Federal Court Pauses Case Seeking to Restrict Abortion and Miscarriage Medication

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.

WASHINGTON — The American Civil Liberties Union (ACLU) and National Center for Youth Law (NCYL) filed a Freedom of Information Act (FOIA) request today seeking information regarding the Trump administration’s treatment of pregnant unaccompanied minors in federal immigration custody. The FOIA seeks transparency from the Trump administration, which has reportedly been sending pregnant minors to government-funded shelters in states with abortion bans despite federal policy that requires the Office of Refugee Resettlement (ORR) to prioritize placement of pregnant youth in states without abortion bans. Furthermore, the Trump administration has announced that it will propose changing a regulation regarding abortion access for unaccompanied immigrant minors. Current regulations and policy require ORR to ensure access to all pregnancy related care, including abortion. 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 regulation, issued in 2022, is 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. “Unaccompanied immigrant youth must be able to access the full range of reproductive health care, including abortion,” said Brigitte Amiri, deputy director of the Reproductive Freedom Project at the ACLU. “The ACLU represented a class of minors in a lawsuit after they were denied abortion access in the first Trump administration. We saw first-hand the importance of the ability of young people to make decisions about their pregnancies, and what it meant for their lives and futures. Our lawsuit led to the current policy, which protects access to crucial reproductive health care for these marginalized young people. Any attempts to restrict abortion access for youth in immigration shelters will be devastating. If any youth in ORR custody is denied access to reproductive health care, they should contact us at 212-549-2633.” Unaccompanied immigrant minors 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. “ORR is responsible for a population of inherently vulnerable minors – minors that the agency has been making more vulnerable by keeping them unnecessarily separated from their families for longer and longer periods of time,” said Mishan Wroe, directing attorney at the National Center for Youth Law. “Given the prolonged detention youth are experiencing, it is more critical than ever that ORR maintain its legal obligations to ensure they have access to reproductive health care while detained.” Current ORR regulations require that pregnant unaccompanied minors be provided with information about and access to reproductive health care, including pregnancy care and abortion. ORR must also prioritize placing minors in shelters where abortion is legal because any pregnant minor could experience miscarriage or complications that require life- or health-saving abortion care. If a minor is in a shelter in a state with an abortion ban and she requests an abortion, ORR must transfer her to state where abortion is legal. But earlier this year, the Trump administration announced that it would cave to the demands of its anti-abortion allies and change this policy. Although the text of the proposed regulation is not yet available, immigration and reproductive rights advocates are concerned that the Trump administration will either try to impose a de facto or outright ban on abortion, similar to what the Trump administration imposed in its first term, and which the ACLU struck down. The FOIA request seeks all records and correspondence from the Department of Health and Human Services (HHS) and its associated agencies, the Administration for Children and Families (ACF) and ORR, from January 2025 to the present regarding the administration’s treatment of unaccompanied pregnant minors, including any policies, procedures, and guidelines followed. The FOIA also requests any records regarding unaccompanied minors who seek information about or access to reproductive health care, including abortion and pregnancy care.

