RALEIGH, NC — A federal judge has permanently blocked several efforts in North Carolina to limit how abortion pills can be distributed, saying they illegally conflict with the authority of the US Food and Drug Administration. But it allowed other state laws to remain in place, giving only a partial victory to a doctor who sued.
The order entered Monday by U.S. District Judge Catherine Eagles in Greensboro upholds her April 30 ruling that some of North Carolina’s medication abortion regulations are preempted by rulings by federal drug regulators that determined they were not necessary.
Monday’s order means North Carolina cannot require only doctors to prescribe the pills; that the drugs are given to the patient only personally; and for the patient to schedule a follow-up appointment. It also prohibits state and local prosecutors, state health and medical officials, and other defendants from enforcing such rules or penalizing people who do not enforce them with criminal, civil, and professional penalties.
Congress delegated authority to the FDA to review the use of mifepristone, which the agency approved in 2000 to end pregnancy when used in combination with a second drug, misoprostol. The FDA expressly determined that restrictions similar to those in North Carolina were no longer necessary, based on assessments of their safe distribution and use, Eagles wrote in April.
Her order appears to mean that patients in North Carolina can now get the pills through pharmacies — prescribed through someone like a nurse practitioner or physician assistant or using telehealth — and take them home, according to with FDA decisions.
But Eagles also supported some challenged restrictions, such as requiring a 72-hour advance in-person consultation, an in-person exam and an ultrasound before getting a prescription. She said these rules were either not reviewed and expressly rejected by the FDA, or they focus more on the practice of medicine or the overall health of the patient.
Dr. Amy Bryant, who provides abortions and filed this legal challenge last year, said in a prepared statement that the permanent order “will allow for increased access to safe and effective medication abortion care throughout North Carolina “.
The contested medication abortion regulations are in a 2023 law passed by the Republican-controlled General Assembly that continued or expanded many previous abortion restrictions. One change reduced the time frame for most abortions from after 20 weeks of pregnancy to 12 weeks.
Tami Fitzgerald, executive director of the North Carolina Conservative Values Coalition, said Tuesday that the decision “lowers the standard of care for women.” She also criticized the order for banning a state requirement that “nonfatal adverse events” related to mifepristone be reported to the FDA, saying it would hide “dangerous complications and side effects of abortion drugs.”
Democratic Attorney General Josh Stein, an abortion rights supporter now running for governor, did not defend the restrictions in court because he already argued they were preempted by FDA rulings. He blamed Republican lawmakers on Tuesday for the illegal provisions and said, “this decision helps women regain some control over their personal health care decisions.”
The offices of House Speaker Tim Moore and Senate Majority Leader Phil Berger, who joined the suit to defend the laws, did not immediately respond Tuesday to an email seeking comment. They can appeal the Eagles’ order. An upcoming ruling in a separate case at the U.S. Supreme Court brought by anti-abortion doctors who want the justices to limit access to mifepristone could affect the outcome of the North Carolina litigation.
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