A federal appeals court packed with conservatives has handed abortion opponents a major victory against the US Food and Drug Administration, reinstating an in-person dispensing requirement for the abortion medication mifepristone and shutting down telemedicine providers—at least temporarily—from prescribing the abortion pill across the US.

In a 3-0 order issued Friday afternoon, the Fifth Circuit Court of Appeals granted Louisiana’s request for an injunction against FDA rule changes from 2023 that have allowed blue-state telehealth providers to send mifepristone to thousands of patients every month in states where abortion is banned. Abortion pills now account for almost two-thirds of abortions nationwide, and more than a quarter of abortions occur via telemedicine.

The injunction does not affect misoprostol, the second medication used with mifepristone under the FDA-approved protocol—and a powerful abortion drug on its own. Nor does it stop in-person prescription of abortion pills. Nonetheless, the greatest impact will likely be felt by women in the dozen or so states—many in the South—where lawmakers and attorneys general have sought to end abortion access completely.

For women of color and immigrants, “medication abortion by mail is one of the few ways people can overcome systemic barriers to care,” said Lupe Rodríguez, executive director of the National Latina Institute for Reproductive Justice. “Taking it away is deliberate and dangerous and puts politics over the health and well-being of our communities.”