TO: Interested Parties FROM: American Civil Liberties Union DATE: February 24, 2026 SUBJECT: Urging Federal Court to Reject Abortion Opponents’ Efforts to Make it Harder for People to Get Medication Abortion, Preeminent Medical Associations, Former FDA Commissioners, Advocates for Domestic Violence Survivors and People with Disabilities, Reproductive Freedom Organizations, and Other Experts File Suite of Amicus Briefs On Feb. 24, a federal court in Louisiana will hear arguments in a lawsuit, Louisiana v. U.S. Food and Drug Administration (FDA), that threatens to imminently limit nationwide access to mifepristone, a safe and effective medication used in nearly two-thirds of U.S. abortions, as well as for miscarriage care. In a suite of amicus briefs filed in advance of the hearing, a range of experts — including the American College of Obstetricians and Gynecologists and other premier medication associations; nine former FDA Commissioners; the National Domestic Violence Hotline; disability rights advocates; and more than 100 organizations supporting people in need of abortion care — urged the court to deny this attempt to make it harder for people around the country to get medication abortion and miscarriage care. The lawsuit, filed by Louisiana’s attorney general and an individual plaintiff, seeks to end patients’ access to mifepristone through telemedicine — the method by which more than 1 in 4 people who have abortions obtain care today — by reinstating a medically unnecessary and extremely burdensome requirement that all patients travel in person to a health center for the sole purpose of being handed the medication, rather than filling their prescription by mail or at a local pharmacy. The court could rule any time after the Feb. 24 hearing, when it is scheduled to hear both Louisiana’s request for immediate restrictions and the Trump administration’s request to pause the case while it continues a sham FDA review that lays the groundwork for additional nationwide restrictions. The amicus briefs outline how this lawsuit — one of three pending cases brought by anti-abortion state politicians seeking nationwide restrictions on mifepristone — threatens to upend how essential reproductive health care is currently delivered to patients across the country. The briefs describe the wealth of peer-reviewed research over more than 25 years confirming mifepristone’s safety and efficacy, including when prescribed through telemedicine. The briefs also explain how mail and pharmacy access is a lifeline for patients who might otherwise struggle to access abortion and miscarriage care, including survivors of domestic violence, people with disabilities, and those living in rural areas or health care deserts. For some patients, being able to safely get their prescription at home, instead of being forced to travel long distances just to pick up a pill, can be the difference between getting the timely care that they need on the one hand, and, on the other, being forced to continue a pregnancy and have a child, or being forced to endure untreated miscarriage complications. Below are excerpts from key amicus briefs urging the court to deny Louisiana’s request to limit access to mifepristone nationwide: Expert Medical Associations, including the American College of Obstetricians and Gynecologists, the American Academy of Family Physicians, and the Society for Maternal-Fetal Medicine: “Mifepristone—whether dispensed in person or not—is extremely safe. More than two decades, hundreds of medical studies, and vast amounts of data have confirmed mifepristone’s safety and efficacy for abortion care and miscarriage management.” “Preserving access to mifepristone and expanding access to telehealth are both crucial steps to support vulnerable populations who face structural barriers to abortion care, including patients of color, patients of lower incomes, patients who are disabled, and/or patients who are living in rural areas or health care deserts. Telehealth allows such patients to avoid significant costs associated with travel to obtain care (such as transportation, gas, and lodging), childcare expenses, and lost wages—burdens that deter and delay abortion access. Telehealth also reduces delays in obtaining care because it enables patients to avoid long wait times at physical clinics—a particularly urgent concern since Dobbs v. Jackson Women’s Health Organization, as state abortion bans have increased demand for abortion care in many states where abortion remains lawful.” The National Domestic Violence Hotline and Legal Voice: “Restricting access to mifepristone will cause irreparable harm to the many Americans who face IPV [intimate partner violence], need abortions to protect their own health and safety, and face unique barriers to access this time-sensitive care because of the nature of abusive relationships. Abusive partners often exert control and maintain power within the relationship by undermining survivors’ autonomy to make reproductive decisions, limiting access to health care, and forcing pregnancy. Being forced to carry a pregnancy to term for lack of access to abortion care exposes survivors of IPV to a higher likelihood of further violence, poses significant health risks, and increases the chance of being trapped in violent relationships. The consequences of such