A federal appeals court temporarily reinstated a nationwide requirement that abortion pills be obtained in person, undermining access to the method of abortion that has only grown more widespread since the US Supreme Court overturned Roe v. Wade.

Friday’s ruling from the 5th US Circuit Court of Appeals is a major victory in the anti-abortion movement’s war against medication abortion, which now accounts for roughly two-thirds of all abortions in the United States.

The ruling stems from a lawsuit filed by Louisiana last year against the US Food and Drug Administration, after President Donald Trump’s administration refused to act on calls to reinstate the in-person dispensing requirement for abortion pills through the regulatory process.

The opinion was written by Trump-appointed Circuit Judge Kyle Duncan, joined by Circuit Judges Leslie Southwick and Kurt Engelhardt, who were appointed by Presidents George W. Bush and Trump, respectively.

Referring to Louisiana abortion prohibitions, they wrote that the current federal regulations create “an effective way for an out-of-state prescriber to place the drug in the hands of Louisianans in defiance of Louisiana law.”

Mifepristone manufacturer Danco Laboratories has asked the 5th Circuit to put its ruling on hold for seven days so it can appeal.

Since the Covid-19 pandemic, abortion-seekers have been able to obtain mifepristone – one of the two drugs in the medication abortion regimen – through telehealth appointments. President Joe Biden’s administration finalized rules that ended the requirement that the pills be obtained through an in-person doctor’s visit in 2023, after the US Supreme Court overturned the 1973 Roe precedent protecting abortion rights nationwide with Dobbs v. Jackson Women’s Health Organization.

Louisiana alleged that that regulatory maneuver was aimed at undermining the abortion ban that went into effect in the state with the reversal of Roe and says that now, hundreds of abortions are occurring every year within its borders because women are able to obtain pills via mail after telehealth visits with providers.

“Every abortion facilitated by FDA’s action cancels Louisiana’s ban on medical abortions and undermines its policy that ‘every unborn child is human being from the moment of conception and is, therefore, a legal person,’” the appeals court wrote Friday.