Thousands of women in states with abortion bans and restrictions are receiving abortion pills through the mail from states with laws protecting prescribers, according to a new report.
The #WeCount survey, released Tuesday, shows that by the end of 2023, around 8,000 women per month in states with severe abortion restrictions or telehealth limitations were getting abortion pills by mail. This marks the first time a number has been quantified for this medical workaround. The research was conducted by the Society of Family Planning, which supports abortion rights.
Additionally, the survey found that another 8,000 women per month in states without such bans or major restrictions were obtaining pills through virtual appointments.
Overall, the survey recorded approximately 90,000 monthly surgical or medication abortions provided by medical professionals in 2023, a higher figure than the previous year. Another study found that nearly two-thirds of these procedures involved the use of pills.
The group discovered that by December 2023, providers in protective states were prescribing pills to about 6,000 women a month in states where abortion was banned at all stages or after cardiac activity detection — roughly six weeks into pregnancy. Another 2,000 women per month in states with telemedicine abortion pill restrictions were also receiving prescriptions.
“People … are using the various mechanisms to get pills that are out there,” said Drexel University law professor David Cohen. This “is not surprising based on what we know throughout human history and across the world: People will find a way to terminate pregnancies they don’t want.”
Medication abortions typically involve two drugs: mifepristone and misoprostol. The increase in the use of these pills is one reason the total number of abortions rose even after the Supreme Court overturned Roe v. Wade in 2022.
A Pew Research Center poll conducted in April 2023 found that Americans are more likely to support medication abortion being legal in their state than illegal. According to the poll, more than half of U.S. adults believe medication abortion should be legal, about a fifth think it should be illegal, and roughly a quarter are unsure.
Following the Roe decision, abortion bans were enacted in most Republican-controlled states. Currently, 14 states prohibit abortion with few exceptions, while three others ban it after about six weeks of pregnancy.
Conversely, many Democratic-controlled states have enacted laws to protect individuals from investigations related to abortion crimes in other states. By the end of last year, five states — Colorado, Massachusetts, New York, Vermont, and Washington — had such protections specifically for abortion pill prescriptions via telemedicine.
“If a Colorado provider provides telehealth care to a patient who’s in Texas, Colorado will not participate in any Texas criminal action or civil lawsuit,” Cohen explained. “Colorado says: ‘The care that was provided in our state was legal. It follows our laws because the provider was in our state.’”
Wendy Stark, president and CEO of Planned Parenthood of Greater New York, described the state’s shield law as “a critical win for abortion access in our state.”
James Bopp Jr., general counsel for the National Right to Life Committee, argued that the law where the abortion takes place — not where the prescriber is located — should apply in pill-by-telemedicine abortions. “That’s the way it is with other laws,” he said.
However, this aspect of abortion policy has not yet been tested in court. Bopp suggested that a prosecutor in a state with a ban could charge an out-of-state prescriber with providing an illegal abortion to challenge a shield law.
Researchers note that before the shield laws, people were obtaining abortion pills from sources outside the formal medical system, though exact numbers are unclear.
Alison Norris, an epidemiologist at Ohio State University and lead researcher on the #WeCount report, stated the group is not breaking down the number of pills shipped to each state with a ban “to maintain the highest level of protection for individuals receiving that care and providers providing that care.”
Dr. Rebecca Gomperts, director of Aid Access, an abortion pill supplier working with U.S. providers, emphasized the importance of shield laws for the resilience of the healthcare system. “They’re extremely important because they make doctors and providers … feel safe and protected,” she said. “I hope what we will see in the end is that all the states that are not banning abortion will adopt shield laws.”
