Abortion providers and opponents in Mass. await decision in legal battle over mifepristone

Abortion providers in Massachusetts can continue sending the pill mifepristone through the mail until at least next week after the U.S. Supreme Court paused a lower court’s ruling that would have banned shipping the medicine nationwide.

About 63% of all abortions recorded in Massachusetts in 2024 were provided through telehealth using two medications — mifepristone and misoprostol — and shipped to patients, many of them out of state.

On Friday, a federal appeals court in Louisiana found that allowing mail orders of mifepristone undermined that state’s ban on medication abortions. But on Monday, Justice Samuel Alito ordered a temporary pause while the full court determines how to move forward.

A permanent restriction on mailing mifepristone would have major impacts in Massachusetts where the vast majority of prescriptions for abortion pills written in 2024 were delivered via telehealth.

Groups that provide telehealth abortions would have to mail just one medication, misoprostol, instead of the preferred two-drug regimen. Those providers say the single drug can work safely and be effective, but they say patients may experience more side effects than they would if they were also taking mifepristone.

Planned Parenthood League of Massachusetts had planned to switch this week and mail just misoprostol, but will resume sending both pills for now.

"Patients can continue to access the medication abortion method of their choice,” said the League’s President and CEO Dominique Lee. “These health care decisions should be solely between patients and their doctors, not judges or politicians."

While the ban was briefly in effect over the weekend, groups like the Massachusetts Medication Abortion Access Project, or The MAP, prepared to transition to mailing just misoprostol. The organization told WBUR it spent hours contacting patients to explain the change.

The MAP fills about 100 orders a day and expects to send between 35,000 and 40,000 packages of either the two pill combination or single pill this year. In 2024, it provided about a third of the telehealth medication abortions recorded in Massachusetts.

Abortion opponents in Massachusetts had celebrated the appeals court ruling Friday banning telehealth prescriptions for mifepristone. And on Monday, Massachusetts Citizens for Life President Myrna Maloney Flynn said in an email she was “pleased” the Supreme Court is reviewing the shipment of abortion pills.

“We look forward to a final ruling that prioritizes women’s safety above the abortion industry’s bottom line,” she said.

Maloney Flynn said pills that are ingested later in a pregnancy or during an ectopic pregnancy can lead to serious health complications and death. But Lee, of Planned Parenthood, said complications occur in fewer than 1% of cases where patients receive a medication abortion.

Mifepristone “has a stronger safety record than many commonly used medications that do not face this level of political scrutiny,” Lee said in a statement, “including acetaminophen and Viagra.”