A federal appeals court will reopen consideration of a North Carolina lawsuit that has left state regulations on mifepristone, a drug used in medication abortions, on hold for nearly two years.
The 4th U.S. Circuit Court of Appeals ruled Tuesday that attorneys could file new motions in the case, known as Bryant v. Moore, which has been on hiatus since December 2024.
The case arrived at the appeals court in June 2024, after U.S. District Court Judge Catherine Eagles struck down parts of the North Carolina law restricting mifepristone, including a requirement that only physicians could prescribe the pill.
Both supporters and opponents of North Carolina’s abortion restrictions said in 2024 that Eagles had erred in blocking some, but not all, of the provisions of Senate Bill 20 concerning mifepristone.
North Carolina abortion pill restrictions struck down by federal judge
Republican legislative leaders first appealed, seeking to lift the district court’s order striking down some elements of the law. Attorneys for former House Speaker U.S. Rep. Tim Moore (R-N.C.) and state Senate President Pro Tem Phil Berger (R-Rockingham) argued that blocking the state from setting its own restrictions could have “devastating effects on real people.”
“[The district court’s ruling] puts in jeopardy not only North Carolina’s commonsense safety requirements for abortion drugs but also any state law that imposes a ‘safety-related’ protection on particularly high-risk drugs,” lawyers for Moore and Berger wrote in their 2024 opening brief.
The plaintiff in the case, Hillsborough OB-GYN Amy Bryant, also appealed the case in hopes of lifting the remaining restrictions. Those barriers, her attorneys argued in their 2024 brief, were “expressly considered and rejected” by the FDA.
“The court erred by holding that some of the challenged restrictions are not preempted because they are not ‘directed to the risks of mifepristone’ but instead relate to ‘broader health issues,’” her attorneys wrote.
Neither the attorneys for the Republican lawmakers nor Bryant’s attorneys responded to a request for comment on the case moving forward.
The appeals have been on hold while the 4th Circuit considered a separate case blocking mifepristone access in West Virginia under the state’s near-total abortion ban. That case was resolved in July 2025, when the 4th Circuit upheld West Virginia’s restrictions on mifepristone, ruling that FDA regulations do not supersede a state’s right to ban abortion at large.
In that case, 4th Circuit Judge J. Harvie Wilkinson wrote in his opinion that allowing mifepristone as a means to circumvent West Virginia’s abortion ban would undermine the Supreme Court’s intent in Dobbs v. Jackson. “For us to once again federalize the issue of abortion without a clear directive from Congress, right on the heels of Dobbs, would leave us one small step short of defiance.”
North Carolina Senate leader Phil Berger (R-Rockingham) speaks to reporters on Oct. 20, 2025. (Photo: Galen Bacharier/NC Newsline)Bryant v. Moore is one of a dozen ongoing cases relating to mifepristone, one of the most hotly contested abortion policy issues in the wake of the Dobbs v. Jackson decision.
In a March 26 motion, attorneys for Moore and Berger asked the 4th Circuit to allow supplemental briefs addressing the West Virginia decision so the North Carolina case may move forward.
Abortion opponents have taken the West Virginia decision as a signal that higher courts are open to state restrictions on mifepristone, while advocates say the courts may still oppose state restrictions that directly contradict the Food and Drug Administration’s Risk Evaluation and Mitigation Strategies policies.
Susanna Birdsong serves as general counsel for Planned Parenthood South Atlantic, which has no involvement in the case. She said state lawmakers may feel “energized” by the West Virginia decision, leading them to push to continue the Bryant case now.
But she says there are “key differences” between the two laws being challenged — namely, that North Carolina’s law seeks to regulate mifepristone, not ban it, so the FDA’s drug safety guidance is more likely to prevail in the North Carolina case.
Supporters of reproductive rights protested outside the U.S. Supreme Court on Tuesday, March 26, 2024, as justices heard oral arguments over access to mifepristone, one of two pharmaceuticals used in medication abortion. (Photo: Ashley Murray/States Newsroom)“The North Carolina case is really a finer kind of overlay of looking at these specific restrictions in North Carolina law,” Birdsong said. “We’re not talking about a total ban on access. We’re talking about specific limitations or restrictions in North Carolina law that are in direct conflict with things that the FDA has studied.”
The 2024 ruling kept in place requirements for an in-person exam and consent visit, as well as a 72-hour wait period before the pill can be prescribed. But it continued to allow any health care provider to prescribe mifepristone and to do so via telehealth in accordance with FDA policy, making it possible for a patient to avoid having to make a second in-person visit to an abortion provider.
“In the same way that telehealth has revolutionized access to health care, it has also revolutionized access to medication abortion care,” Birdsong said. “If you have to travel a farther distance, if you have to figure out child care and time off work for two appointments versus one, that can be an insurmountable burden for some folks.”
Parties in the Bryant v. Moore case will have until April 27 to file supplemental briefs on how the ruling in the West Virginia case changes how the court should view the North Carolina lawsuit.
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