A federal appeals court on Friday blocked the mailing of mifepristone prescriptions, sharply curtailing access to one of the most common methods of abortion in the United States.

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The unanimous ruling by a three-judge panel of the Fifth U.S. Circuit Court of Appeals requires the abortion pill to be dispensed only in person at clinics, overruling Food and Drug Administration regulations that allowed it to be distributed by mail.

Judge Kyle Duncan wrote that mailing the drug into Louisiana undermines the state’s abortion ban. Danco Laboratories, the manufacturer of mifepristone, has appealed to the U.S. Supreme Court to overturn the decision. The Supreme Court unanimously ruled against an attempt by pro-life groups to restrict access to mifepristone in 2024, but the decision was on technical grounds that left the door open to future attempts to limit the drug’s distribution.

Surveys show that mifepristone is the most common method of abortion in the U.S., with many women receiving prescriptions via telehealth.