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Updated 08/25/2026

Written by Dineli Lewke, DO and Maya Bass, MD

In June 2022, the U.S. Supreme Court decision in Dobbs v. Jackson Women’s Health Organization overturned Roe v. Wade and eliminated federal constitutional protections for abortion.¹ Abortion policy is now determined at the state level. While some states have banned abortion, 22 states established protections called shield laws to protect clinicians who provide abortions and patients from legal action, and to safeguard medical records from disclosure. These laws have become increasingly important as patients now travel farther and cross state lines to access care post-Dobbs. For example, Louisiana, with a total abortion ban, has had 2,040 residents travel out of state for abortion care in 2025.^2-5 The rise in interstate travel emphasizes the need for safeguards for patients and clinicians in these scenarios.

Telemedicine has also become vital in maintaining access to abortion care. Multiple observational studies have demonstrated that medication abortions through telemedicine have rates of complete abortion comparable to those of in-person care, with similarly low rates of adverse event.^6-10 In 2023, the U.S. Food and Drug Administration (FDA) modified the Risk Evaluation and Mitigation Strategy (REMS) for mifepristone by removing the in-person dispensing requirement, allowing mail-in prescriptions and certified pharmacies to dispense mifepristone. As a result, telemedicine was able to expand access to medication abortion, especially for patients living in states with abortion restrictions.^11-13 In 2025, 142,000 people from states with restrictive laws had accessed abortion care via telemedicine.¹⁴ Telemedicine can reduce the significant financial and logistical hurdles for patients who previously had to travel for care.

In response, states with limited abortion access have initiated legal challenges to restrict shipments of mifepristone across state lines. On May 1st, 2026, the 5th Circuit Court of Appeals temporarily reinstated the in-person requirement for mifepristone following a lawsuit filed by the state of Louisiana against the FDA. The Supreme Court decided to maintain the status quo while litigation continues, allowing telemedicine prescribing and mailing of mifepristone to remain available.¹⁵ 

Shield laws have become a vital mechanism for protecting both patients and clinicians while preserving access to abortion services in the post-Dobbs era. Despite ongoing legal challenges, telemedicine remains an evidence-based approach to expanding access to medication abortion. Recent litigation in Louisiana highlights the continued legal challenges facing shield laws and abortion care. Shield law protections can vary widely. Clinicians should familiarize themselves with their state’s statutes and policies, particularly when providing telemedicine care across state lines. For state-specific information on shield law protections, clinicians can consult the Guttmacher Institute’s state policy tracker.⁵

Telehealth Care for Medication Abortion Protocol