States with abortion bans target pills sent by out-of-state providers

As states that already ban abortion look to further restrict access this year, much of the focus is on pills sent by out-of-state providers.

A survey released Tuesday helps explain the emphasis. It suggests that more women in states with bans obtained abortions last year using the pills prescribed via telehealth than by traveling to places where it's legal.

Most of the states with the political will to impose broad bans have already done so in the nearly four years since the U.S. Supreme Court overturned Roe v. Wade and opened the door to enforcing them. So far this year, just one state has a new one.

Here's a look at where things stand as many state legislatures are wrapping up or have completed their 2026 sessions.

States are taking steps to make abortion pills harder to get

South Dakota Gov. Larry Rhoden, a Republican, signed a bill last week that makes it a felony to advertise, distribute or sell abortion pills.

Similar measures have cleared both legislative chambers this year in Mississippi, where the House and Senate need to iron out differences before sending a bill to Republican Gov. Tate Reeves.

A survey of state abortion policies from the Guttmacher Institute, which supports abortion rights, finds that at least three states — Florida, Oklahoma and Texas — already have laws that specifically ban providers from mailing the pills to patients. Louisiana has classified mifepristone as a controlled dangerous substance.

READ MORE: What to know about state proposals to ban abortion pills and punish women who seek to end pregnancies

Bills intended to keep out the pills have cleared one chamber in Arizona, Indiana and South Carolina this year. Republicans control the legislatures in all three states and the governor's office in two of them. In Arizona, any restrictions that pass could be vetoed by Democratic Gov. Katie Hobbs.

Survey suggests more women using abortion pills in states with bans

A Guttmacher survey released Tuesday sheds light on why abortion opponents may be focusing on pills.

The report suggests that in 2025, for the first time, more women in the 13 states that ban abortion at all stages of pregnancy obtained pills through telehealth than traveled to other states for abortion.

The prescriptions come from providers in states with laws adopted since the fall of Roe that are intended to protect those who prescribe abortion pills to patients in states with bans. Most often, women using pills for abortion are prescribed a regimen of two drugs — mifepristone and misoprostol. They're approved for use in the first 10 weeks of pregnancy.

The estimated increase in the mailing pills comes as Guttmacher's estimates also suggest fewer women are traveling to obtain abortions in states like Colorado, Illinois, Kansas and New Mexico.

Guttmacher's estimates are based on data from a monthly survey conducted among a random sample of U.S. abortion providers, combined with historical data from every provider in the U.S. They reflect a trend documented in other surveys of abortion providers.

Court battles are also centered on pills

Multiple states are challenging the federal rules that allow mifepristone to be prescribed via telehealth. Requiring in-person prescriptions instead would at least dent the ability of out-of-state providers to get pills into states with bans.

Louisiana has such a lawsuit in federal court there; the attorneys general of Florida and Texas have one in Texas; those two states, along with Idaho, Kansas and Missouri, are making the same case in a Missouri court.

Meanwhile, Texas has filed civil cases and Louisiana criminal ones against providers accused of sending pills into their states.

The Food and Drug Administration last year approved a generic version of mifepristone, which frustrated abortion opponents.

One state imposed a ban, but its fate is uncertain

Wyoming is the only state this year that has imposed a new abortion ban.

Under a law signed in March by Republican Gov. Mark Gordon, it became the fifth state with a ban on abortion at about six weeks' gestational age — before many women realize they're pregnant. Like most of the others, Wyoming's bans abortions once cardiac activity can be detected.

But courts have rejected previous Wyoming efforts to limit abortion, and the Wyoming Supreme Court in January struck down a ban on abortion at all stages of pregnancy.

The idea of punishing women is not gaining ground

No state has adopted a measure intended to allow criminal prosecutions against women who have abortions.

Proposals to do so keep getting made but sputter early in the legislative process.

The farthest such a bill has advanced was a hearing last year before a Senate subcommittee in South Carolina. One was scheduled for a subcommittee hearing in Tennessee this month, but didn't get one.

Pregnancy Justice, which advocates for the rights of pregnant people, says it's tracked new "abortion-as-homicide" measures introduced in six states in 2026 — down from 13 states last year.

The major established anti-abortion groups oppose the approach. "Women require compassion and support," said Ingrid Duran, the state legislative director for National Right to Life. "Not prosecution."

Melissa Murray, a professor at New York University School of Law, says that by introducing bills with penalties against women, the movement's less compromising abolitionists can break down the idea that such policies are off-limits.

"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."

She also noted that women are already sometimes charged with crimes related to their pregnancies. This month, police in Georgia charged a woman with murder after allegedly using an abortion pill and the opioid painkiller oxycodone.

Abortion will be on ballots in November

Abortion questions will be before voters in at least three states in November.

Missouri lawmakers are asking voters to repeal the right to reproductive freedom that they put into the state constitution in 2024.

Elsewhere, voters are being asked to add constitutional amendments that largely mirror current state abortion laws.

In Nevada, a state constitutional amendment to allow abortion until fetal viability — generally considered to be sometime after 21 weeks of pregnancy — passed in 2024, and needs voter approval a second time to take effect.

A Virginia ballot measure would guarantee the right to reproductive freedom, including access to contraception and making decisions on abortion care during the first two trimesters of pregnancy.

Associated Press reporter Amelia Thomson DeVeaux contributed to this article.