After the Supreme Court overturned Roe v. Wade, the historic 1973 decision that made abortion legal nationwide, many started to speculate about the potential implications for access to abortion pills, which currently account for more than half of all U.S. abortions. While the future of abortion access remains uncertain, here’s what you need to know about obtaining abortion pills through mail.

In December 2021, the Food and Drug Administration (FDA) announced that it would permanently permit Americans to acquire abortion pills via mail. Since the ruling, patients have been able to receive FDA-approved abortion medication, which was originally only obtainable through in-person pick-up, via mail. However, some states have regulations in place that prohibit their residents from receiving abortion pills through mail, regardless of the FDA’s decision.

According to The New York Times, nineteen states currently have restrictions that outlaw the use of telemedicine for abortion medication. Additionally, individuals residing in states that have already banned abortions following the fall of Roe v. Wade or have upcoming “trigger laws” (laws intended to take effect when Roe v. Wade is overturned), which would greatly limit or prohibit all abortions, will not be able to access medication abortions, whether in person or through mail, as reported by NBC News in June 2022.

However, the Justice Department issued a legal opinion on December 23, 2022, stating that the U.S. Postal Service can deliver abortion drugs to all states, as it is not prohibited by the Comstock Act. Under this act, it is legal to send abortion pills by mail if the sender is unaware that the drugs will be used unlawfully, and there are various lawful applications for abortion pills in all states, according to the legal opinion.

This recent decision also applies to other mail carriers like FedEx and the United Parcel Service. However, it is important to note that this ruling solely addresses the legality of sending abortion pills by mail to states with abortion laws governed by the Comstock Act. It does not address the legal status of mailing abortion medication to all states under other federal laws, so it cannot guarantee legal protection.

For many individuals, the FDA’s decision to allow Americans to obtain abortion pills through mail means increased accessibility to Mifeprex (mifepristone), a pill used in conjunction with another medication called misoprostol to terminate an early pregnancy up to 70 days or 10 weeks of gestation.

when it has been 70 days or fewer since the initial day of the previous menstrual period). The two-part procedure is secure and efficient when prescribed by a qualified healthcare provider, as stated by the Food and Drug Administration (FDA). A research study published in Obstetrics & Gynecology comparing the safety of medication abortion through telemedicine and in-person abortion discovered that the rate of complication was identical (less than one percent). To provide some perspective, the FDA acknowledges that out of approximately 4 million patients who have used these medications to induce abortion since 2000, there have been 26 associated deaths as of June 2021.

While the FDA sanctioned Mifeprex in 2016, patients were obligated to retrieve the medication in person until July 2020, when the FDA lifted the requirement due to the pandemic. In the December 2021 update, the FDA declared that the modification would persist, even after the pandemic subsides. The pills still necessitate a prescription, but the FDA permits mifepristone and misoprostol to be prescribed via a telehealth visit prior to being sent by mail.

Though this ruling has aided in broadening accessibility to terminations for plenty of Americans, abortion legislations in the U.S. are currently under scrutiny. The downfall of Roe v. Wade imparts the decision of abortion’s legality to individual states, causing a substantial disparity in the availability, timing, and circumstances of abortions depending on geographical location. Moreover, some states have already taken measures to criminalize it: As of January 2023, the majority of abortions are outlawed in at least 13 states, with other states likely to follow suit or impose restrictions as legal battles persist, according to The New York Times. TL;DR: The permissibility of obtaining abortion pills in states where abortion is prohibited or could soon be is currently uncertain.

It’s also important to note that abortion pills are only effective up to 10 weeks into a pregnancy, which is still too early for many individuals, particularly those with irregular menstrual cycles or those who experience contraceptive failures, to realize their pregnancy, according to current FDA guidance.

However, one abortion pill startup, Choix, will provide abortion pills to individuals prior to conception for “peace of mind,” as reported by People. This could aid individuals in accessing the medication promptly if they do become pregnant. However, this telemedicine clinic is only authorized to operate in states where abortion is legal, including California, Colorado, Illinois, Maine, and New Mexico. Therefore, if you reside outside of these states, you will not be able to avail of their services.

Wisp, a telehealth brand specializing in sexual and reproductive health, is also actively striving to enhance accessibility to abortion pills. They now offer the FDA-approved abortion pill for online ordering at a cost of $200. Individuals can utilize this service if they require the pills in a timely manner.

The service comprises a consultation with a physician, and if determined to be secure and suitable, Wisp will ship the medication for terminating a pregnancy, ibuprofen, pills to alleviate nausea, and a pregnancy test (utilized to confirm the success of the abortion) directly to your residence. They will also provide continuous 24-hour support as required, in addition to two check-ins to ensure your well-being following the treatment. To utilize the service, you must be a minimum of 18 years old, pregnant for no more than 10 weeks, and a resident of California, Colorado, Connecticut, Illinois, Maine, Maryland, New Mexico, New York, or Washington.

The battle for accessibility to abortion remains uncertain, particularly in states where lawmakers are determined to ban and limit access to abortion, regardless of whether it is obtained through medication sent by mail or at a clinic. And given that approximately 1 in 4 women in the United States will have an abortion by the age of 45, safe access is of utmost importance.

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