For pro-lifers, few days were more monumental than when the U.S. Supreme Court ruled on the Dobbs v. Jackson Women’s Health Organization case in 2022. That ruling overturned Roe v. Wade, empowering states to protect women and their babies.
Naturally, there were some states that embraced this. States like Texas and Louisiana, just to name a couple, passed laws protecting unborn life. Other states—like New York and California— continued to sanction the killing of the unborn.
But shortly after the Dobbs decision, the Biden FDA launched a nationwide effort to circumvent laws in pro-life states like Louisiana. How? Through mail-order abortion drugs.
The Biden FDA’s mail-order abortion-drug scheme opens the door for widespread lawbreaking
As the pro-abortion Society of Family Planning’s most recent #WeCount report states, abortion rates have only increased following the overturn of Roe v. Wade—even in states with the strongest pro-life protections.
Why? Because in 2023 the Biden FDA systematically stripped away the in-person dispensing protection from the abortion drug mifepristone, making these high-risk drugs available by mail. Now, abortion drugs account for the majority of abortions in the U.S.
Importantly, by the FDA’s own admission, these drugs carry serious risks for women. The FDA’s own drug label states that roughly one in 25 women who take abortion drugs as directed will end up in the ER and that up to 7 percent of women who take the drugs will require follow-up surgery. Despite those numbers, the Biden FDA made these high-risk drugs available in the mail without any interaction with a medical professional to evaluate whether the woman is even pregnant, the gestational age of her baby, if she is ordering the drugs willingly, or if the recipient is an abuser.
Perhaps one of the most egregious examples of the fallout from this can be found in Louisiana. Local outlet WWNO compiled recent data to show that the Pelican State, despite prohibiting abortions outside of narrow exceptions post-Dobbs, has seen more mail-order abortions in 2024 (7,510) than the total clinic-provided abortions in 2020 (7,473) and 2021 (7,444). And in 2025, the data from the #WeCount report shows that there are nearly 1,000 mail-order abortions per month.
Those numbers are alarming, especially in a state like Louisiana, where pro-life laws came into effect immediately following the Dobbs decision. The fact that abortions in Louisiana have increased despite those strong pro-life laws is simply unacceptable.
Instead, the Biden FDA deliberately enabled pro-abortion doctors and activists to circumvent those laws by allowing the drugs to be sent in the mail, regardless of the consequences.
Of note, there were 5,410 mail-order abortions in Louisiana in the first half of 2025 alone. And thanks to the Biden FDA’s mail-order abortion-drug scheme, some of those abortions were coerced.
Rosalie Markezich’s child should be here today
In October 2023, Rosalie Markezich was met with an unexpected—but welcome—surprise. She was pregnant.
“When I took [a pregnancy test] and I immediately saw the line, the first thing I did was just smile,” she described.
Rosalie’s then-boyfriend also seemed on board with welcoming a new child into the world. But that attitude quickly soured—and turned into a nightmare for Rosalie.
“He told me that he actually did not want to keep the child,” Rosalie said.
When Rosalie insisted on raising her child, her boyfriend grew furious and eventually ordered abortion drugs by mail from a doctor in California without Rosalie’s consent. Rosalie initially resisted taking those drugs.
“I remember getting asked why I wanted to do this and why I want to keep it even if it’s going to ruin his life,” Rosalie recounted. “And again going back and forth, I want it. He did not.”
Then Rosalie’s boyfriend got angry, and things got very scary for her. The two were driving together alone—unbeknownst to Rosalie’s friends—when her boyfriend snapped and abruptly pulled into a hospital parking lot. Rosalie’s boyfriend had a criminal record, and she’s been a victim of domestic abuse before, so this situation was especially harrowing for Rosalie. She was “terrified” and felt her only route to safety was to take the drugs and attempt to vomit them when she could escape.
Despite her best efforts, Rosalie could not expel the drugs. When Rosalie saw blood, she knew her chances of saving her baby were slim. Abortion drugs killed Rosalie’s child.
