A three-judge panel of the 4th U.S. Circuit Court of Appeals in Richmond, Virginia, affirmed a ruling by a U.S. district judge in 2023 despite federal regulators' approval of the abortion pill as a safe and effective medication.

A federal appeals court has ruled that West Virginia can limit access to mifepristone, a medication used to end early pregnancies.

West Virginia enacted a law prohibiting abortion in most circumstances. The question before us is whether certain federal standards regulating the distribution of the abortion drug mifepristone preempt the West Virginia law as it applies to medication abortions. The district court determined there was no preemption, and we now do the same.