Dima Qato, leading author and USC senior scholar, described the findings as striking for how few retail pharmacies, especially chains, dispense mifepristone where abortion is legal and telehealth is allowed.

Notable disparities persist even among states with strong protections, indicating uneven implementation of telehealth and pharmacy dispensing options.

In 11 states where abortion is legal but telehealth access is restricted, about 61% of mifepristone prescriptions are fulfilled at in-store pharmacies, showing reliance on local retail dispensing where telehealth is limited.

The findings underscore mail-order dispensing for mifepristone as a central channel in the wake of the 2022 Supreme Court ruling, contributing to a surge in medication abortion that now makes up about 60% of U.S. abortions.

Medication abortion has risen to roughly 60% of all U.S. abortions, driven in part by restrictions on in-person access and ongoing legal and political battles surrounding mifepristone.

Disparities in access to mifepristone persist, particularly after the 2022 ruling and the FDA’s 2023 decision permitting retail pharmacies to dispense the drug.

Pharmacy chains face political pressure from both abortion-rights advocates and anti-abortion groups amid regulatory changes and ongoing legal challenges related to the drug.

The broader policy and legal context includes continued legal challenges and investigations into mifepristone manufacturers and FDA oversight as lawmakers scrutinize online sales and access.

In the 27 states plus the District of Columbia where telehealth abortion is permitted, fewer than 2% of mifepristone prescriptions are filled at physical retail pharmacies, highlighting mail-order dominance.