entrapment range from heightened abuse during pregnancy to death. As difficult as it is for all survivors of IPV to escape abusive relationships and exercise their reproductive autonomy, IPV survivors of color—who already experience disproportionately high rates of unintended pregnancy and increased health risks—face systemic inequities that make doing so even more difficult.” “Reducing abortion access harms survivors. Research has shown a significant increase in IPV rates in areas with limited access to abortion, including Louisiana. Removing telemedicine options is especially harmful to survivors. The availability of telehealth, the ability to fill prescriptions at local pharmacies, and the ability to receive medication by mail are essential to survivors of IPV because these options reduce both the cost of abortion care and the barriers of having to pay for and arrange transportation, childcare, and time off work outside the surveillance of an abuser. Indeed, in-home medication abortion is often a survivor’s only option for abortion care because the survivor must obtain care without the abuser finding out. Having a variety of options for accessing that care—in one’s home via telehealth or from a local provider—helps survivors maintain safety and privacy.” Disability Rights Education and Defense Fund and Other Disability Justice Advocates: “Granting Plaintiffs’ requested relief would deepen the already substantial barriers disabled people face in accessing health care: physical inaccessibility, transportation limitations, financial strain, and entrenched medical bias. For many disabled people, telemedicine access to mifepristone is not mere convenience but a critical safeguard. Disabled people experience heightened rates of reproductive coercion and intimate partner violence, in part because reliance on others for daily assistance can compromise privacy and autonomy. Eliminating remote access would strip away a vital layer of safety and control.” Telehealth Abortion Providers, Sharing Stories From Their Patients, In Their Own Words: “[Patients’] accounts illustrate that without timely access, abortion care may be out of reach for many, and especially for those already navigating complicated demands of work, caregiving, and economic precarity. Telehealth addresses these constraints directly, allowing patients to obtain care quickly, safely, and privately, without sacrificing employment, income, or responsibilities to the families they already support.” “Amici’s patients described the telehealth services they received as ‘lifesaving’” care that provided meaningful intervention and support during moments when they felt scared or vulnerable[:] ‘I would have died if this pregnancy went through. My 3 other kids would be without a mother. Thank you for being there and not judging me.’ ‘You saved my life. I was scared and alone and I didn’t know what to do and I’m grateful to have these services. Without care I’m not sure what would have happened.’” “Beginning with the initial consultation, continuing through real-time support during the process, and extending into comprehensive follow-up care, many patients describe their telehealth abortion experiences as high-quality, trustworthy, and affirming, Patients shared: ‘During a very personal and challenging time, [Telehealth Provider] provided not only expert care but genuine compassion and support. From the first patient intake to the final follow-up, everyone made me feel seen, heard, and safe. The level of professionalism and attention to detail was unmatched. I’m incredibly grateful for their care and would recommend them without hesitation to anyone in need of top-tier medical support. They are so private & easy to work with! I loved it.’ [...] ‘[Telehealth Provider] offered care that felt personal, compassionate, and judgment-free. In a vulnerable moment, they made me feel safe, seen, and supported. Grateful beyond words.’” 100+ Reproductive Health, Rights, and Justice Organizations, including the ACLU Foundation: “Telehealth, which is an increasingly common method of healthcare delivery in general, is now a standard method of care for medication abortion, both in the United States and around the world. ... [T]elehealth care is individually tailored to each patient’s circumstances, with in-person testing or examination ordered when appropriate based on individualized patient screening. Rigorous studies from the past several years resoundingly reinforce that patients can be screened and counseled for medication abortion via telehealth as safely and effectively as in-person screening and dispensing.” “Abortion access saves lives, reduces maternal and infant mortality, narrows racial health disparities, and protects survivors of violence. Telehealth is the mechanism through which millions of patients access that care. Restricting it would not protect anyone; it would cause the gravest harm to those who can least afford it.” Medical Students for Choice: “[R]einstating the in-person dispensing requirement would have a profound impact on medical training and the future of the medical profession nationwide. Future medical professionals rely on learning the best, evidence-based practices to care for patients now and in the future. ... Louisiana’s attempt to impose its political preferences on the medical profession and