Massachusetts abortion advocates say court decisions on pills by mail are giving providers, patients "whiplash"

Abortion providers in Massachusetts are trying to work in a field with ever-changing rules. On Friday, a federal court ruled they couldn't prescribe the abortion pill "mifepristone" through telehealth or mail it to patients. The decision was in response to claims by the state of Louisiana that providers nationwide used telehealth to skirt its strict abortion ban.

On Monday, the U.S. Supreme Court briefly paused the ruling, a pause that will last one week while it considers next steps.

One Massachusetts provider who mails prescriptions nationwide told WBZ by phone that the clinic was busy repacking orders to include mifepristone on Monday, after switching to a different medication abortion regiment all weekend in response to the federal court's ruling.

When asked what providers should do, Massachusetts Attorney General Andrea Campbell said, "Keep doing your job, keep providing the reproductive health care. Telehealth is still working, telemedicine is still working, and we will keep fighting in the courts."

Campbell filed an amicus brief and plans to continue the legal battle for access to mifepristone.

The drug is part of a two-pill regimen that is considered the gold standard for a medical abortion, followed by misoprostol. It can also be used to help manage miscarriages. "It's a medication that is a little bit of an anti-progesterone, so progesterone is one of the hormones that helps support pregnancy, and it blocks that hormone," explained Tufts Medical Director of Family Planning Dr. Danielle Roncari. The two pill regimen she says is "more effective than taking the misoprostol alone. Patients actually have fewer side effects."

Critics say the legal challenges are a step in a conservative movement to dismantle abortion access nationwide. "The playbook is to target the drug that is used basically exclusively in abortion, because that's… if you really want to curtail abortion via telehealth, that is a direct way to do it," said MaryRose Mazzola, an adjunct professor of reproductive rights at the Harvard Kennedy School. "So, really targeting this as a way to, first of all, target a medication that is really only used in these instances, and second, to be able to go into states that have chosen to protect abortion and restrict how they administer healthcare as well."

Massachusetts has a shield law to protect abortion providers who provide medication via telehealth to people out of states.

Since Roe v. Wade was overturned in 2022 with the Supreme Court's Dobbs decision, the number of abortions nationwide has increased slightly, Mazzola said.

In Massachusetts, the numbers have skyrocketed.

In 2024, the state performed 40,408 medical abortions – 27,836 of them to out of state patients, according to Massachusetts Department of Health data.

In 2021, before the Dobbs decision, just 8,311 medical abortions happened in the state, and 792 of them were to out of state patients.

In addition to the pandemic shifting healthcare to virtual, "Dobbs played a huge role in this," Mazzola said. "Where we now have bans, either total or really restrictive abortion bans in about half the states across the country, but that doesn't stop abortion."

While Planned Parenthood League of Massachusetts only provides telehealth to patients in state, decisions like this from the courts create "whiplash," according to Chief Medical Officer Dr. Luu Ireland. "This ruling does nothing to help patients take care of their health," she told WBZ. "This is hard and intimidating for staff and it's hard and intimidating for patients. It frustrates them, it confuses them, and it breaks their trust."

The Supreme Court's temporary pause on the ruling will last at least one week, until May 11. Parties have to file their amicus briefs by Thursday, May 7, and then SCOTUS will decide whether it takes the case fully and proceeds.