Federal Appeals Court Orders Nationwide Restrictions on Common Medication for Abortion and Miscarriage Care

NEW YORK — The American Civil Liberties Union (ACLU), the National Center for Youth Law (NCYL), and the New York Civil Liberties Union filed a lawsuit today to demand transparency from the Trump administration regarding its treatment of pregnant unaccompanied immigrant youth in federal immigration custody. The lawsuit seeks to enforce the ACLU and NCYL’s February 2025 Freedom of Information Act (FOIA) request for records and correspondence from the Office of Refugee Resettlement (ORR), which oversees the care and custody of unaccompanied immigrant youth until they are placed with a sponsor, usually a family member, in the United States. The release of this information is important to monitor whether the Trump administration is ensuring that these marginalized young people have access to the full range of pregnancy-related care while in government custody, as is required by law. “When a pregnant young person needs abortion care, every moment counts,” said Chelsea Tejada, staff attorney with the ACLU Reproductive Freedom Project. “We demand transparency from the Trump administration about these marginalized young people’s access to reproductive health care. Unaccompanied immigrant youth must have access to the full range of pregnancy care, including abortion — and if the Trump administration is making it harder for young people to get that care, please report it by calling us at 212-549-2633, and we will hold them accountable.” “Cuando una joven embarazada necesita un aborto, cada momento cuenta,” dijo Chelsea Tejada, una abogada con el Proyecto de Libertad Reproductiva de la ACLU. “Exigimos transparencia de la administración Trump sobre su tratamiento de menores embarazadas no acompañadas en albergues federales de inmigración y su acceso al aborto. Bajo la ley, estas jóvenes deben tener acceso a todos los servicios de salud reproductiva, incluyendo el aborto. Si conoce a una menor de edad embarazada que necesita ayuda en acceder a estos servicios mientras está bajo custodia federal de inmigración, llámenos al 212-549-2633.” In 2017, the first Trump administration implemented a policy — which the ACLU successfully challenged — outright denying pregnant unaccompanied youth access to abortion care. Building off the settlement in the ACLU’s case, the Biden administration instituted policies and issued regulations requiring ORR to prioritize placing pregnant youth in states without abortion bans to ensure access to miscarriage treatment and abortion care. If a minor is placed in a state with an abortion ban, and she requests an abortion, she must be transported to a state where abortion is legal. But the current Trump administration has announced that it intends to change the current ORR regulations regarding abortion access for unaccompanied immigrant youth. Immigration and reproductive rights advocates are concerned that the Trump administration will either try to impose a de facto or outright ban on abortion. “Transparency regarding the treatment of unaccompanied youth in federal immigration custody is critical to ensuring these vulnerable young people’s rights are protected,” said Mishan Wroe, Directing Attorney at the National Center for Youth Law. “All youth deserve access to comprehensive medical care, including those who are detained by our government.” “The government must provide every young person in ORR custody access to comprehensive reproductive healthcare — but right now, the Trump administration is keeping us in the dark about whether or not they’re upholding that obligation,” said Anya Weinstock, Richard Feldman Legal Fellow at the NYCLU. “As the Trump administration continues to escalate its aggressive attacks on immigrant families and youth, we need transparency to ensure every young person’s rights are protected.” Unaccompanied immigrant youth come to the United States without their parents, often fleeing violence or abuse in their home country. They usually have family in the United States who they are seeking to be reunited with. But until then, they are placed in shelters overseen by ORR. Some young people first learn that they are pregnant when they receive an initial medical exam at the shelter. Given the high rates of sexual assault on the journey to the U.S., some of these young people are pregnant as a result of violence. The FOIA seeks all records from the Department of Health and Human Services (HHS) and its associated agencies, the Administration for Children and Families (ACF) and ORR, from January 2023 to the present regarding the federal government’s treatment of unaccompanied pregnant youth, including documentation of handling requests for and ensuring access to all manner of pregnancy-related care, such as abortion, pre-natal care, and childbirth. The FOIA request and complaint are just the latest in the ACLU’s long effort to ensure that unaccompanied immigrant youth have access to abortion and pregnancy care. In its 2017 class action lawsuit Garza v. Hargan, the ACLU successfully sued the first Trump administration on behalf of a then 17-year-old Central American immigrant, Jane Doe, who had been prevented from accessing abortion care. Jane bravely fought not only for her own reproductive freedom, but that of hundreds of other young people subjected to this dangerous policy. Today’s ORR regulations and policies regarding access to reproductive healthcare are built upon the ACLU’s 2020 settlement in the case. In the years since Garza was settled, the ACLU and NCYL have continued to seek transparency from federal officials, including since President Trump began his second term.

