions to stand. The one-week timeline suggests the justices recognize the urgency of providing clarity on mifepristone access.

Legal observers note that the case could have broader implications beyond mifepristone, potentially affecting how telemedicine regulations interact with state-level restrictions on various medical procedures.

The Supreme Court’s ultimate decision on whether to hear this case will likely depend on whether the justices view the legal questions as sufficiently significant to warrant full review. The court has been selective in taking abortion-related cases since Dobbs, focusing primarily on issues with clear constitutional dimensions.

As the May 11 deadline approaches, healthcare providers, patients, and legal advocates are closely monitoring developments. The outcome will affect not only immediate access to mifepristone but also the broader landscape of reproductive healthcare delivery in a post-Roe environment.