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TO: Interested Parties FROM: American Civil Liberties Union DATE: February 24, 2026 SUBJECT: Urging Federal Court to Reject Abortion Opponents鈥� Efforts to Make it Harder for People to Get Medication Abortion, Preeminent Medical Associations, Former FDA Commissioners, Advocates for Domestic Violence Survivors and People with Disabilities, Reproductive Freedom Organizations, and Other Experts File Suite of Amicus Briefs On Feb. 24, a federal court in Louisiana will hear arguments in a lawsuit, Louisiana v. U.S. Food and Drug Administration (FDA), that threatens to imminently limit nationwide access to mifepristone, a safe and effective medication used in nearly two-thirds of U.S. abortions, as well as for miscarriage care. In a suite of amicus briefs filed in advance of the hearing, a range of experts 鈥� including the American College of Obstetricians and Gynecologists and other premier medication associations; nine former FDA Commissioners; the National Domestic Violence Hotline; disability rights advocates; and more than 100 organizations supporting people in need of abortion care 鈥� urged the court to deny this attempt to make it harder for people around the country to get medication abortion and miscarriage care. The lawsuit, filed by Louisiana鈥檚 attorney general and an individual plaintiff, seeks to end patients鈥� access to mifepristone through telemedicine 鈥� the method by which more than 1 in 4 people who have abortions obtain care today 鈥� by reinstating a medically unnecessary and extremely burdensome requirement that all patients travel in person to a health center for the sole purpose of being handed the medication, rather than filling their prescription by mail or at a local pharmacy. The court could rule any time after the Feb. 24 hearing, when it is scheduled to hear both Louisiana鈥檚 request for immediate restrictions and the Trump administration鈥檚 request to pause the case while it continues a sham FDA review that lays the groundwork for additional nationwide restrictions. The amicus briefs outline how this lawsuit 鈥� one of three pending cases brought by anti-abortion state politicians seeking nationwide restrictions on mifepristone 鈥� threatens to upend how essential reproductive health care is currently delivered to patients across the country. The briefs describe the wealth of peer-reviewed research over more than 25 years confirming mifepristone鈥檚 safety and efficacy, including when prescribed through telemedicine. The briefs also explain how mail and pharmacy access is a lifeline for patients who might otherwise struggle to access abortion and miscarriage care, including survivors of domestic violence, people with disabilities, and those living in rural areas or health care deserts. For some patients, being able to safely get their prescription at home, instead of being forced to travel long distances just to pick up a pill, can be the difference between getting the timely care that they need on the one hand, and, on the other, being forced to continue a pregnancy and have a child, or being forced to endure untreated miscarriage complications. Below are excerpts from key amicus briefs urging the court to deny Louisiana鈥檚 request to limit access to mifepristone nationwide: Expert Medical Associations, including the American College of Obstetricians and Gynecologists, the American Academy of Family Physicians, and the Society for Maternal-Fetal Medicine: 鈥淢ifepristone鈥攚hether dispensed in person or not鈥攊s extremely safe. More than two decades, hundreds of medical studies, and vast amounts of data have confirmed mifepristone鈥檚 safety and efficacy for abortion care and miscarriage management.鈥� 鈥淧reserving access to mifepristone and expanding access to telehealth are both crucial steps to support vulnerable populations who face structural barriers to abortion care, including patients of color, patients of lower incomes, patients who are disabled, and/or patients who are living in rural areas or health care deserts. Telehealth allows such patients to avoid significant costs associated with travel to obtain care (such as transportation, gas, and lodging), childcare expenses, and lost wages鈥攂urdens that deter and delay abortion access. Telehealth also reduces delays in obtaining care because it enables patients to avoid long wait times at physical clinics鈥攁 particularly urgent concern since Dobbs v. Jackson Women鈥檚 Health Organization, as state abortion bans have increased demand for abortion care in many states where abortion remains lawful.