Massachusetts health care professionals are now providing abortions to more people out of state than residents. And a new report released by the state’s Department of Public Health this week suggests most of those appointments are happening without a single in-person visit.
Massachusetts has some of the nation’s strongest protections for abortion providers, easing the way for medical professionals to prescribe and mail abortion pills out of state — even to states where abortion is illegal. Now, tens of thousands of people in their first trimester of pregnancy are getting abortions remotely: Reaching out to a telehealth provider, getting a prescription, and having abortion pills mailed to them.
The Massachusetts report doesn’t show where those pills are sent, but providers like Dr. Angel Foster say that — in states with the most restrictions — telemedicine is behind almost all of residents’ medication abortions.
Foster co-founded the Massachusetts Medication Abortion Access Project, or the MAP, which is based out of Cambridge and provides abortions by telehealth into other states.
“Massachusetts — it’s a small state, right?” Foster said. “It’s not California. It’s not New York. I just think it’s so heartening that Massachusetts is playing this outsized role in protecting reproductive autonomy and supporting abortion patients like throughout the country.”
According to the new state data, more than 30,000 people accessed abortions by telehealth in Massachusetts in 2024, five times more than the year before. Foster expects the numbers have only increased.
In 2024, the MAP alone had 11,000 medication abortion patients. In 2025, the organization had 25,000 patients and, so far, they’re on track to have as many as 40,000 in 2026.
Since Roe v. Wade was overturned nearly four years ago, Massachusetts state leaders have lowered barriers to getting an abortion. They funneled millions of taxpayer dollars into nonprofit abortion funds to help individuals cover costs, expanded legal exceptions for third-trimester abortions and — perhaps most consequentially — passed the Shield Law. The law protects abortion providers from out-of-state criminal or civil investigations, like those authorized under Texas’ abortion bounty law.
That puts Massachusetts among a small group of eight states that specifically offer legal protection to providers that serve patients out of state via telehealth.
“Women across the country — whether they live in Massachusetts or not — need health care,” said state Sen. Cindy Friedman, the bill’s lead sponsor. “This is health care, and they’re getting it where they can.
“The point of the Shield Law was to protect our commonwealth from outside influence by other states and other entities, right?” Friedman added. “It doesn’t upset me that we have created a space where women everywhere can get the care they need. So it wasn’t the purpose of the law, but the fact that it is providing that care for women — wherever they live — I feel very good about that.”
The number of people traveling across state lines for an abortion more than doubled after the fall of Roe v. Wade compared to pre-pandemic numbers, according to national data from the Guttmacher Institute, a reproductive rights organization. Some people have to travel farther to get the care they’re seeking. But travel to Massachusetts, especially from outside of New England, remains limited.
Isaac Maddow-Zimet is a data scientist with the Guttmacher Institute who tracks abortion and travel across state lines. He says travel to a brick-and-mortar facility is still preferred or necessary for many people, like those in later pregnancy. But the logistics add an additional challenge.
“Travel to another state can be incredibly difficult. It requires an enormous amount of resources and support,” Maddow-Zimet said. “If people are able to have abortions in their own home — with abortions prescribed by a provider out-of-state — that’s something that can be a really critical mode of access.”
Since the Dobbs v. Jackson Women’s Health Organization ruling created a patchwork of state-by-state abortion laws, 13 states now have a total ban on abortion, and another five ban abortion after six weeks, according to the Guttmacher Institute.
That patchwork has also sparked what Foster calls a “revolution” in telemedicine. A quarter of all abortions in the United States were provided by telehealth in 2024, according to the Society of Family Planning’s WeCount report.
“There is a deep irony that, I think, in some areas of the country, affordable abortion care is more accessible today than it was prior to Dobbs,” Foster said.
She pointed to Mississippi, where the Supreme Court case began.
“There was one clinic — Jackson Women’s Health Organization — that was providing care,” Foster recalled. “A medication abortion costs upwards of $500 or $600. Patients had to make multiple visits. There were all kinds of other restrictions.”
“But now, because of Shield Law provision, patients who need abortion care in Mississippi can get medication abortion pills through the mail for $5 from our service,” she added.
