After the Supreme Court overturned Roe v. Wade on June 24, 2022, many states almost completely banned abortion. However, according to the Society of Family Planning's #WeCount report, the number of abortions performed in the country in 2025 nearly doubled compared to 2021.
As of December 2025, 29% of all abortions were performed via telemedicine. Experts say that abortion pills sent by mail played a key role in this increase.
Telemedicine and medication abortion era
Angel Foster, director of the Massachusetts Medication Abortion Access Project, said her team sends abortion pills to about 3,500 patients per month nationwide, including in banned states. After a federal appeals court ruled in May that mailing mifepristone was illegal, Foster sent only misoprostol to her patients.
Foster reported that the vast majority of patients say, "Just send it, as long as it comes as soon as possible." Elisa Wells, co-founder of Plan C, said, "The genie is out of the bottle. People have learned they can get safe, fast, and affordable help by mail; there's no going back."
Legal battles and administrative pressure
The lawsuit, led by Louisiana and supported by 21 states, alleges that the FDA under the Biden administration violated the law by allowing mifepristone to be prescribed without an in-person examination. The Supreme Court temporarily protected access to mifepristone via telemedicine while the case is being heard in lower court.
Meanwhile, anti-abortion groups are demanding that the Trump administration make access to the drug more difficult through the FDA or enforce the Comstock Act of 1873. Kristi Hamrick, vice president of Students for Life of America, said, "People are losing patience," comparing the long-promised safety review to a "mythical unicorn."
Alternative methods ready
David Cohen, a law professor at Drexel University, said that even if mifepristone is restricted, misoprostol is an FDA-approved treatment for ulcers and it's nearly impossible to prevent off-label use. Melissa Grant, co-founder of Carafem, stated that during the temporary restriction in 2021, they switched to a misoprostol-only protocol and are prepared for that scenario.
Foster emphasized that with additional doses, misoprostol can provide similar efficacy. She added that in May, with the intervention of the Supreme Court, they were able to resume sending mifepristone, but if necessary, the pills would still reach patients.