鈥� The National Domestic Violence Hotline and Legal Voice: 鈥淩estricting access to mifepristone will cause irreparable harm to the many Americans who face IPV [intimate partner violence], need abortions to protect their own health and safety, and face unique barriers to access this time-sensitive care because of the nature of abusive relationships. Abusive partners often exert control and maintain power within the relationship by undermining survivors鈥� autonomy to make reproductive decisions, limiting access to health care, and forcing pregnancy. Being forced to carry a pregnancy to term for lack of access to abortion care exposes survivors of IPV to a higher likelihood of further violence, poses significant health risks, and increases the chance of being trapped in violent relationships. The consequences of such entrapment range from heightened abuse during pregnancy to death. As difficult as it is for all survivors of IPV to escape abusive relationships and exercise their reproductive autonomy, IPV survivors of color鈥攚ho already experience disproportionately high rates of unintended pregnancy and increased health risks鈥攆ace systemic inequities that make doing so even more difficult.鈥� 鈥淩educing abortion access harms survivors. Research has shown a significant increase in IPV rates in areas with limited access to abortion, including Louisiana. Removing telemedicine options is especially harmful to survivors. The availability of telehealth, the ability to fill prescriptions at local pharmacies, and the ability to receive medication by mail are essential to survivors of IPV because these options reduce both the cost of abortion care and the barriers of having to pay for and arrange transportation, childcare, and time off work outside the surveillance of an abuser. Indeed, in-home medication abortion is often a survivor鈥檚 only option for abortion care because the survivor must obtain care without the abuser finding out. Having a variety of options for accessing that care鈥攊n one鈥檚 home via telehealth or from a local provider鈥攈elps survivors maintain safety and privacy.鈥� Disability Rights Education and Defense Fund and Other Disability Justice Advocates: 鈥淕ranting Plaintiffs鈥� requested relief would deepen the already substantial barriers disabled people face in accessing health care: physical inaccessibility, transportation limitations, financial strain, and entrenched medical bias. For many disabled people, telemedicine access to mifepristone is not mere convenience but a critical safeguard. Disabled people experience heightened rates of reproductive coercion and intimate partner violence, in part because reliance on others for daily assistance can compromise privacy and autonomy. Eliminating remote access would strip away a vital layer of safety and control.鈥� Telehealth Abortion Providers, Sharing Stories From Their Patients, In Their Own Words: 鈥淸Patients鈥橾 accounts illustrate that without timely access, abortion care may be out of reach for many, and especially for those already navigating complicated demands of work, caregiving, and economic precarity. Telehealth addresses these constraints directly, allowing patients to obtain care quickly, safely, and privately, without sacrificing employment, income, or responsibilities to the families they already support.鈥� 鈥淎mici鈥檚 patients described the telehealth services they received as 鈥榣ifesaving鈥欌�� care that provided meaningful intervention and support during moments when they felt scared or vulnerable[:] 鈥業 would have died if this pregnancy went through. My 3 other kids would be without a mother. Thank you for being there and not judging me.鈥� 鈥榊ou saved my life. I was scared and alone and I didn鈥檛 know what to do and I鈥檓 grateful to have these services. Without care I鈥檓 not sure what would have happened.鈥欌�� 鈥淏eginning with the initial consultation, continuing through real-time support during the process, and extending into comprehensive follow-up care, many patients describe their telehealth abortion experiences as high-quality, trustworthy, and affirming, Patients shared: 鈥楧uring a very personal and challenging time, [Telehealth Provider] provided not only expert care but genuine compassion and support. From the first patient intake to the final follow-up, everyone made me feel seen, heard, and safe. The level of professionalism and attention to detail was unmatched. I鈥檓 incredibly grateful for their care and would recommend them without hesitation to anyone in need of top-tier medical support. They are so private & easy to work with! I loved it.鈥� [...] 鈥榌Telehealth Provider] offered care that felt personal, compassionate, and judgment-free. In a vulnerable moment, they made me feel safe, seen, and supported. Grateful beyond words.鈥欌�� 100+ Reproductive Health, Rights, and Justice Organizations, including the ACLU Foundation: 鈥淭elehealth, which is an increasingly common method of healthcare delivery in general, is now a standard method of care for medication abortion, both in the United States and around the world. ... [T]elehealth care is individually tailored to each patient鈥檚 circumstances, with in-person testing or examination ordered when appropriate based on individualized patient screening. Rigorous studies from the past several years resoundingly reinforce that patients can be screened and counseled for medication abortion via telehealth as safely and effectively as in-person screening and dispensing.