Forced Abortions via Mail-Order Pills: Emerging Crisis and Policy Response

Since the start of 2024, U.S. officials and advocacy groups have documented a growing pattern of women being coerced into taking medication-induced abortions that were obtained through mail-order telehealth services. The practice—often described as “forced abortion”—involves a partner, family member, or other trusted individual obtaining abortion pills without the woman’s informed consent and administering them covertly. Reported incidents span multiple states, including Louisiana, Texas, and Ohio, and have resulted in fetal deaths, criminal prosecutions, and civil lawsuits.

The women forced to abort: How U.S. law enables abusers

Abortion pills can be shipped across state lines under telehealth arrangements that require minimal verification of the patient’s identity. After the 2020 policy changes enacted by the Trump administration, the Food and Drug Administration reduced oversight of mail-order distribution, leaving the market largely unregulated. Advocacy groups now call for the reinstatement of stricter controls, including enforcement of the 1873 Comstock Act, which prohibits the interstate shipment of abortifacients, and the removal of “shield laws” that protect providers who dispense the medication in states where it is illegal.

The women forced to abort: How U.S. law enables abusers

Heartbeat International’s “Abortion Pill Tracker” lists 17 documented forced-abortion cases from 2007 through 2023, with two additional reports filed in 2024 alone. The organization notes that the tracker likely captures only a fraction of the true incidence. Nationally, chemical abortions account for roughly 65 % of all abortions, representing an estimated 7.5 million fetal deaths, according to data cited by anti-abortion advocates.

The women forced to abort: How U.S. law enables abusersThe Sydney Morning HeraldFair Observer

• Texas, 2025: Justin Anthony Banta was charged with capital murder after spiking his girlfriend’s drink with crushed abortion pills, resulting in the death of the unborn child.

The women forced to abort: How U.S. law enables abusers

• Ohio, 2024: Physician Hassan Abbas allegedly forced crushed abortion pills into his pregnant girlfriend’s mouth, leading to fetal loss.

The women forced to abort: How U.S. law enables abusers

• Louisiana, 2023: Rosalie Markezich reported that her boyfriend pressured her to ingest abortion medication obtained via mail; she later joined an abortion-pill lawsuit against the FDA.

The women forced to abort: How U.S. law enables abusers

Heartbeat International emphasizes that “every woman deserves to make decisions about her pregnancy free from coercion, threats, manipulation, violence, or deception.” Students for Life Action’s Kristi Hamrick urged the administration to “enforce the Comstock Act” and eliminate shield laws, arguing that current policies “empower abusers and pill pushers.” Live Action’s Noah Brandt called the situation “the brutal reality of the abortion pill” and advocated for the complete removal of the medication from the market. Pregnancy-help centers, numbering about 3,000 nationwide, are being mobilized to provide counseling, safety assessments, and, where legally permissible, assistance with medication reversal.

The women forced to abort: How U.S. law enables abusers

Andrea Trudden, spokesperson for Heartbeat International, cautioned that “publicly reported cases likely represent only a fraction of what is actually occurring,” highlighting the difficulty of quantifying the problem due to under-reporting and the private nature of the abuse.

The women forced to abort: How U.S. law enables abusers

Legislators in several states have introduced bills to reinstate the Comstock Act’s prohibitions and to criminalize the non-consensual distribution of abortifacients. Federal agencies are reviewing the FDA’s 2020 policy changes, and ongoing civil litigation may shape future regulatory frameworks. Advocacy groups continue to monitor the tracker and to lobby for expanded resources for victims of forced abortion.

The women forced to abort: How U.S. law enables abusers

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• “Publicly reported cases likely represent only a fraction of what is actually occurring,” — Andrea Trudden, spokesperson, Heartbeat International

The women forced to abort: How U.S. law enables abusers

• “Every woman deserves to make decisions about her pregnancy free from coercion, threats, manipulation, violence, or deception,“ Brown said.” — Christa Brown, senior director of Medical Impact, Heartbeat International

The women forced to abort: How U.S. law enables abusers

• “The chemical abortion pill policies left in place by the Trump administration empower abusers and pill pushers and abandon women and children,” — Kristi Hamrick, spokeswoman, Students for Life Action

The women forced to abort: How U.S. law enables abusers

• “A civilized society does not mail poison to mothers or their abusers so their children can die alone at home.” — Noah Brandt, spokesman, Live Action

The women forced to abort: How U.S. law enables abusers

• “Sixty-five percent of abortions in America are chemical abortions, which have already ended the lives of an estimated 7.5 million preborn children,” — Noah Brandt, spokesman, Live Action

The women forced to abort: How U.S. law enables abusers