A new survey released Tuesday helps explain why conservative state lawmakers are increasingly focused on banning abortion pills. The Guttmacher Institute, a research organization that supports abortion rights, estimated that in 2025, for the first time, more women in the 13 states that ban abortion at all stages of pregnancy obtained pills prescribed via telehealth from out-of-state providers than traveled to other states for in-clinic care. The data are drawn from a monthly survey of a random sample of U.S. abortion providers combined with historical provider data, and they mirror trends seen in other surveys.
That shift in how women end pregnancies has prompted a legislative response. Last week, South Dakota Gov. Larry Rhoden, a Republican, signed a bill making it a felony to advertise, distribute, or sell abortion pills. In Mississippi, both legislative chambers have passed similar measures, and they are now working to reconcile differences before sending a final bill to Republican Gov. Tate Reeves. Florida, Oklahoma, and Texas already have laws that specifically ban mailing the pills, and Louisiana has classified mifepristone — one of the two drugs most commonly used in medication abortion — as a controlled dangerous substance.
Bills aimed at keeping the pills out have cleared one chamber this year in Arizona, Indiana, and South Carolina, where Republicans control the legislature and, in Indiana and South Carolina, the governor’s office. In Arizona, any restrictions that pass could face a veto from Democratic Gov. Katie Hobbs.
The battle is also being fought in federal court. Louisiana has sued to block rules that permit mifepristone to be prescribed via telehealth; similar challenges have been filed by the attorneys general of Florida and Texas in Texas, and by those two states along with Idaho, Kansas and Missouri in a Missouri court. Requiring in‑person prescriptions, the challengers argue, would at least hinder the ability of out‑of‑state providers to mail pills into states with bans. Last year, the Food and Drug Administration approved a generic version of mifepristone, a move that frustrated abortion opponents.
Wyoming is the only state so far this year to enact a new ban. Republican Gov. Mark Gordon signed a law in March prohibiting abortion once cardiac activity can be detected — typically around six weeks’ gestation, before many women know they are pregnant. But courts have repeatedly blocked Wyoming’s previous restrictions, and in January the state Supreme Court struck down a total ban. The new law’s legal future is uncertain.
While states are moving against the pills, efforts to directly prosecute women who have abortions continue to stall. No state has adopted such a measure this year. Proposals have been introduced in six states, down from 13 in 2025, according to Pregnancy Justice, an advocacy group. The most progress any such bill has made was a hearing last year in a South Carolina Senate subcommittee; a Tennessee bill scheduled for a hearing this month did not receive one.
“Women require compassion and support,” said Ingrid Duran, state legislative director for National Right to Life, “Not prosecution.” The major anti‑abortion organizations oppose the tactic.
Melissa Murray, a professor at New York University School of Law, said that by regularly introducing bills with criminal penalties against women, the movement’s more uncompromising abolitionist factions work to erode the taboo against such policies. “You keep pushing the boundary, pushing the envelope, eventually you will get what you’re seeking,” Murray said. “It will no longer feel fanciful or shocking.”
Murray noted that women are already sometimes charged with crimes related to their pregnancies. This month, police in Georgia charged a woman with murder after she allegedly used an abortion pill and the opioid oxycodone.
The issue will also appear on ballots in November. Missouri lawmakers are asking voters to repeal the right to reproductive freedom enshrined in the state constitution in 2024. In Nevada, a constitutional amendment allowing abortion until fetal viability — generally after 21 weeks — passed in 2024 and must be approved a second time to take effect. A Virginia ballot measure would guarantee the right to reproductive freedom, including access to contraception and abortion care during the first two trimesters.
The Associated Press contributed reporting.