鈥� 鈥淎bortion access saves lives, reduces maternal and infant mortality, narrows racial health disparities, and protects survivors of violence. Telehealth is the mechanism through which millions of patients access that care. Restricting it would not protect anyone; it would cause the gravest harm to those who can least afford it.鈥� Medical Students for Choice: 鈥淸R]einstating the in-person dispensing requirement would have a profound impact on medical training and the future of the medical profession nationwide. Future medical professionals rely on learning the best, evidence-based practices to care for patients now and in the future. ... Louisiana鈥檚 attempt to impose its political preferences on the medical profession and patients nationwide would erect obstacles in the paths of medical students and undermine medical schools鈥� ability to provide future medical professionals with evidence-based, patient-centered education. Reinstating the in-person dispensing requirement risks creating gaps in medical education and diminishing the quality of medical care in this country for generations to come.鈥� 鈥淩estrictive abortion laws have exacerbated maternal care deserts, including by impacting the choices of where medical students are able and willing to complete their education and training, and later work and reside. ... [S]tates with restrictive abortion laws are experiencing a 鈥榤edical brain drain,鈥� in which many future physicians are choosing to study, and then practice, out-of-state. Even existing maternal healthcare providers are moving out of states with restrictive abortion laws in part due to fears of legal consequences for providing at times life-saving care, which has detrimental effects on maternal healthcare including for women who want to continue their pregnancies.鈥� Nine Former FDA Commissioners: 鈥淚f [Louisiana鈥檚] position were adopted, it would upend FDA鈥檚 rigorous, well-established system for drug approvals, which relies on voluntary reporting by prescribing physicians for almost all drugs. 鈥� The orderly system that Congress and FDA have established would screech to a halt if litigants could weaponize the limitations of [FDA鈥檚 adverse-events] data to support successful challenges to drug approvals.鈥� 19 States and the District of Columbia that Protect Access to Abortion Care: 鈥淚f granted, [Louisiana鈥檚] requested relief would increase costs to amici鈥檚 health systems, harm amici鈥檚 residents, and undermine amici鈥檚 sovereign policy decisions [to protect abortion access]. ... [M]any [amici States] have experienced a steep rise in demand at clinics from out-of-state patients after Dobbs. While providers have endeavored to meet the increased demand, the influx has stretched clinics past their already-strained capacity and has dramatically increased wait times for patients from both within and outside of their States. Eliminating access to medication abortion via telemedicine would deprive amici States of a critical tool in expanding capacity to meet this demand.鈥� 鈥淸Removing the in-person dispensing requirement has] been critical to extending access for amici鈥檚 residents in rural and underserved communities where barriers to abortion and other forms of healthcare are most acute. The availability of abortion care by telehealth has reduced the impact of many practical and cost barriers that can make it difficult for many people to obtain an abortion鈥攊ncluding childcare needs, missed work and resulting lost income, lack of insurance coverage, and travel costs and logistics, all of which increase with distance traveled.鈥� Former Department of Justice Officials: 鈥淎dopting [Louisiana鈥檚] erroneous interpretation of the Comstock laws would risk a profound destabilization of medical care. ... [I]t necessarily would affect in-person abortion and a broad range of other kinds of healthcare ... [including because] many abortion-inducing drugs and devices are used for non-abortion-related care. For instance, mifepristone is regularly used to treat miscarriages, and misoprostol is frequently used during labor and delivery.鈥�

