Skip to main content

Medication abortion using a mail-order pharmacy is feasible and effective

For more than two decades, the U.S. Food and Drug Administration has required that mifepristone used for medication abortion be dispensed only in clinics, medical offices, and hospitals. But this study finds mail-order pharmacy dispensing of mifepristone is effective, feasible, and acceptable to patients—presenting a possible alternative for those who live in areas where abortion access is difficult.

Key Findings

Out of 224 participants who received mifepristone and misoprostol through a mail-order pharmacy after an in-person assessment for eligibility, 217 (96.9%) had a complete abortion with medications alone, including eight (3.6%) who received a second dose of misoprostol.
Five participants (2.2%) had ongoing pregnancies, and two (0.9%) had incomplete abortions treated with uterine aspiration.
Eleven participants (4.9%) had an adverse event that was possibly related to the medication abortion, but investigators determined that none of the events would have been avoided by dispensing medications in person instead.
Most participants received their medications within three days, but 18% experienced a longer wait.
In a survey 14 days after the experience, 193 (91.0%) of respondents reported satisfaction with their overall medication abortion experience, and 190 (89.6%) said that they would use the mail-order service again if needed.

Study Design

In this interim analysis of an ongoing study, researchers enrolled consenting patients who were less than nine weeks pregnant and who were seeking medication abortion at five clinics in four states. After clinicians evaluated patients and prescribed them mifepristone and misoprostol, a mail-order pharmacy shipped the medications using next-day delivery to their preferred address. Patients then took two surveys—one after three days and one after 14—about the experience and whether they believed their abortion was complete.


ANSIRH’s prior research found that the number of obstetrician-gynecologists willing to provide medication abortion could double if they could prescribe the pills for their patients, which could then be obtained in a pharmacy. Using a mail-order pharmacy is a feasible way to provide mifepristone and misoprostol and expand the number of abortion providers, particularly in areas that may have fewer clinics providing the service. In addition, mail-order pharmacies are an important component in providing direct-to-patient telehealth medication abortion.

As the researchers write:

“These interim results, together with studies of other care models that include mailing pills for medication abortion and pharmacist dispensing at brick-and-mortar pharmacies, support the removal of the FDA’s in-person dispensing requirement for mifepristone.”

The article, Mail-order pharmacy dispensing of mifepristone for medication abortion after in-person clinical assessmentis available in Contraception.