The American Civil Liberties Union (ACLU), the National Center for Youth Law (NCYL), and the New York Civil Liberties Union filed a lawsuit to demand transparency from the Trump administration regarding its treatment of pregnant unaccompanied immigrant youth in federal immigration custody. The lawsuit seeks to enforce the ACLU and NCYL’s February 2025 Freedom of Information Act (FOIA) request for records and correspondence from the Office of Refugee Resettlement (ORR), which oversees the care and custody of unaccompanied immigrant youth until they are placed with a sponsor, usually a family member in the United States. The release of this information is important to monitor whether the Trump administration is ensuring that these marginalized young people have access to the full range of pregnancy-related care while in government custody, as is required by law.

LAFAYETTE, La. — A federal court today paused a lawsuit, Louisiana v. U.S. Food and Drug Administration (FDA), that seeks to make it harder for people nationwide to get medication abortion by restricting access to mifepristone, a medication used in nearly two-thirds of U.S. abortions as well as for miscarriage care. The court put the litigation on hold to allow the Trump administration to move forward with its own review of the medication based on discredited anti-abortion propaganda. The Trump administration’s review appears designed to lay the groundwork for additional restrictions on the safe and effective medication. The restrictions that could result threaten to push a medication that millions of patients have safely used for more than 25 years further out of reach, even in states where abortion is legally protected. The court ordered FDA to provide a report on the status of its review by October 7, 2026. “Putting this baseless case on hold is certainly a better outcome than what Louisiana asked for: severe and immediate restrictions on mifepristone that would upend abortion and miscarriage care across the country,” said Julia Kaye, senior staff attorney for the Reproductive Freedom Project of the American Civil Liberties Union (ACLU). “But it is small comfort that the Trump administration now holds the baton in this ongoing attack on medication abortion when we can see the administration teeing up the same harmful restrictions that abortion opponents are trying to win in court. The Trump administration is moving forward with an FDA review designed to manufacture an excuse for further restricting medication abortion across the country. If the Trump administration limits access to mifepristone, it would fly in the face of science and break President Trump’s campaign promises not to impose new federal restrictions on abortion, which Americans overwhelmingly oppose.” In pausing the litigation, the court declined Louisiana’s request that it force the FDA to immediately end patients’ ability to fill a prescription for mifepristone by mail or at a local pharmacy after being evaluated and counseled by a health care provider through telemedicine. Today, more than 1 in 4 people in the U.S. who have an abortion do so using telemedicine. Without this method of care delivery, patients using mifepristone would be forced to travel, sometimes hundreds of miles, to a health center just to pick up a pill, a requirement that leading medical authorities agree has no safety benefit. For some patients — especially people with low incomes, those living in rural areas, people with disabilities, younger people, and survivors of domestic violence — traveling to a clinic is an added barrier that can prevent them from getting an abortion altogether. While the Louisiana case has been paused, two other legal challenges to mifepristone access brought by anti-abortion state attorneys general remain pending. Despite abundant proof that mifepristone has been safely used by millions of patients over 25 years — and that people nationwide support access to medication abortion — anti-abortion politicians and groups continue to push for restrictions based on anti-abortion propaganda. The Trump administration’s review was prompted by a self-published paper from a Project 2025 sponsor that distorts mifepristone’s excellent safety record and has been widely debunked by expert researchers. Despite the paper’s lack of peer review, lack of transparency, and grossly flawed methodology, Health and Human Services Secretary Kennedy has doubled down on the publication’s importance. Secretary Kennedy also stated that changes to the FDA’s mifepristone regulations would “ultimately go through the White House, through President Trump.”

