Federal judge blocks some abortion pill rules in North Carolina

RALEIGH, North Carolina – A federal judge has permanently blocked some efforts in North Carolina to restrict how abortion pills can be dispensed, saying they are illegally in conflict with the authority of the US Food and Drug Administration. But she allowed other state laws to remain in effect, handing only a partial victory to the doctor who sued.

The injunction granted Monday by U.S. District Judge Catherine Eagles in Greensboro continues her April 30 ruling that some of North Carolina’s regulations on medication abortion were overturned by rulings by federal drug regulators. which they determined were not necessary.

Monday’s order means North Carolina cannot require only doctors to prescribe the pills; that medicines are provided to the patient only in person; 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 fail to comply with them with criminal, civil, and professional penalties.

Congress delegated authority to the FDA to scrutinize the use of mifepristone, which the agency approved in 2000 to terminate 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.

His order appears to mean that patients in North Carolina can now receive the pills at pharmacies — prescribed by someone like a nurse practitioner or physician assistant or via telehealth — and take them at home, in accordance with FDA rulings.

But Eagles also maintained some disputed restrictions, such as requiring an in-person appointment 72 hours in advance, an in-person exam and an ultrasound before getting a prescription. She said these rules have not been expressly reviewed and rejected by the FDA or focus more on the practice of medicine or the patient’s overall health.

Dr. Amy Bryant, who provides abortions and raised this legal challenge last year said in a prepared statement that the permanent injunction “will allow for greater access to safe and effective medication abortion care throughout North Carolina.”

Contested regulations on medical abortion are in a law of 2023 enacted by the Republican-controlled General Assembly that carried forward or expanded many previous restrictions on abortion. One change reduced the time frame for most abortions from 20 weeks of pregnancy to 12 weeks.

Tami Fitzgerald, executive director of the conservative North Carolina Values ​​Coalition, said Tuesday that the decision “lowers the standard of care for women.” She also criticized the order to block a state requirement that “non-fatal adverse events” related to mifepristone be reported to the FDA, saying it would hide “dangerous complications and side effects of abortion medications.”

Democratic Attorney General Josh Stein, an abortion rights advocate who is now running for governor, did not defend the restrictions in court because he has already stated that they were prevented by the FDA’s decisions. He blamed Republican lawmakers 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 Leader Phil Berger, who joined the case to defend the laws, did not immediately respond Tuesday to an email seeking comment. They could appeal the Eagles’ order. An upcoming ruling in a separate U.S. Supreme Court case brought by anti-abortion doctors who want judges to restrict access to mifepristone could affect the results of litigation in North Carolina.