Developments in Abortion, Autonomy, and Access:
This week’s Reproductive Health Digest discusses a new lawsuit out of Louisiana that challenges the FDA’s handling of mifepristone, the continued fight over abortion access in Missouri, abortion-related prosecutions in Texas, an ongoing case in Tennessee, and policy and practical-access developments in the states. As always, please read on to the end for the news that you need to know.
Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.
Reproductive Rights and Health Equity News:
This Week’s Must-Read:
This week’s Must-Read comes from Rewire News; it describes how increased restrictions on reproductive freedom and choice are a hallmark and warning sign of growing authoritarianism. Looking to international examples, the piece makes the case that “reproductive rights . . . are an essential element of democracy.”
Legislation & Litigation:
Overview:
Louisiana filed a lawsuit challenging the FDA’s regulations for mifepristone’s use and seeking to reinstate in-person distribution requirements; the state argues that telehealth is allowing Louisianians to continue to have abortions, despite the state’s ban;
A Missouri court has affirmed a lower court's decision pausing medically unnecessary requirements for care, allowing abortions to continue consistent with the state’s recently passed constitutional protections;
Texas Attorney General Ken Paxton announced that eight more individuals have been arrested in connection with the state’s first prosecution under its abortion ban; counsel for those arrested deny the charges that they engaged in illegal activity; and
A Tennessee court has ruled to allow a lawsuit challenging the state’s extremely narrow life and health exceptions to move forward.
Louisiana Brings a Lawsuit Challenging FDA’s Mifepristone Regulations:
If you have read this Digest for a while, you are well aware that anti-abortion groups and states have been using every tool available to attack access to medication abortion post-Dobbs. As we discussed in the last issue, Texas Judge Matthew Kacsmaryk recently transferred a case challenging FDA’s approval and subsequent relaxations of regulations for use of mifepristone to the Eastern District of Missouri, where it is likely to be allowed to progress. Now, Louisiana Attorney General Liz Murrill has filed a separate lawsuit against FDA, challenging its approval of the use of telehealth for distribution of mifepristone.
In the Complaint, Louisiana alleges that telehealth has allowed “pro-abortion activists … to blanket pro-life states with mifepristone – with impunity and without any fear of liability” and that “hundreds of unlawful abortions occur every month in Louisiana.” The state argues that the FDA’s actions are a violation of both the Administrative Procedure Act and the Comstock Act. This direct invocation of the Comstock Act is particularly significant. The 1873 anti-vice law, by its language, bans the mailing of any materials involved in abortions; however, it has been largely treated as a dead law for decades. Anti-abortion activists are now attempting to revive it in order to block telehealth abortions, or – if read and enforced broadly – to halt the mailing of materials used for any type of abortion, including in-clinic procedural care.
Missouri Court Affirms Decision Allowing Abortions to Continue:
Since last November’s passage of a constitutional amendment protecting reproductive healthcare in the state, Missouri has been locked in a battle to restrict access and block the implementation of that amendment by any legally available means. On paper, Missourians have a constitutional right to abortion pre-viability; however, the state has argued to enforce a number of practical barriers to access that have effectively halted care at multiple points in the past year. These include licensing requirements for clinics, state approval of complication plans, a 72-hour waiting period, and restrictions on telemedicine. Litigation challenging these restrictions has been making its way through Missouri courts, including the state supreme court. On October 14th, a panel of three judges in a Missouri appeals court affirmed a lower court's ruling that temporarily blocked many of the challenged restrictions, allowing care to continue in the state. While the state’s battle to restrict access plays out in the courts, anti-abortion lawmakers have also put forth a second constitutional amendment that, if passed, would undo the first and reinstate a total abortion ban, with limited exceptions. The proposed constitutional amendment will go before voters next November.
Texas Has Arrested Eight More People In Connection with an Investigation Into Alleged Unlawful Abortions:
Texas has reportedly arrested eight more people in connection with a prosecution for the alleged provision of unlawful abortions. In March, a Houston-area midwife was arrested on charges of practicing medicine without a license and performing abortions in violation of state law. Her attorneys vigorously deny these claims, arguing that the state relied heavily on circumstantial evidence that did not prove any of its allegations. Now, Texas Attorney General Ken Paxton has announced that the state is bringing felony-level charges against eight additional people associated with the previously-arrested midwife and her clinics. This case appears to be the first prosecution brought directly under Texas’s abortion ban. Paxton’s press release announcing the arrests was rife with inflammatory language, including labeling several of the individuals involved “foreign nationals,” despite that having no apparent relevance to the case. He also referred to the arrestees as a “cabal of abortion-loving radicals” and “dens of fake doctors” engaged in conduct that he described as “evil.”
