Over 40,000 women in states with abortion restrictions have accessed abortion medication from providers in other states via telehealth appointments, according to a study published on Tuesday.
According to the Society of Family Planning, a pro-abortion-rights organization, 19% of all abortions in the United States in December 2023 were conducted via telehealth appointments, during which a physician would prescribe abortion pills to be sent to the patient via mail.
Even in states that have banned or strictly regulated abortion, including telehealth abortion consultation, patients have been able to seek abortions via telehealth from providers in states that have so-called shield laws, which are designed to protect healthcare providers from prosecution in states where the procedure is banned.
Within the study period of July to December 2023, shield laws were active in five states, including Colorado, Massachusetts, New York, Washington, and Vermont. These laws allow telehealthcare providers to facilitate abortion procedures in any state regardless of the laws in the patient’s state.
The study found that providers operating under the protection of shield laws conducted an average of 5,800 telehealth abortions per month in states with near-total abortion bans or bans on abortion after six weeks gestation.
An additional 2,000 abortions per month were facilitated by shielded telehealthcare providers in states with explicit restrictions on telehealth abortions.
The Society of Family Planning has been measuring access to telehealth abortion care under the #WeCount initiative since the Dobbs v. Jackson Women’s Health Organization decision overturned federal constitutional protections for abortion in June 2022.
Telehealth abortions are exclusively medication abortions shipped to patients directly via the mail.
Medication abortion involves a two-step medication process. The first medication, mifepristone, essentially cuts off the nutrient supply to the developing fetus in the womb by blocking the pregnancy hormone progesterone. The second medication, misoprostol, administered 24-48 hours after mifepristone induces contractions to expel the remaining pregnancy tissue.
The Guttmacher Institute, a pro-abortion-rights research organization, also says that over 63% of the over 642,000 abortions in 2023 in the U.S. were medication abortions, up 10 percentage points from 2020.
Excluding states with abortion bans, the #WeCount report found an average of 86,000 abortions occurred each month in 2023, nearly 4,000 more than the average monthly count in 2022.
“Even as the total national number of abortions nationally has increased, we can’t lose sight of the fact that access to in-person abortion care has virtually disappeared in states where abortion is banned,” said Alison Norris, a #WeCount co-chair and a professor at the Ohio State University College of Public Health.
Although in-clinic providers also dispense medication abortion, Norris and her co-chair from the University of California, San Francisco, Ushma Upadhya, argue that telehealth access is important for states with abortion bans as well as rural communities with limited access to healthcare resources generally.
“Access to medication abortion through telehealth continues to play an ever-increasing role in abortion care nationwide — even as the Supreme Court weighs the fate of telehealth abortion care,” Upadhya said. “The need for abortion care across the country demands that providers, advocates, and lawmakers continue to come together to innovate new strategies to help people access abortion care.”
Mifepristone has come under increased legal scrutiny in the past year after anti-abortion doctors sued in federal court to overturn the Food and Drug Administration’s approval of the drug and subsequent deregulation of the substance that allowed it to be mailed directly to patients without in-person screenings.
Tessa Longbons Cox, senior research associate for the anti-abortion Charlotte Lozier Institute told the Washington Examiner that the #WeCount data “highlights a concerning trend.”
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“Nationally, extreme policies are boosting abortion rates, including a sharp increase in dangerous mail-order abortion drugs in violation of pro-life state laws,” Cox said. “By recklessly removing in-person medical visits and giving abortionists immunity through shield laws, abortion advocates have put women’s health and safety last.”
The Supreme Court heard oral arguments on the FDA’s deregulation of mifepristone in March and is expected to rule on the fate of the pill by June.
