Several Democrat-governed states have enacted "shield laws" to protect doctors who prescribe and send abortion pills from an unregulated European company to states with abortion bans. These laws, passed in states like New York, Massachusetts, Washington, Vermont, and Colorado, aim to circumvent restrictions in Republican-led states where abortion pills are prohibited.

Aid Access, an Austrian non-profit, revealed it has used this system to distribute abortion pills, prescribed by U.S. providers, to 3,500 women in states with abortion bans. While the organization previously relied on European doctors for prescriptions, the new "shield laws" allow them to partner with American physicians. One New York doctor working with Aid Access told The Washington Post that their home was a hub for abortion pills destined for the South and Midwest, asserting that their actions are legal despite conflicting state laws.

Aid Access, established in 2018 to broaden abortion pill access globally, now claims to offer services in all 50 U.S. states. This has led to legal challenges, including a 2019 cease-and-desist letter from the FDA alleging the distribution of "misbranded and unapproved new drugs." Aid Access countered with a lawsuit, and the FDA has not pursued further action.

Abortion pills now represent a majority of abortions performed in the U.S., a trend likely amplified by the overturning of Roe v. Wade. Aid Access reported a significant surge in orders from Texas following the implementation of the state's restrictive abortion law.

Anti-abortion groups, such as Susan B. Anthony Pro-Life America, contest the legality of the "shield laws" and express concerns about women's health. They argue that sending abortion pills across state lines is unsafe and disregards the will of the people in states with abortion restrictions.

The abortion pill regimen involves two medications: mifepristone, which requires a prescription and ends the pregnancy, followed by misoprostol, which induces uterine contractions to expel the pregnancy. These pills can be taken at home without direct medical supervision, raising concerns about potential complications, although they are generally considered less risky than surgical abortions.