Tennessee Chancery Court Allows Lawsuit Challenging State’s Ban to Move Forward:
A three-judge panel in a Tennessee Chancery Court has ruled that a 2023 lawsuit challenging Tennessee’s extremely narrow life and health exceptions to its otherwise total abortion ban can move forward. The original lawsuit was brought by a group of Tennessee physicians and patients who had suffered medical harm as a result of the law’s vagueness and extremely punitive nature. A court previously partially sided with those plaintiffs, temporarily blocking doctors from facing professional discipline for emergency abortion care. In 2025, Tennessee amended its ban to allow abortions in cases of previable preterm premature rupture of the membranes (PPROM), inevitable abortion, and fatal fetal diagnoses that lead to severe maternal health conditions or infections causing uterine rupture or loss of fertility. The state argued that this amendment rendered the plaintiffs’ case moot. The court disagreed, writing that the “changes made by the 2025 amendment do not significantly alter the status” of the case, and plaintiffs “have sufficiently alleged that the defects in the Medical Necessity Exception place their lives at risk.”
Trend and Policy Watch:
Republican Senators Ask HHS and FDA to Restrict Access to Medication Abortion:
In yet another attack on mifepristone, every Republican senator aside from Susan Collins (ME) and Lisa Murkowski (AK), has signed a letter published to FDA and HHS calling for restrictions on access to the safe, effective medication. Relying on anti-abortion talking points and slanted ‘studies,’ the senators ask the agencies to, among other things, conduct a new REMS safety review, suspend approval of any new generic versions of mifepristone, reinstate in-person dispensing requirements, “suspend the distribution of mifepristone” as an “imminent hazard under Section 505(e) of the Federal Food, Drug and Cosmetic Act (FDCA),” and withdraw permissions for pharmacy distribution of mifepristone. Earlier this year, 22 Attorneys General sent a similar letter urging FDA and HHS to reevaluate mifepristone’s regulations. The Administration has indicated that it is currently undertaking a review of the drug’s safety and efficacy, despite decades of reliable science supporting its use for early abortion care.
Virginia’s Upcoming Election May Determine the Future of Reproductive Rights in the State:
Although Virginia remains a bastion of abortion access in an otherwise restricted South, that could change with the state’s upcoming election. This November, voters will choose their next governor (and the state’s first woman governor) and determine control of the Virginia House of Delegates. The outcome will be substantially determinative of the state’s reproductive rights policy moving forward. Current Republican Governor Glenn Youngkin has repeatedly vetoed pro-choice bills passed by the state legislature; however, if Virginians elect Democratic Candidate Abigail Spanberger and hold control of the house and senate, they could see expanded reproductive freedoms and rollbacks on medically unnecessary restrictions. Virginia’s elections will serve as an important signal of where abortion sentiment sits in the state and how powerful of a factor reproductive rights are in electoral decisions three years post-Roe.
Planned Parenthood Southeast Launched an Investigation into Anti-Abortion Sentiment From New Leadership:
The Board of Directors at Planned Parenthood Southeast has reportedly hired a law firm to conduct an investigation into “troubling allegations” made about its Executive Leadership team and Board. A petition circulated earlier this year described a culture in which new leadership had systematically de-emphasized abortion policy and removed public policy and organizing staff. Reportedly, newly hired leadership included an executive director who once referred to herself as pro-life in an interview, and a VP for external affairs who raised the question of working with Students for Life. Former leadership also alleged that support for the LGBTQ+ community had waned. This internal investigation comes as Planned Parenthood nationwide faces attempts by the federal and some state governments to defund its operations.
Clinic Closures Continue Following Passage of the So-Called “Big Beautiful Bill”:
Maine Family Planning, a network of 19 clinics that serve primarily low-income Medicaid patients across the state, will cease providing primary care at the end of this month. As we reported on in our last Digest, clinics across the country are closing their doors or ceasing care following the federal administration’s rescission of Medicaid funding for clinics that provide abortions and received more than $800,000 in Medicaid funding in 2023. This is the case even for clinics where abortion is only one of many services offered. Clinics like Maine Family Planning are unable to absorb the cost of that loss, and thousands of state residents will lose critical primary healthcare services as a result. Although Maine Family Planning is attempting to fight the funding cuts in court, it has thus far been unsuccessful.