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Abortion pills are now shipped across state lines with little to no in-person screening, and that single shift may be doing more to shape abortion access than dozens of state laws. We sit down with Gabriella McIntyre, legal counsel with Alliance Defending Freedom, to unpack Louisiana v. FDA and the fight over the FDA’s decision to allow mail-order mifepristone under its REMS rules. With a Fifth Circuit hearing ahead, we talk about what a win could change, why this case matters after Dobbs, and how state protections can be undercut when pills arrive through the mail from out-of-state prescribers. 

We also get specific about the medical and regulatory questions people rarely hear explained: why the FDA originally treated mifepristone as a high-risk drug, what safeguards existed, and what it means when those safeguards disappear. The stakes are not abstract. We discuss ectopic pregnancy risk, lack of ultrasounds, adverse events that can send women to the ER, and the public costs that follow. 

Then we go deep on the legal mechanics that decide whether any of this is even reviewable. We break down the standing battle that can keep courts from reaching the merits, the debate over agency deference, and the role of the Comstock Act in restricting the mailing of abortion drugs. We also touch on abortion shield laws and why enforcement gets complicated when states refuse to cooperate with each other. 

If you care about chemical abortion, mail-order abortion pills, mifepristone, FDA REMS policy, and what post-Dobbs abortion law looks like in real life, this conversation will clarify the map. Subscribe, share this episode with someone who follows the issue, and leave a review. What question do you want answered next about abortion pills by mail?

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