Most Republican-led states will limit access to abortion pills despite the move by federal regulators to lift restrictions permanently on prescribing and accessing the drugs.

The Food and Drug Administration this month updated the terms for regulating the abortion-inducing drug combination mifepristone and misoprostol, approved by the FDA in 2000 under the name Mifeprex, to say that doctors could prescribe pills through telehealth services and send them to patients in the mail. Patients will also be able to pick up the medication from their local pharmacies, increasing access for women who live far away from clinics where they would otherwise have to pick up the medication.

“For too long, patients have had to jump through burdensome hoops just to get medication abortion that we know is safe and effective,” Washington Democratic Sen. Patty Murray said after the FDA's decision.

The newest guidelines from the FDA expand abortion access even as the possibility looms that Roe v. Wade, the 1973 decision legalizing abortions nationwide, will be overturned by the Supreme Court. Though the medication can only be taken within the first 10 weeks of gestation, the new prescribing guidelines make medication abortion in many states more accessible than ever.


The Biden administration had temporarily suspended the in-person dispensing requirement that said women had to see a healthcare provider in person to get the two-pill medication regimen, cutting down on risks of exposure to COVID-19. However, several states have laws on the books to limit access to the drug, and the updated FDA guidance will not hold any weight.

The following states have explicitly banned telehealth visits to prescribe abortion medication in addition to other existing restrictions on dispensing the drug, such as waiting periods.

Arizona: Mifeprex is prohibited from being prescribed via telehealth and sent through the mail. Patients must see a doctor at least 24 hours before receiving the medication, and they cannot take the medications on their own at home. Patients must also be monitored by a healthcare professional during and after the procedure.

Arkansas: The use of telemedicine for abortion medication is banned, and the pills cannot be sent through the mail. The state has also mandated a 72-hour waiting period between abortion counseling from a licensed provider, a requirement usually reserved for surgical abortions. The rule requires women to make several trips to a clinician.

Missouri: Women are barred from being prescribed Mifeprex through telehealth services, and the only place to get it is from the state’s sole abortion provider, Planned Parenthood in St. Louis. That clinic was nearly shuttered last year after a contentious yearlong legal battle in which the state threatened to revoke its license due to health and safety problems uncovered during an inspection. However, Missouri’s Administrative Hearing Commission said in May 2020 that the state was wrong to withhold the clinic's license.

Louisiana: Women cannot get the abortion medication through telemedicine, and a physician must be present in the room when they take it. Democratic Gov. John Bel Edwards, a steadfast ally of the anti-abortion cause, approved a mandate last summer that had abortion providers advise patients of a possible abortion reversal "if after taking the first pill you regret your decision.” The idea that the abortion process could be halted halfway through the process has been disputed by a panel assembled in 2016 by the state department of health.

West Virginia: The use of telemedicine to obtain abortion medication is banned, as is mailing the drugs. The prescribing healthcare provider, who does not have to be a physician as long as he or she is certified to dispense the drug, also has to be in the room with the patient when she takes the medication.


Fifteen other states have not explicitly banned telehealth for abortion access. However, they have mandated that a physician be present when the patient obtains the medication and during the procedure, effectively banning the use of telemedicine to prescribe and dispense the drug. Those states are Alabama, Indiana, Kansas, Kentucky, Mississippi, Nebraska, North Carolina, North Dakota, Oklahoma, South Dakota, South Carolina, Tennessee, Texas, and Wisconsin.