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• Posted July 16, 2025

Court Allows West Virginia to Restrict Abortion Pill Mifepristone

A federal appeals court has ruled that West Virginia can limit access to mifepristone, a medication used to end early pregnancies.

The decision is the first of its kind and could affect how other states handle access to drugs that are approved by the U.S. Food and Drug Administration (FDA).

Mifepristone is part of a two-drug regimen used in medication abortions. It has been FDA-approved since 2000 and is considered a safe and effective alternative to surgical abortion, The Washington Post said.

The drug has become a focus of legal fights over abortion access, especially since the U.S. Supreme Court overturned Roe v. Wade in 2022. 

Since that decision, medication abortion has accounted for more than half of all abortions in the U.S., according to the Guttmacher Institute, a public policy think tank focused on reproductive rights.

After the court’s 2022 decision, West Virginia passed a law banning nearly all abortions, including medication abortions, with very few exceptions, such as to save the mother’s life or in cases of rape or incest.

The ruling this week came after GenBioPro, one of the few makers of generic mifepristone, sued West Virginia. 

The company argued that FDA approval should overrule state law, The Post reported.

But the 4th U.S. Circuit Court of Appeals disagreed. In a 2-1 ruling, the court said federal law does not clearly prevent states from making their own decisions about restrictions on drugs.

The federal law “falls well short of expressing a clear intention to displace the states’ historic and sovereign right to protect the health and safety of their citizens,” the court said, according to The Post.

GenBioPro CEO Evan Masingill warned the ruling could cause “a dangerous ripple effect on the availability of essential medications in this country.”

Seventeen states ban or heavily restrict medication abortion.

Greer Donley, a law professor at the University of Pittsburgh, said the ruling could change how states regulate other FDA-approved medication, including vaccines, contraceptives and care used in gender transitions.

“In some ways, this case is green-lighting the state to be political in how it regulates medications,” she told The Post.

The dissenting judge wrote that West Virginia’s law “invades the very space occupied by the federal government and reserved for federal oversight — the regulation of medication.”

Writing for the majority, Judge J. Harvie Wilkinson III said regulating how drugs are used in medical practice falls under state control, not the FDA.

West Virginia Gov. Patrick Morrisey celebrated the ruling. 

“West Virginia can continue to enforce our pro-life laws and lead the nation in our efforts to protect life," he said.

U.S. Health and Human Services Secretary Robert F. Kennedy Jr. has previously said he has asked the FDA to conduct a full review of mifepristone’s safety.

An HHS spokesperson declined to comment on the West Virginia ruling.

More information

The Mayo Clinic has more on mifepristone.

SOURCE: The Washington Post, July 15, 2025