What to Know About Later Abortions: Myths, Barriers and Patient Stories

Later abortion is one of the most stigmatized and least understood aspects of reproductive health, and yet some of the voices perpetuating that stigma come from inside the reproductive rights movement itself. Meanwhile, while most abortions happen in the first trimester, later abortions are increasing as restrictions and bans are delaying care and creating the very conditions that make them necessary.

To address these misconceptions, Erika Christensen and Garin Marschall created Patient Forward after Christensen experienced a later abortion in 2016. The organization is dedicated to eliminating later abortion stigma and barriers.

“We have a lot of folks in the media, including repro[ductive rights] advocates, saying, ‘Nobody wants to do this,’ or, ‘It’s not even available,’ or, ‘Nobody’s getting abortions that late.’ Yes, they are. They’re getting them in safe, modern, incredibly compassionate abortion clinics,” said Christensen. “We do a lot of destigmatizing work.”

Patient Forward emphasizes that most people who obtain a later abortion would have preferred to access an abortion earlier: “Contrary to popular rhetoric, patients do not wait. Rather, they are delayed.”

“We have found that young people are much later to recognize they’re pregnant because their periods are irregular anyway, because they may not be familiar with all the symptoms of pregnancy,” says Dr. Diana Foster Greene of University of California San Francisco. “People with chronic health conditions are also later to discover they’re pregnant because often chronic health conditions have the same symptoms of pregnancy.”

The Antiabortion Playbook Is Coming for Birth Control

The United States is on its way to banning or severely restricting birth control.

I know this statement will be met with incredulity—but I would refer you to the disbelief so many of us in the reproductive health field faced when we warned that the constitutional right to abortion was in danger. Nearly four years later, we are living in this reality that so many dismissed as alarmist fantasy.

If the anti-contraception tactics we see today look extremely familiar, it’s because they come straight from the antiabortion playbook: spreading mis- and disinformation, advancing incremental regressive policies, and denying problems with access—the same tactics that helped pave the way for the eventual overturning of Roe.

Abortion Rates Continue to Climb as Telehealth Reshapes Post-Dobbs America

Four years after Dobbs, a striking reality has emerged: Abortion bans have not eliminated the need for abortion.

Instead, new #WeCount data show that abortions have increased nationwide, driven in large part by the rapid expansion of telehealth and abortion pills by mail.

Even in states that have attempted to ban abortion entirely, patients continue to find ways to obtain care through shield-law providers, telehealth services and community-based networks.

The data also reveal how dramatically abortion care has changed. Telehealth now accounts for more than a quarter of all abortions provided within the formal healthcare system, offering many patients a safer, more affordable and more private alternative to in-person care.

For people living under bans and severe restrictions, it has become an essential lifeline—one that has reshaped where and how abortion care is delivered across the country.

Yet the numbers likely tell only part of the story. As antiabortion politicians and the Trump administration target mifepristone and telehealth abortion, providers are already adapting.

The lesson of the post-Dobbs era is clear: The demand for abortion has not disappeared, and despite relentless efforts to restrict it, people continue to find ways to access the care they need.

Yes, You Can Still Get Abortion Pills by Mail—Here’s What to Know

On May 1, the Fifth Circuit Court of Appeals issued a sweeping ruling seeking to prohibit telehealth prescribing of mifepristone, forcing women to see a provider in-person to acquire the first pill in the standard two-drug medication abortion regimen. The decision would have blocked U.S. clinicians from mailing abortion pills after telehealth consultations nationwide.

On May 4, however, the U.S. Supreme Court temporarily paused that ruling, preserving current telehealth and mail access while the justices consider next steps. The Court’s temporary ruling was set to last until 5 p.m. ET on Monday, May 11, giving the justices time to decide whether to extend the pause or let the lower-court ruling take effect.

Then, on Monday afternoon, the U.S. Supreme Court briefly extended its temporary order preserving telehealth and mail access to mifepristone while the justices continue deliberating over the emergency appeal. Justice Samuel Alito extended the Court’s administrative stay through Thursday, May 14, at 5 p.m. ET, keeping on hold the Fifth Circuit’s May 1 ruling that would have required patients nationwide to obtain the medication through in-person visits. The order means that, for now, people can still access mifepristone through telehealth consultations and mail delivery under the current FDA rules.

National Institute for Reproductive Health president Christian LoBue said the Supreme Court’s decision “preserves telehealth access to mifepristone for now,” but warned it also “prolongs an untenable state of uncertainty for patients and providers nationwide.” Antiabortion forces are “focused on creating chaos and fear, not improving health outcomes,” she said, urging states to instead focus on strengthening protections for providers, patient privacy and access to medication abortion.

Regardless of what the courts ultimately decide, abortion access advocates, international telehealth providers and community networks say they are prepared to continue helping people access abortion pills.

Either way, the infrastructure for medication abortion access already exists—and it is not disappearing.

After Years of Silence, Texas Medical Board Issues Training for Doctors on How to Legally Provide Abortions

For the first time since Texas criminalized abortion, the state’s medical regulator has instructed doctors on when they can legally terminate a pregnancy to protect the life of the patient—guidance physicians long sought as women died and doctors feared imprisonment for intervening.