“If the Biden FDA had not removed in-person dispensing, my then-boyfriend would not have been able to obtain abortion drugs and pressure me to take them against my will,” Rosalie said.
Far from empowering Rosalie to make her own choice and preserving her autonomy, mail-order abortion drugs had Rosalie feeling trapped and terrified.
The FDA must be held accountable
Due to the recklessness of the Biden-FDA’s mail-order abortion-drug scheme, more stories like Rosalie’s are surfacing, and more women face similar terrifying and painful circumstances. That’s why Rosalie and the state of Louisiana, alongside attorneys from Alliance Defending Freedom, filed a lawsuit against the FDA for enabling pro-abortion activists and doctors to mail streams of high-risk abortion drugs into states that protect the lives of unborn babies.
In April 2026, a federal court rightly ruled that Louisiana has standing to challenge the FDA’s abortion-by-mail regime. The court also said Louisiana is likely to succeed on the merits of its challenge. But despite these rulings, the court also granted the FDA’s request to stay the case while the agency conducts a new safety study of current mifepristone regulations—a study the agency has already been planning for over a year, and that could last indefinitely. The court ordered the FDA to provide a status update on its review within six months.
“ADF is grateful for the significant wins on standing and the merits of our case. But with women’s health and babies’ lives at stake, we are disappointed by the delay in accountability,” ADF President, CEO and Chief Counsel Kristen Waggoner wrote on X.
Rosalie and the state of Louisiana have appealed to the U.S. Court of Appeals for the 5th Circuit.
The bottom line
Nobody should feel coerced to have an abortion. Women like Rosalie and every unborn child deserve better. This regulatory regime undermines the state’s pro-life laws, harms women, and ends the lives of nearly 1,000 Louisiana babies each month.
“Out-of-state abortion drug peddlers are violating the criminal laws of Louisiana and other states across the country that choose life. They aren’t providing healthcare, they’re drug dealers,” Louisiana Attorney General Liz Murrill said. “Louisiana’s … lawsuit seeks to hold the FDA accountable for unlawfully removing its original safeguard that ensured women receive an in-person office visit to check for life-threatening conditions, such as ectopic pregnancy, before taking high-risk abortion drugs.
“The FDA’s reckless actions also opened wide the door for women to suffer reproductive coercion and assault. We are simply asking the FDA to restore this basic safety standard for women’s health.”
Rosalie particularly knows the importance of those safety standards.
“If mail-order abortion wasn’t a thing, I’m 100% sure I would have my child,” she said.
As the Supreme Court put it, the Dobbs decision “return[ed] the issue of abortion to the people’s elected representatives.” But that promise has not been realized in Louisiana or its sister pro-life states due to the Biden FDA’s politically-motivated actions.
And it’s women like Rosalie who are paying a painful price for that. That’s why Rosalie has bravely chosen to be a voice for the voiceless women who have suffered or will suffer like she did because of the FDA.
The State of Louisiana v. U.S. Food and Drug Administration
- June 2022: The Supreme Court overturns Roe v. Wade in Dobbs v. Jackson Women’s Health Organization. Louisiana’s pro-life laws immediately go into effect following that decision.
- January 2023: The Biden FDA permanently removes the in-person dispensing requirement from the Mifepristone Risk Evaluation and Mitigation Strategy, making abortion drugs available by mail.
- October 2023: Rosalie Markezich is coerced into taking abortion drugs in pro-life Louisiana after her then-boyfriend ordered abortion drugs from a doctor in California.
- October 2025: Alongside ADF attorneys, the State of Louisiana and Rosalie sue the FDA in the U.S. District Court for the Western District of Louisiana, Lafayette Division, for its 2023 actions.
- April 2026: A federal district court upholds Louisiana’s ability to challenge the FDA, also adding that it is likely to succeed on the merits of the case. However, the court also puts the case on hold while the FDA conducts a safety study on mifepristone. ADF and Louisiana appeal to the U.S. Court of Appeals for the 5th Circuit.
Related Articles
