As states that already ban abortion look to further restrict access, much of the focus is on pills sent by out-of-state providers. A survey released Tuesday by the Guttmacher Institute, which supports abortion rights, helps explain the emphasis. It suggests that more women in states with bans obtained abortions last year using pills prescribed via telehealth than by traveling to places where it is legal.

Most states with the political will to impose broad bans have already done so in the nearly four years since the U.S. Supreme Court overturned Roe v. Wade. So far this year, just one state — Wyoming — has adopted a new abortion ban.

What the Right Is Saying

Anti-abortion legislators say restricting pills is a logical next step in protecting unborn life. South Dakota Gov. Larry Rhoden, a Republican, signed a bill last week that makes it a felony to advertise, distribute or sell abortion pills. Similar measures have cleared both legislative chambers this year in Mississippi.

"Women require compassion and support," said Ingrid Duran, the state legislative director for National Right to Life. The major established anti-abortion groups oppose prosecuting women who have abortions, though some pushing for more aggressive restrictions argue the movement should not shy away from such measures.

Bills intended to keep out pills have cleared one chamber in Arizona, Indiana and South Carolina this year. Republicans control the legislatures in all three states and the governor's office in two of them.

Multiple states are challenging the federal rules that allow mifepristone to be prescribed via telehealth. Louisiana has such a lawsuit in federal court there; the attorneys general of Florida and Texas have one in Texas; those two states, along with Idaho, Kansas and Missouri, are making the same case in a Missouri court.

What the Left Is Saying

Abortion rights advocates point to the Guttmacher survey as evidence that telehealth has expanded access despite state bans. The report suggests that in 2025, for the first time, more women in the 13 states that ban abortion at all stages of pregnancy obtained pills through telehealth than traveled to other states for abortion.

"You keep pushing the boundary, pushing the envelope, eventually you will get what you're seeking," said Melissa Murray, a professor at New York University School of Law. "It will no longer feel fanciful or shocking." She noted that women are already sometimes charged with crimes related to their pregnancies, citing a recent case in Georgia where police charged a woman with murder after allegedly using an abortion pill.

Reproductive rights groups say the focus on restricting pills reflects how central medication abortion has become to access. The prescriptions come from providers in states with laws adopted since the fall of Roe that are intended to protect those who prescribe abortion pills to patients in states with bans.

Pregnancy Justice, which advocates for the rights of pregnant people, says it has tracked new "abortion-as-homicide" measures introduced in six states in 2026 — down from 13 states last year.

What the Numbers Show

The Guttmacher Institute survey found that in 2025, more women in the 13 states with total abortion bans obtained pills through telehealth than traveled to other states for abortions — the first time this has occurred since Roe was overturned.

At least three states — Florida, Oklahoma and Texas — already have laws that specifically ban providers from mailing pills to patients. Louisiana has classified mifepristone as a controlled dangerous substance.

Wyoming is the only state this year that has imposed a new abortion ban. Under a law signed in March by Republican Gov. Mark Gordon, Wyoming became the fifth state with a ban on abortion at about six weeks' gestational age — before many women realize they are pregnant.

Guttmacher's estimates are based on data from a monthly survey conducted among a random sample of U.S. abortion providers, combined with historical data from every provider in the U.S.

Abortion questions will be before voters in at least three states in November. Missouri lawmakers are asking voters to repeal the right to reproductive freedom that they put into the state constitution in 2024.

The Bottom Line

The Guttmacher data suggests telehealth has fundamentally altered the landscape of abortion access in ban states, with medication abortion now surpassing travel as the primary method for women seeking to end pregnancies. As state legislatures wrap up their 2026 sessions, restricting pills has become the focal point for both sides — opponents seeking to close a loophole and supporters working to preserve what access remains.

Multiple federal court challenges could reshape the landscape further. If courts rule that telehealth prescriptions for abortion pills are not permitted, it would significantly limit the ability of out-of-state providers to serve patients in ban states. The Food and Drug Administration approved a generic version of mifepristone last year, which abortion opponents have cited as a frustration. Voters in at least three states will decide abortion-related questions in November, potentially shaping the political environment for years to come.