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Mifepristone ruling could halt mailed abortion pills in ‘shield states’ like Maryland

This article was republished with permission from СӰ’s news partners at . Read the story at Maryland Matters.

Every month, an estimated 500-plus Marylanders receive abortion medication that was mailed to them after a telehealth medical visit, a convenient method for terminating unwanted pregnancies that has been growing since 2022.

But abortion advocates say a Supreme Court case reviewing mail access for mifepristone, part of a two-drug regimen used for both medication abortions and miscarriage care, could threaten the ability of Marylanders to get abortion medication by mail.

“There’s often the misconception that we are safe in Maryland from these politically motivated attacks on abortion,” Lynn McCann-Yeh, executive director for the Abortion Fund of Maryland, said Tuesday. “This particular Supreme Court case is so concerning because it has nationwide implications on how mifepristone can be dispensed and prescribed if this court case moves forward.”

Last Friday, May 1, blocked a 2023 U.S. Food and Drug Administration rule that allowed mifepristone to be dispensed without an in-person visit with a physician.

That decision briefly blocked health providers from sending the medication through the mail nationwide, creating chaos and confusion for abortion providers and patients in Maryland, according to Karen J. Nelson, president and CEO of Planned Parenthood of Maryland.

But Monday, the U.S. Supreme Court issued a temporary stay on the appellate court’s decision until May 11, giving both sides time to file briefs in the case — and allowing mifepristone to be sent over the mail for at least one more week.

“This is politically motivated and it’s a darn shame that our patients have to be concerned about this,” Nelson said. “The voters in the state of Maryland have demanded that reproductive health care be available in this state, and they codified it in the state constitution two Novembers ago.”

Anti-abortion organizations like the Maryland Family Institute agree that the court case has significant implications for reworking abortion policies across the United States and in Maryland.

Jonathan Alexandre, legislative counsel for the Maryland Family Institute, said the temporary stay by the Supreme Court was a “super-wise decision” to allow time to gather enough evidence and data to make the case that sending mifepristone through the mail is harmful.

“We don’t shy away from realizing the cataclysmic effect this will have on reorienting the entire nation’s laws when it comes to protecting life in the womb,” Alexandre said.

The court challenge was brought by the state of Louisiana, which argues that the FDA’s 2023 decision to no longer require in-person visits for mifepristone undermines its near-total ban on abortion, allowing providers from other states to send the medication into Louisiana through the mail.

Louisiana also claims that it paid $92,000 in Medicaid bills for two women who needed medical care due to complications related to mifepristone.

But the current lawsuit against mifepristone has nationwide implications and could threaten even Maryland residents from receiving the medication from a Maryland provider, even though abortions are legal in the state.

“While it was great that there was this kind of temporary reprieve … we know that the broader case is still unresolved,” McCann-Yeh said. “Telehealth medication abortion is an increasingly important way of accessing abortion care in the country.”

Abortion in the U.S. has become a patchwork of state policies since June 2022, when the Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization largely overturned federal abortion protections and sent the issue back to legislatures.

Some states, such as Louisiana, have near-total bans for abortion services, while states like Maryland are known as “shield law” states that protect providers from prosecution for providing abortion care to residents in more-restrictive states.

Nationally, approximately 27% of abortions happen through telehealth services, according to 2025the  data from the Society of Family Planning, a research and advocacy group that publishes an annual report called #WeCount. That’s up from just 5% nationwide in early 2022, before the Dobbs decision.

In Maryland, an average of 533 abortions a month took place through telehealth services from June 2024 through June 2025, according to most recent #WeCount data. An average of 2,729 abortions a month occurred in person at Maryland clinics during the same period.

Compare that to data from before the Dobbs decision, when 40 Marylanders received telehealth abortions in April 2022 and just 50 in May 2022.

While most abortions occur in clinics still, McCann-Yeh said the Supreme Court could block the ability to receive mifepristone in the mail, creating hurdles for Marylanders seeking abortion care.

“For a Maryland resident who may not be able to get to a clinic, this is a huge logistical hurdle,” she said. “You now have to travel to the clinic, which might be anywhere from 30 minutes to a few hours away.

“If you are a parent or have disabilities, if you’re working to make ends meet and you’re concerned about costs – all of these create a lot of additional hassles that people in Maryland would have to go to get abortion care that’s otherwise protected and supported in their state,” McCann-Yeh said.

Meanwhile, in states with strict abortion bans, such as Louisiana or Maryland’s neighbor West Virginia, approximately 96% to 100% of abortions were acquired through telehealth services in 2025, according to the data.

Abortion advocates say some providers in Maryland will prescribe and send abortion medications like mifepristone through the mail to residents in other states who are unable to get them otherwise. It’s not clear how much mifepristone is sent out of Maryland into states with more restrictive abortion bans, but Alexandre says that the state’s lax telehealth requirements put women at risk.

“You have males buying this and forcing women to take it, or women will take it past the age of gestation that are safe for ingesting this pill,” Alexandre said. “What this law that Louisiana has passed, and ultimately what the court is going to review, is saying whether or not you should put these safety protocols in place to ensure that the dangers of this pill are fully addressed and that women are offered the protection that they need.”

Abortion providers like Nelson with Planned Parenthood are continuing to provide telehealth care to Marylanders, as she said the organization does not send mifepristone out of state.

But behind the scenes, staff with Planned Parenthood and other abortion advocacy groups are preparing for what may happen if the Supreme Court takes up the Louisiana case.

“We’re super glad that the recent stay does temporarily restore access to medication abortions by telehealth,” Nelson said, “But with the chaos and the confusion, with the back and forth between rulings does have an impact on those who are seeking sexual and reproductive health care.”

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