The new training from the Texas Medical Board was released nearly five years after the state passed its strict abortion ban in 2021, threatening doctors with severe penalties. Pregnancy became far more dangerous in the state after the law took effect: Sepsis rates spiked for women suffering a pregnancy loss, as did emergency room visits in which miscarrying patients needed a blood transfusion; at least four women in the state died after they didn’t receive timely reproductive care. More than a hundred OB-GYNs said the state’s abortion ban was to blame.

The new medical training, which ProPublica obtained under a public records request, assures doctors they can now legally provide abortions, even when a patient’s life isn’t imminently in danger, and goes over nine example scenarios, including a patient’s water breaking before term and complications from an incomplete abortion. 

But medical and legal experts who reviewed the training said the case studies represent only the most straightforward situations doctors encounter. The complications that women face in pregnancy are varied, complex and impossible to capture in a brief presentation, many cautioned. One attorney called the training “the bare minimum.”

Community Providers Play a Critical Role in Supporting Sexual and Domestic Violence Survivors Self-Managing Abortions

Decentralized community networks have mushroomed across the country. Existing outside of the formal medical system, community providers mail free abortion pills (mifepristone and misoprostol) to tens of thousands of pregnant women and people each year and support them to self-manage their abortions.

Staffed by volunteers, many of these community networks offer highly-trained abortion doulas to provide emotional and informational support to all those with whom the groups share abortion pills, and offer specially trained doulas for survivors of sexual and domestic violence.

“Pregnancy is one of the most dangerous times for someone experiencing domestic violence,” one doula told Ms., and “one of the top three reasons that people seek abortion is due to abuse in their relationship.”

Community Groups Sharing Free Abortion Pills Expand to States Where Abortion Is Legal But Out of Reach

In response to abortion bans and restrictions, feminists across the country have created networks of community groups that share abortion pills by mail, free of charge, with people who need them. Mostly run by volunteers, these mutual aid networks have served over 100,000 people since 2022. 

“Everybody deserves bodily autonomy,” said one volunteer, who got involved out of rage after the Supreme Court revoked women’s constitutional right to abortion in 2022.

Increasingly decentralized and moving closer to the people they serve, these community providers are expanding their reach. While originally focused on states with bans and severe restrictions, they are now increasingly serving people in states where abortion is legal, but may not be affordable or accessible.

Abortion Continues to Increase in 2025 as Telehealth Expands, Especially in States with Bans and Restrictions

Despite many states imposing sweeping abortion bans after Dobbs, more Americans are having abortions, not fewer, according to the Society of Family Planning’s latest #WeCount report.

“Abortion bans don’t stop people from needing and pursuing essential abortion care,” said Alison Norris, M.D., Ph.D., professor at The Ohio State University’s College of Public Health and #WeCount co-chair.

Despite these increases, Ushma Upadhyay, professor and fellow #WeCount co-chair, warned that unwarranted attacks on telehealth abortion may restrict access in the future. “This care is under assault by abortion opponents’ relentless attacks on mifepristone and telehealth—even though medication abortion is backed by a 25-year track record of safety and gold-standard science, and research shows that telehealth abortion is just as safe and effective as in-person care.”  

A Global Telehealth First: Women Help Women Begins Producing Abortion Pill Combipack

The feminist telehealth provider Women Help Women is redesigning how abortion pills are packaged to reflect what users actually need: a combination pack that includes one mifepristone tablet and eight misoprostol tablets for use up to 12 weeks of pregnancy.

“It’s a huge revolution of who actually gets to decide when, how and with the support of whom they can have an abortion and until when,” said Women Help Women coexecutive director Kinga Jelinska. “It centers the needs of users rather than institutions or markets. The underlying notion is that abortion can be friendly, and abortion can be easy.” 

Self-managed abortion is disruptive. We were told that abortion is a difficult decision; that it has to be difficult to access, and that only doctors control it. Self-managed abortion subverts that,” said Lucía Berro Pizzarossa, fellow coexecutive founder.

‘Mife No Matter What’: Community Abortion Providers Pledge to Continue Sharing Free Abortion Pills, Even if FDA Imposes Restrictions

Since 2022, community providers have built a nationwide network discretely mailing free abortion pills to those in ban or restricted states.

People can find community providers through several platforms that research and share information about abortion pill access, including Plan C, I Need An A and Red State Access. On these sites, visitors can search for options by their state or territory. Once the client reaches out, community providers typically respond within 24 hours and mail the pills within 48 hours. The medication typically arrives within seven days, and are shipped in an unmarked, discrete package.

More than 100 people are involved in community provision across the United States. One provider told Ms. why she stepped in to become a community provider: “I saw a great need and I could do it,” noting she is single with no children and is white, making her less vulnerable to police surveillance. “I love helping people. It’s rewarding.”

A recent client wrote back to her community provider with a message of gratitude: “I would like to extend my gratitude and appreciation. What you guys are doing is saving lives and giving us a choice when we don’t have the means of money or the resources. Thank you so much. I received the package and it worked as intended. Thank you for being here for me and millions of other girls that are in need.”