Survey finds 8,000 women a month got abortion pills despite their states' bans or restrictions


Thousands of women in states with abortion bans and restrictions are receiving abortion pills in the mail from states that have laws protecting prescribers, a new report shows.

Tuesday’s release of the survey shows about 8,000 women a month in states that severely restrict abortion or place limits on having one through telehealth were getting the pills by mail by the end of 2023, the first time a number has been put on how often the medical system workaround is being used. The research was conducted by a group which supports abortion rights.

Another 8,000 women in states without bans or major restrictions on telehealth abortion were receiving pills each month through virtual appointments, the study showed.

In all, the survey counted about 90,000 monthly surgical or medication abortions offered by medical providers in 2023, higher than the previous year. Another study recently found that close to two-thirds of the total use pills.

The group found that by December 2023, providers in states with the protections were prescribing pills to about 6,000 women a month in states where abortion was banned at all stages of pregnancy or once cardiac activity can be detected — about six weeks, often before women realize they're pregnant. The prescriptions also were going to about 2,000 women a month in states where the local laws limit abortion pill prescriptions by telemedicine.

“People ... are using the various mechanisms to get pills that are out there,” Drexel University law professor David Cohen said. 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 a combination two drugs: mifepristone and misoprostol. The rise of these pills is one reason total abortion numbers increased even after the Supreme Court overturned Roe v. Wade in 2022.

After Roe was overturned, abortion bans took effect in most Republican-controlled states. Fourteen states now prohibit it with few exceptions, while three others bar it after about six weeks of pregnancy.

But many Democratic-controlled states went the opposite way. They've adopted laws intended to protect people in their states from investigations involving abortion-related crimes by authorities in other states. By the end of last year, five of those states — Colorado, Massachusetts, New York, Vermont and Washington — had such protections in place specifically to cover abortion pill prescriptions by 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 said. “Colorado says: ‘The care that was provided in our state was legal. It follows our laws because the provider was in our state.’”

James Bopp Jr., general counsel for the National Right to Life Committee, said 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.

But unlike many other aspects of abortion policy, this issue hasn't been tested in court yet.

Bopp said that the only way to challenge a shield law in court would be for a prosecutor in a state with a ban to charge an out-of-state prescriber with providing an illegal abortion.

“It’ll probably occur, and we’ll get a legal challenge,” Bopp said.