We haven’t catechized our own people, let alone our culture, into recognizing the truth that a human embryo is a human being. Until we do, a pill like mifepristone that ends a life at seven weeks won’t feel like a technology being used to kill humans.

Most pro-lifers are familiar with significant abortion-related legal cases, such as Roe v. Wade, Planned Parenthood v. Casey, and Dobbs v. Jackson Women’s Health Organization. But few have ever heard about Louisiana v. FDA. And yet, 20 years from now, we may look back and conclude that this little-noticed ruling—and whatever the Supreme Court does with it next—mattered more for the future of unborn life in America than any of the better-known headline cases.

The case is about whether abortion pills can be mailed directly into states where abortion is illegal—and in the span of 72 hours, two federal courts gave opposite answers.

In a unanimous opinion issued on May 1, the Fifth Circuit panel reinstated the FDA’s pre-2023 in-person dispensing requirement for mifepristone, the first drug in the two-drug medication abortion regimen. Until last week, the FDA’s 2023 rule allowed mifepristone to be prescribed via telemedicine and mailed directly to a patient’s home—no clinic visit, no pharmacist, no in-person evaluation needed. Then, on May 4, the Supreme Court issued an administrative stay allowing the practice to continue nationwide while the underlying litigation proceeds.

The numbers behind this rule explain why the stakes are so high. By the first half of 2025, more than one in four U.S. abortions were obtained via telemedicine. Medication abortion (using mifepristone) accounted for the majority of abortions in 2023 in nearly all U.S. states without a total ban, ranging from 44 percent in Washington, D.C. and 46 percent in Ohio to 84 percent in Montana and 95 percent in Wyoming. And in the most recent year for which we have full data, an estimated 91,000 abortions were provided by telehealth in states with total bans.

Many of us pro-lifers haven’t fully reckoned with the fact that, while Dobbs returned the question of abortion to the states, the FDA quietly took it back. It’s hard to fight for life when abortions are invisible. If mifepristone can be prescribed by a doctor in California and shipped to a teenager in Baton Rouge, then the laws in Baton Rouge are, in practical effect, unenforceable in the earliest state of pregnancy. The result is that the Dobbs decision becomes toothless and every mailbox becomes a potential abortion clinic.

Why It’ll Be Hard to Undo

The Fifth Circuit’s ruling is a genuine victory worth celebrating. But pro-lifers should also recognize that even if the Supreme Court ultimately upholds it, three deeper currents make the medication-abortion era difficult to roll back.

First, there’s no political will to restrict abortion in the first few weeks of conception. This is the hardest truth for pro-lifers to absorb. The 2024 Republican platform—the less pro-abortion of the two major parties—dropped its long-standing support for a national 20-week limit, declined to mention the Comstock Act (which prohibits mailing abortion drugs), and committed only to opposing “late term abortion” while affirming support for IVF.

The platform leaves abortion regulation entirely to the states. If even the GOP is unwilling to defend the unborn earlier than the third trimester, the political ceiling for restoring real protections is lower than many activists realize or concede.

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