In recent years, the rise of mail-order abortion drugs has become a serious public health concern. Pro-abortion states like California and New York shamelessly violate pro-life state laws by flooding their mail with abortion drugs, sending women and girls to the ER and killing countless unborn children that were previously protected by law.

It was Biden’s FDA that recklessly stripped abortion drug dispensing requirements using COVID-19 as their justification. Today, that rule is still inexplicably in place, despite the Trump Administration in office. Now, nationwide, this crisis is rampant. Widespread distribution without in-person medical oversight has led to increased complications, emergency room visits, coercion, and cases where abusers secretly poison women and girls.

In response, many pro-life states and their attorneys general (AGs) are stepping up with lawsuits, new laws, enforcement actions, and public pressure to challenge federal policies and address this crisis head-on.

Here’s a look at some of the key efforts underway.

Multi-State Lawsuits Challenging the FDA

Several states are directly confronting the FDA in court over its handling of mifepristone.

• Missouri, Kansas, and Idaho joined forces in federal court to challenge the FDA’s approval of new generic versions of the abortion drug, mifepristone, citing evidence of harm to women and lax oversight. Missouri’s statements emphasize that claims of the drug being “as safe as Tylenol” are misleading, with women ending up in emergency rooms. The Trump-Vance DOJ moved to dismiss this case.
• Florida and Texas filed suit in December 2025 against the FDA, targeting its original approval of mifepristone and the progressive removal of safety standards. They describe the original approval process as politically driven from the start. The Trump-Vance DOJ also attempted to dismiss this case, siding with the abortion industry on mail-order drugs against pro-life states for the second time in one week.
• Louisiana, joined by coercion survivor Rosalie Markezich, is also suing the FDA. Markezich’s case underscores how mail-order access enabled her boyfriend to obtain and pressure her into using the drugs without her full consent, resulting in the loss of her baby. Louisiana law treats abortion-drug poisoning as a crime. The Trump-Vance DOJ asked a federal district court to deny relief in this case, claiming both the state and a survivor of abortion drug violence lack standing and are not suffering ongoing harm from the FDA’s Covid-era policy of allowing deadly abortion drugs to be sent in the mail.

Innovative State-Level Measures

Beyond federal challenges, states are enacting their own protections.

• Louisiana made history in Spring 2024 by classifying mifepristone and misoprostol as Schedule IV controlled dangerous substances — similar to certain narcotics — while preserving legitimate medical uses. This adds penalties for unauthorized possession or distribution of the dangerous drugs.

 

🙌SB 276 was signed ✍️today by @LAGovJeffLandry, protecting women from forced or coerced abortion, minors from obtaining the abortion pill & 🛑 predators from distributing them to abuse victims.
Thank you Senator @TAPressly for authoring this important legislation, co-author… pic.twitter.com/57T7JEfEl2

— Louisiana Right to Life (@LARighttoLife) May 28, 2024

• Texas passed a significant law in the of Fall 2025, allowing private citizens to sue manufacturers, distributors, or anyone mailing abortion-inducing drugs illegally the state. Successful suits can yield at least $100,000 in damages, with exemptions for the women themselves.

 

Congrats to @leachfortexas & @SenBryanHughes and pro-life advocates for their hard work in crafting a new bill to take on abortion drug manufacturers who ship these dangerous drugs into Texas, harming Texan women and ending the lives of unborn children.

Once again, TX is leading… pic.twitter.com/XbVvhV9vtP

— SBA Pro-Life America (@sbaprolife) August 29, 2025

Enforcement and Warnings to Out-of-State Abortion Businesses

AGs are issuing direct warnings and taking action against companies and bad actors circumventing state law, resulting in harmed women and unborn children.

• A large coalition of GOP AGs, led by Arkansas, sent letters to Congress and the FDA urging the restoration of pre-Biden regulations and crackdowns on out-of-state providers.

Thank you @AGTimGriffin and all the AGs defending their citizens and raising the harms these dangerous drugs cause.https://t.co/XhGN48vtZ2

— SBA Pro-Life America (@sbaprolife) January 14, 2026

• Arkansas, South Dakota, and Texas AGs issued cease-and-desist letters to abortionists and groups illegally advertising or providing drugs in pro-life states. South Dakota’s efforts prompted a New York-based company to settle quickly and remove their ads.

• North Dakota‘s AG issued a January 2026 cease-and-desist order against an abortion fund promoting illegal sales. Undercover investigations revealed providers skipping requirements for health information, age verification, or identity checks.

• In January 2026, Kentucky‘s AG subpoenaed six gas stations advertising Mayday Health, a group allegedly directing people to online sources that violate state laws.

.@kyoag Russell Coleman is taking on the mail-order abortion drug pipeline.

He’s investigating a New York based abortion group & subpoenaing gas stations running their predatory ads, enforcing KY’s laws on shipping abortion drugs.

“Keep your illegal pills out of our…

— SBA Pro-Life America (@sbaprolife) March 18, 2026

States are clearly trying to address the danger the unregulated flood of abortion drugs has had on the citizens of their states. As complications mount and public support for in-person medical oversight grows, these states are leading the charge to demand accountability from the FDA and out-of-state actors.

The fight continues, but the message is clear: pro-life states will not stand idly by while pro-abortion states and federal policies undermine their laws and endanger lives.