PHOENIX 鈥� An Arizona state court today permanently blocked several burdensome and medically unnecessary abortion restrictions, including a law forcing patients to make two separate trips to their health care provider and wait at least 24 hours before getting care, as well as a ban on the use of telemedicine for abortion. The court ruled that these and other restrictions violate the state's new constitutional amendment protecting the right to abortion. This decision will significantly expand abortion access in the state, allowing patients to get time-sensitive care in their communities. The restrictions struck down today include: Laws forcing providers to relay, and patients to receive, biased and inaccurate information about abortion in person, and then wait at least 24 hours before being able to obtain care 鈥� requiring two separate trips to a provider. Patients are often unable to get time-sensitive care for days, if not weeks, because of these restrictions. Laws banning abortion as an option for patients with fetal diagnoses, forcing doctors to turn their patients away if they even suspect someone鈥檚 reason for seeking care is due to a fetal condition. A prohibition on the use of telemedicine for medication abortion, despite ample evidence that this is a safe and effective form of care. In his decision, Judge Gregory Como ruled that abortion restrictions that override patient autonomy and have no medical justification cannot stand: 鈥淭he Challenged Laws鈥� universal suppression of medical judgment and choice ... renders them invalid in all circumstances.鈥� In November 2024, Arizona voters overwhelmingly approved Proposition 139, the Arizona Abortion Access Act, to enshrine the fundamental right to abortion in the state constitution. Soon after, Arizona health care providers challenged and successfully struck down the state鈥檚 15-week abortion ban. Today鈥檚 ruling represents yet another landmark victory to expand abortion access in the state, including by allowing Arizonans to finally receive abortion pills by mail. These medically unnecessary restrictions have long made it harder, if not impossible, for Arizonans to get abortion care in the state. Despite voter-approved protections for abortion, state lawmakers are currently attempting to undermine this constitutional right by pushing legislation to restrict access to care. 鈥淭his is a relief. For the first time in a long time, my patients will not have to jump through hoops to get the care they need,鈥� said Dr. Paul Isaacson, OB-GYN and co-owner of the Family Planning Associates Medical Group. 鈥淚 became an OB-GYN to provide compassionate care to my patients, but these restrictions have stood in the way of that. Finally, I can help patients as they decide what鈥檚 best for themselves without interference from the state.鈥� 鈥淭he court made clear today that the power to make health care decisions should be in patients鈥� hands, not politicians鈥�,鈥� said Dr. William Richardson, OB-GYN and owner of Choices Women鈥檚 Center. 鈥淔or years, I鈥檝e seen Arizonans from rural communities struggle to find the means to make two separate trips to my clinic. I鈥檓 thrilled to now be one step closer to offering my patients evidence-based care via telemedicine.鈥� 鈥淭his is a major victory for the Arizonans who showed up to protect their right to abortion. Thanks to them and the dedicated health care providers in this case, we are even closer to making that right a reality in the state,鈥� said Caroline Sacerdote, senior attorney at the Center for Reproductive Rights. 鈥淣o one should be forced to wait for time-sensitive care or listen to disinformation about abortion. Anti-abortion lawmakers in Arizona want to override the will of the people, but we refuse to let them.鈥� 鈥淎s a physician, I am relieved that I no longer will be forced by Arizona鈥檚 restrictions to undermine my patients鈥� decisions,鈥� said Dr. Laura Mercer, OB-GYN and Arizona Medical Association board member at-large. 鈥淢y patients will no longer be forced to make additional unnecessary visits for care, nor will I be required to give them disinformation that stigmatizes abortion. And as an Arizonan, I am proud that the abortion protections we fought so hard to win are bringing reproductive freedom closer to reality.鈥� 鈥淭he court鈥檚 decision to block these stigmatizing, medically baseless restrictions enables Arizonans to access abortion without politics standing in the way,鈥� said Rebecca Chan, staff attorney for the ACLU Reproductive Freedom Project. 鈥淭his ruling brings us many steps closer to realizing the promise of Arizona鈥檚 constitution: that every Arizonans鈥� freedom to make decisions about their pregnancy is respected and supported." 鈥淲hen voters approved Prop. 139, we recognized abortion as a fundamental right. Today鈥檚 decision makes that vote tangible: it removes harmful legislative roadblocks that interfered with patients鈥� private healthcare decisions,鈥� said Lauren Beall, staff attorney for the ACLU of Arizona. 鈥淭ogether we celebrate this victory for bodily autonomy throughout our state.鈥� This case was brought by Dr. Paul A. Isaacson, M.D., Dr. William Richardson, M.D., and the Arizona Medical Association represented by the Center for Reproductive Rights, the American Civil Liberties Union, and ACLU of Arizona.