MONTGOMERY, Ala. — A group of Alabama midwives and birth centers have asked the Supreme Court of Alabama to review a January 2026 state appellate court decision that would allow the Alabama Department of Public Health (ADPH) to require birth centers to obtain burdensome and unnecessary licenses as “hospitals.” The appeals court decision could make it effectively impossible for birth centers to continue operating, despite evidence that these independent facilities safely provide much-needed midwifery care to low-risk pregnant patients in a homelike setting. If the Alabama Supreme Court decides to hear this case and sets aside the appellate decision, it would permanently protect the ability of freestanding birth centers across the state to continue providing essential midwifery care to their communities. Amid the state’s maternal and infant health crisis — which disproportionately impacts Black women and families, Alabamians with low incomes, rural communities, and others impacted by widespread maternity care deserts — birth centers play a critical role in expanding access to pregnancy-related care. Evidence shows that the midwifery care provided at birth centers is safe and improves patient outcomes, including by reducing preterm births, unnecessary cesarean sections, and health disparities. “The care we provide at birth centers not only improves pregnant Alabamians’ outcomes — it changes their lives,” said Dr. Yashica Robinson, founder of the Alabama Birth Center. “Being able to get pregnancy care in their own communities, in a home-like setting, makes a world of difference — especially for Black Alabamians, who are more likely to experience complications and be disempowered as the result of medical racism. With Alabama facing a serious maternal and infant health crisis that is disproportionately affecting Black Alabamians, those with low incomes, and rural communities, the support birth centers provide our communities is more important than ever.” “My patients choose midwifery care because of the comprehensive support we provide throughout pregnancy,” said Jo Crawford, CPM, and staff midwife at Oasis Family Birthing Center. “I have seen first-hand how midwife-led care empowers birthing mothers, giving them control over their care and ensuring that they can deliver safely. It is essential that we continue to be able to provide this care to pregnant Alabamians.” Plaintiff Oasis Family Birthing Center in Birmingham, Alabama’s first freestanding birth center, first opened and began safely providing essential care for pregnant Alabamians in 2022. Additional birth centers, including Plaintiff Alabama Birth Center in Huntsville, have also opened since an Alabama state trial court first blocked the Alabama Department of Public Health’s attempt to restrict access to birth center-provided care at an earlier stage in this case. These birth centers will be able to continue providing care while this case continues on appeal. “Birth centers are essential for Alabama women and families, and we remain steadfast in fighting for them,” said Whitney White, staff attorney with the ACLU Reproductive Freedom Project. “Pregnant Alabamians should be able to access evidence-based midwifery care in birth centers, without burdensome, unnecessary interference from the state. Birth isn’t one-size-fits-all. Alabamians deserve to be able to access the model of care that serves their needs and their families best. We hope that the Alabama Supreme Court will recognize how crucial birth centers are and protect Alabamians’ ability to continue receiving this essential care in their communities.” “Alabama’s maternity care desert is growing larger every year, and no family should have to worry about whether they can find the care they need during pregnancy and through birth in the manner in which they desire,” said JaTaune Bosby Gilchrist, the ACLU of Alabama’s executive director. “We are hopeful that the Alabama Supreme Court will ensure that families will continue to have healthcare options throughout our state.” The lawsuit, Oasis Family Birthing Center et. al. v. Alabama Department of Public Health, was originally filed in the Fifteenth Judicial Circuit Court in Montgomery in August 2023. The plaintiffs – Oasis Family Birthing Center in Birmingham, Heather Skanes, M.D., Alabama Birth Center in Huntsville, Yashica Robinson, M.D., the Alabama affiliate of the American College of Nurse-Midwives, Jo Crawford, CPM, and Tracie Stone, CPM – are represented by the American Civil Liberties Union, the ACLU of Alabama, Covington & Burling LLP, and Bobby Segall of Copeland Franco.