Historically, states have controlled abortion by controlling the providers who performed abortion procedures. But medication abortion — the two-drug regimen that the FDA has approved to end a pregnancy in the first 10 weeks — is now available by mail. People who live in a state where abortion is illegal can buy abortion pills online, either on their own or with the help of international providers. And patients have found ways to obtain abortion pills via telehealth even when they live in states that forbid the practice by using mail forwarding or giving the address of a friend or family member who can forward the medication to them.
This exposes patients, particularly the most vulnerable patients, to various legal risks. But with state and local officials having no ability to tell what a package contains (and no legal authority to inspect packages without specific suspicion and a warrant), mailed pills will be difficult to police.