patients nationwide would erect obstacles in the paths of medical students and undermine medical schools’ ability to provide future medical professionals with evidence-based, patient-centered education. Reinstating the in-person dispensing requirement risks creating gaps in medical education and diminishing the quality of medical care in this country for generations to come.” “Restrictive abortion laws have exacerbated maternal care deserts, including by impacting the choices of where medical students are able and willing to complete their education and training, and later work and reside. ... [S]tates with restrictive abortion laws are experiencing a ‘medical brain drain,’ in which many future physicians are choosing to study, and then practice, out-of-state. Even existing maternal healthcare providers are moving out of states with restrictive abortion laws in part due to fears of legal consequences for providing at times life-saving care, which has detrimental effects on maternal healthcare including for women who want to continue their pregnancies.” Nine Former FDA Commissioners: “If [Louisiana’s] position were adopted, it would upend FDA’s rigorous, well-established system for drug approvals, which relies on voluntary reporting by prescribing physicians for almost all drugs. … The orderly system that Congress and FDA have established would screech to a halt if litigants could weaponize the limitations of [FDA’s adverse-events] data to support successful challenges to drug approvals.” 19 States and the District of Columbia that Protect Access to Abortion Care: “If granted, [Louisiana’s] requested relief would increase costs to amici’s health systems, harm amici’s residents, and undermine amici’s sovereign policy decisions [to protect abortion access]. ... [M]any [amici States] have experienced a steep rise in demand at clinics from out-of-state patients after Dobbs. While providers have endeavored to meet the increased demand, the influx has stretched clinics past their already-strained capacity and has dramatically increased wait times for patients from both within and outside of their States. Eliminating access to medication abortion via telemedicine would deprive amici States of a critical tool in expanding capacity to meet this demand.” “[Removing the in-person dispensing requirement has] been critical to extending access for amici’s residents in rural and underserved communities where barriers to abortion and other forms of healthcare are most acute. The availability of abortion care by telehealth has reduced the impact of many practical and cost barriers that can make it difficult for many people to obtain an abortion—including childcare needs, missed work and resulting lost income, lack of insurance coverage, and travel costs and logistics, all of which increase with distance traveled.” Former Department of Justice Officials: “Adopting [Louisiana’s] erroneous interpretation of the Comstock laws would risk a profound destabilization of medical care. ... [I]t necessarily would affect in-person abortion and a broad range of other kinds of healthcare ... [including because] many abortion-inducing drugs and devices are used for non-abortion-related care. For instance, mifepristone is regularly used to treat miscarriages, and misoprostol is frequently used during labor and delivery.”

COLUMBUS, Ohio — Ohio’s First District Court of Appeals today upheld a trial court ruling permanently blocking Senate Bill 27, a law that requires burial or cremation of fetal and embryonic tissue from procedural abortions. The Hamilton County Court of Common Pleas preliminarily blocked the law in 2021, and issued the permanent injunction in February 2025. Today’s ruling is yet another historic application of the Reproductive Freedom Amendment to the Ohio Constitution, which took effect in December 2023. Per the ruling, “Ohio voters said what they meant. The state may not burden, penalize, or discriminate against those who have an abortion and those who assist them in obtaining one.” “As the court explained, the Reproductive Freedom Amendment protects conduct that occurs before, during, and after a procedural abortion,” said Jessie Hill, cooperating attorney for the ACLU of Ohio. “While this law has not been in effect for years, today’s ruling will allow our clients to focus on providing essential healthcare without further interference from the state. We celebrate this ruling as yet another testament to the power of Ohio’s new Reproductive Freedom Amendment, and the first affirmative interpretation from an appellate court.” “We're pleased that the court upheld the injunction blocking the cruel burial and cremation law,” said Dr. Sharon Liner, medical director for Planned Parenthood Southwest Ohio Region. “Abortion is essential healthcare and this law was nothing more than an opportunity to shame and stigmatize our patients. Our focus remains on the health, safety, and dignity of our patients.” The American Civil Liberties Union, the ACLU of Ohio, Planned Parenthood Federation of America, and Fanon Rucker of The Cochran Firm filed this lawsuit on behalf of Planned Parenthood Southwest Ohio Region, Dr. Sharon Liner, Planned Parenthood of Greater Ohio, Preterm-Cleveland, Women’s Med Group Professional Corporation, Northeast Ohio Women’s Center. The ruling can be found here.