Abortion through telehealth is still possible without mifepristone

The phones of abortion provider Carafem were ringing nonstop over the weekend after a US federal appeals court reinstated a national requirement that the drug… Mifepristoneone of two pills used for Medical abortionmust be obtained in person. The decision, issued Friday, left patients unsure whether they could access their treatment through telehealth. “People are scared and angry,” says Melissa Grant, chief operating officer at Carafem. “I had people call us and say, This cannot be true. Is the medicine still available to you? Can’t you just give it to me? “They were negotiating.”

With the restriction in place, Carafem quickly switched to a backup approach. Instead of prescribing a typical two-drug protocol for medical abortion — mifepristone, which blocks progesterone and prevents the pregnancy from progressing, and then misoprostol, which causes the uterus to contract — the organization began prescribing misoprostol on its own. Although it is slightly less effective than the double-pill option, it has been widely used in the past. “We feel comfortable describing it,” Grant says.

Some family planning clinics also focused on the misoprostol-only regimen this weekend. “Planned Parenthood providers are doing everything they can to make sure patients know that medical abortion is still safe, legal and available,” says Danica Severino, vice president of care and access at Planned Parenthood Federation of America.

On Monday, the Supreme Court offered a temporary postponement of the Court of Appeal ruling for a week. The measure allows patients to once again get mifepristone through virtual clinics until at least May 11, when SCOTUS will take another look at the case. Carafem and Planned Parenthood say they are willing to return to using misoprostol only if necessary. Other providers, including digital abortion clinic HeyJane, have confirmed they will also follow this approach if necessary.

Mifepristone was developed and used in the 1980s in France It has been widely studied For safety and effectiveness. It was approved by the Food and Drug Administration in 2000. Under President Joseph Biden, the FDA first allowed the drug to be obtained by mail instead of in person in April 2021, during the COVID-19 pandemic. The agency permanently lifted the personal redundancy requirement in 2023.

After the Supreme Court overruled Roe v. Wade In 2022, with the end of the constitutional right to abortion, medical abortion via telehealth has become a more popular option, especially for patients in states that have adopted abortion restrictions. Nearly one in three abortions that occurred in the first half of 2025 used abortion pills obtained through telehealth, according to the public health nonprofit Plan C.

Access to mifepristone became the solution The next major battleground is in reproductive healthwith politicians and anti-abortion lobbyists seeking to reinstate in-person dispensing requirements and, in doing so, make obtaining a medication abortion more difficult.

After conflicting legal rulings in 2023 sparked confusion over whether mifepristone would be available in virtual clinics, some planned Temporarily switch To provide misoprostol medical abortions only. Some virtual clinics have offered single-pill options even before that. Carafeem offered Medical abortion using misoprostol only Starting in 2020, in an effort to provide patients with virtual care options during the early days of COVID.

Misoprostol was originally developed to treat stomach ulcers, and has been used for medical abortion since the late 1980s. This remains the primary method of medical abortion in many parts of the world where access to mifepristone is limited.

“Mifepristone and misoprostol are very safe medications, and in general, taking mifepristone increases effectiveness and reduces complication rates of medical abortion,” says Rachel Jensen, MD, a fellow of the American College of Obstetricians and Gynecologists, who advocates for the misoprostol-only protocol when mifepristone is not available. An individual medication regimen has also been previously approved Global Health Organizationthe Family Planning Associationand National Abortion Federation.