Judge rules some North Carolina abortion pill restrictions unlawful

A judge ruled Tuesday that some of North Carolina's restrictions on the distribution of abortion pills are unlawful, citing arguments over the drug mifepristone that bypassed federal regulators.

In her order, U.S. District Judge Catherine Eagles in Greensboro granted the plaintiff, a physician who sued the state over the regulations, a partial victory, for concerns around the pill that were not addressed by the Food and Drug Administration, The Associated Press reported.

Some restrictions on the drug that have not been expressly reviewed and rejected by the FDA, such as requiring an in-person consultation 72 hours before an abortion; an in-person examination, and an ultrasound before prescribing the drug, are allowed to remain in the state, Eagles wrote.  

The judge noted that the state-level laws also hinder Congress from creating a federal regulation for mifepristone.

“The Court finds and concludes that to the extent North Carolina law imposes safety restrictions on the distribution of the drug that the FDA has implemented and then later affirmatively rejected and removed, those laws frustrate the congressional goal of establishing a comprehensive regulatory framework under which the FDA determines conditions for safe drug distribution that do not create unnecessary burdens on the health care system or patient access,” Eagles wrote.

The lawsuit was filed on Jan. 25, 2023, by Dr. Amy Bryant, alleging that it was unconstitutional for North Carolina's government to impose regulations on medication abortion because the federal government already had through the FDA.

Following Eagles’ ruling, Bryant released a statement that said she was pleased the judge recognized the state can’t impose all restrictions on the FDA-approved medication.

Bryant said the state’s restrictions “second-guess or interfere with the FDA’s expert judgment, and that many of North Carolina’s restrictions on mifepristone are preempted — including requirements that mifepristone be prescribed, dispensed, and administered in person,” and the mandatory in-person follow-up appointments and laws that restrict nurse practitioners from prescribing the drug.

“We are carefully reviewing the ruling and the implications it has for providing care to patients in North Carolina,” she wrote.

North Carolina Attorney General Josh Stein (D), a gubernatorial candidate who has supported abortion access throughout his campaign, was named a legal party in the case. He blamed GOP legislators who enacted the law for making it “harder for women, especially in rural North Carolina, to get medication abortion,” per the AP.

The ruling is the latest in efforts to target abortion rights after Roe v. Wade was overturned by the Supreme Court in June 2022 — ending a federal right to abortion access. North Carolina's Republican-led General Assembly enacted new laws in 2023 that moved the ban on abortions from 20 weeks of pregnancy down to 12 weeks.

Restrictions were also placed on medication abortions and violating some rules could result in criminal, civil and professional penalties, the AP noted.

The FDA approved mifepristone in 2000 as a drug that could end pregnancy, when used with a second drug, misoprostol. The FDA announced in 2021 that women would be able to get the drug via an online consultation and through the mail, but the Supreme Court heard arguments in March for advocates who want to further restrict the drug.