A federal judge has rejected the Trump administration’s effort to reinstate rules requiring women seeking abortion medication to visit a doctor’s office or clinic in person during the coronavirus pandemic.

U.S. District Judge Theodore D. Chuang in Maryland said the health risks have “only gotten worse” since he first blocked restrictions in the summer in response to concerns about exposure to the coronavirus.

Requiring an in-person visit to a medical facility to obtain the drugs needed to induce abortion, Chuang said, is unduly burdensome. He initially issued a nationwide injunction against the Food and Drug Administration rule in July, and stood behind his earlier decision this week.

“While the progress on vaccines and medical treatments for COVID-19 are cause for optimism and may advance the day that the Preliminary Injunction will no longer be warranted, the impact of these advances to date has not meaningfully altered the current health risks and obstacles to women seeking medication abortions,” he wrote in a 34-page opinion issued Wednesday.

The Supreme Court in October turned down the Trump administration’s request to reimpose the rule but sent the case back to Chuang to quickly consider the government’s request to “dissolve, modify, or stay the injunction, including on the ground that relevant circumstances have changed.”

In his ruling Wednesday, Chuang emphasized that coronavirus infection rates have only increased since the summer. States throughout the country are imposing more stringent public health measures, he wrote, and there are persistent barriers to in-person visits, such as child care and transportation.

“Where abortion patients in the United States are disproportionately low-income and women of color, the ongoing health risks from exposure to COVID-19 are even more pronounced,” he wrote.

Chuang also noted that the government has lifted restrictions for mandatory in-person visits for patients seeking other drugs, including certain controlled substances such as opioids.

Chuang’s order came in response to a request from the American College of Obstetricians and Gynecologists. Medical providers, represented by the American Civil Liberties Union, told the court there was no reason for an in-person visit.

Medication abortions require taking two drugs, mifepristone and misoprostol, up to 10 weeks into a pregnancy. They have been in use since 2000, and in 2016, the FDA eliminated the requirement that the first drug be administered in a hospital, clinic or doctor’s office. FDA experts said it was just as safe for a woman to take the medications at home.

“With rising COVID-19 infections, hospitalizations, and deaths in New York and across the country, it is critical that the in-person dispensing requirement stays blocked — and we are gratified that the court agreed,” Jason Matuszak, president of the New York State Academy of Family Physicians, said in a statement.

“Health care providers are making heroic efforts to provide the safest possible care to our patients at this unprecedented time, and the federal government should be making our jobs easier, not harder,” he said.

The government told the court that its views on how the drugs should be dispensed has not changed. Government lawyers said the burdens facing abortion patients during the pandemic, such as the increased health risks associated with travel to medical facilities, and child-care and transportation challenges have “either been mitigated or resolved.”

The Justice Department did not immediately respond to a request for comment on the ruling.

A three-judge panel of the U.S. Court of Appeals for the 4th Circuit refused to block Chuang’s earlier order.

At the Supreme Court, Chuang’s earlier ruling drew criticism from two of the court’s conservatives. Justice Samuel A. Alito Jr., joined by Justice Clarence Thomas, said the court’s action to lift restrictions on abortion access could not be squared with restrictions on other activities such as religious gatherings.

“While Covid-19 has provided the ground for restrictions on First Amendment rights, the District Court saw the pandemic as a ground for expanding the abortion right recognized in Roe v. Wade,” Alito wrote.

Robert Barnes contributed to this report.