Telemedicine provides abortion access for rural women in states where the procedure is restricted or banned

Graph by the Society of Family Planning (click to enlarge)

Women living in rural areas with abortion-restrictive state laws are using telehealth and doctors in other states to access abortion medications. State shield laws currently protect out-of-state medical professionals who prescribe abortion medications, but that protection may not remain a guarantee.

Asynchronous telemedicine abortion medication provision rates "were higher in states with abortion restrictions and poorer counties far from clinics," reports Rachael Robertson of MedPage Today. "Of the 118,338 medication abortion pill packs Aid Access provided over a 15-month period, 84% went to states with near-total restrictions or bans on telemedicine abortion," reported Abigail Aiken, PhD, at the University of Texas, in the Journal of the American Medical Association.

When the U.S. Supreme Court overturned Roe v. Wade in 2022, some states followed the decision with abortion bans; however, if the bans were meant to stop abortions, they had limited success. Robertson writes, "Some data suggest that abortion rates remained steady despite these challenges."

Aiken's research points to medication abortions and the shield law as a reason abortion rates remained level, even in states with the most stringent restrictions. Aiken explains, "One plausible contributor is the rise of online asynchronous telemedicine abortion services -- particularly those operating under shield laws, which allow U.S.-licensed clinicians to provide abortion medications to patients in ban states with protection from legal liability."

"Before Roe was overturned, telehealth only accounted for 4% of abortions; that has increased to 25% as of December 2024, and disproportionately to ban states, according to Society of Family Planning data," Robertson adds.

Shield law protections will be tested by a Texas lawsuit "against a New York physician operating a nonprofit delivering telemedicine abortion," Robertson reports. "In the past, states tended to honor and assist other states' law enforcement, but the post-Roe era is different."