Telehealth abortion rises as states use mail-order pills, Guttmacher says
Telehealth now drives about one in four clinician-provided abortions, even as mail-order pills reach states with bans and travel for care falls.
Telehealth has redrawn abortion access into a two-track system: people in restrictive states are increasingly getting medication abortion by mail, while others still cross state lines for care. Guttmacher said that by the first half of 2025, about one in four clinician-provided abortions in the United States were delivered via telehealth, a shift that has accelerated even as bans remain in force across much of the South and Midwest.
The numbers show how that new geography is working. Guttmacher estimated 1,126,000 clinician-provided abortions in 2025, nearly unchanged from 1,124,000 in 2024, and the highest annual total since 2009. In states with total abortion bans, telehealth provision rose from 74,000 abortions in 2024 to 91,000 in 2025. At the same time, interstate travel for abortion care fell from 154,000 people in 2024 to 142,000 in 2025, still more than double the level before Roe v. Wade was overturned in 2022.
That pattern suggests that shield laws and mail delivery have become essential to access for patients who cannot or do not want to leave home. Guttmacher said providers in shield-law states have been able to mail abortion medication across state lines, creating a parallel system that now reaches people in states with total bans. By the end of 2025, 13 states had total abortion bans in effect and six more had six- or 12-week bans.
Medication abortion remains the backbone of that system. Guttmacher said 65% of abortions in the United States were medication abortions in 2023, and the vast majority of telehealth medication abortions used the combined mifepristone-misoprostol regimen, which Guttmacher said was used in 98% of cases as of 2020. That makes the legal status of mifepristone central to how care is delivered nationwide.
The U.S. Supreme Court temporarily preserved that access on May 4, 2026, issuing an administrative stay that kept telehealth, pharmacy and mail access to mifepristone in place while litigation continued. The stay was set to expire Thursday, May 14, at 5 p.m. ET. Guttmacher warned that if the Fifth Circuit Court of Appeals ruling were allowed to stand, it would severely restrict telehealth provision of abortion in all states and amount to one of the biggest threats to abortion access since Roe was overturned.
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