PHOENIX 鈥� A group of Arizona advanced practice nurses filed a lawsuit yesterday challenging the state鈥檚 ban on the provision of abortion by trained advanced practice clinicians (APCs) such as nurse practitioners and certified nurse midwives. The lawsuit, brought on behalf of the nurses by the American Civil Liberties Union (ACLU), the ACLU of Arizona, and the law firm Papetti Samuels Weiss McKirgan LLP, argues that the APC ban violates Arizonans' constitutional right to abortion access, established by voters in 2024, by arbitrarily restricting their choice of provider and, more broadly, making abortion less available in the state. The APC ban bears no relationship to patient safety, clinical standards, or medical evidence. APCs are already allowed to provide abortion in roughly half the states, and clinical studies and experience show that they do so just as safely as their physician peers. APCs are crucial in ensuring timely access for patients who, in addition to state restrictions, face other barriers to care such as transportation limitations, inflexible work schedules, childcare needs, and controlling partners. Leading medical authorities, including the American College of Obstetricians and Gynecologists and the American College of Nurse Midwives, have called on states to repeal these bans so that these highly qualified health care professionals can serve patients seeking abortion. Arizona鈥檚 APC ban has severely limited the pool of available abortion providers in the state. Arizona already has a shortage of physicians, particularly in rural and tribal areas, and many Arizonans see APCs as their primary or reproductive health care provider. When these patients face an unwanted pregnancy or a pregnancy complication, many of them must travel long distances to seek abortion care from a new provider. Because of how few abortion providers there are in the state, some of these patients face delays. They may be forced to have a procedure because they miss the narrow window to end their pregnancy with medications. Some are even forced to carry to term. Being prevented, or even delayed, from accessing abortion raises risks to a patient鈥檚 physical and mental health. 鈥淎rizonans should be free to access abortion care in their communities, including from qualified, trained advanced practice clinicians,鈥� said Alice Clapman, senior counsel with the ACLU鈥檚 Reproductive Freedom Project. 鈥淥verturning the state鈥檚 APC ban would not only bring its healthcare policy in line with the medical science but also make good on the state constitution鈥檚 promise to protect abortion access as a fundamental right. The ACLU will do everything in our power to make sure that Arizonans can get abortion care from providers they trust, including advanced practice clinicians.鈥� 鈥淚 became a midwife because I felt called to care for my patients as whole people with a range of medical, social, and emotional needs throughout the span of their lives,鈥� said plaintiff Janna Stefanek, a certified nurse midwife. 鈥淔or some patients, this includes abortion care. The APC ban forces me to turn those patients away at a vulnerable time when they need me 鈥� that is just wrong. I am honored to fight to ensure Arizonans have access to the care they deserve from trusted and qualified providers in their own communities.鈥� 鈥淎s a physician, I work closely with advanced practice clinicians,鈥� said Dr. Laura Mercer, legislative chair of the Arizona Section of the American College of Obstetricians and Gynecologists. 鈥淧reventing these dedicated professionals from providing abortion care within their scope of practice is harmful and out of step with modern medicine. The evidence is clear: advanced practice clinicians can be trained to provide many types of uncomplicated abortion care as safely as physicians. Furthermore, allowing them to do so has numerous benefits for their patients. Lifting this unjustified ban will mean more Arizonans can access the health care they need, and sooner.鈥� 鈥淭he fundamental right to abortion means little when Arizonans cannot get care from trusted and skilled providers in their own community,鈥� said Lauren Beall, staff attorney at the ACLU of Arizona. 鈥淥verturning senseless restrictions that tie the hands of advanced practice clinicians is the next important step to fulfill the promise of the Arizona Abortion Access Act. Allowing APCs to provide abortion care is essential to ensure all Arizonans can access this health care, especially those who have faced systemic barriers across our state for far too long.鈥� Arizona鈥檚 APC ban overrode the state Board of Nursing鈥檚 decision that, with appropriate training, advanced practice nurses were qualified to provide abortion care. Before this ban, Arizona APCs specializing in reproductive health care safely performed abortions and cared for abortion patients in the state as part of their regular scope of practice. APCs trained in reproductive health care also routinely provide care that is significantly more complex than medication and procedural abortion, including for patients in labor and who are experiencing miscarriages or postpartum complications. The APC ban has prevented these extremely skilled health care providers from giving their patients critical and time-sensitive abortion care, including in medically urgent situations. The lawsuit, Gill et al. v. State of Arizona, was filed in the Arizona Superior Court for Maricopa County by the ACLU, the ACLU of Arizona, and local counsel Papetti Samuels Weiss McKirgan LLP.

A group of Arizona advanced practice nurses filed a lawsuit challenging the state鈥檚 ban on the provision of abortion by trained advanced practice clinicians (APCs) such as nurse practitioners and certified nurse midwives. The lawsuit, brought on behalf of the nurses by the American Civil Liberties Union (ACLU), the ACLU of Arizona, and the law firm Papetti Samuels Weiss McKirgan LLP, argues that the APC ban violates Arizonans' constitutional right to abortion access, established by voters in 2024, by arbitrarily restricting their choice of provider and, more broadly, making abortion less available in the state.