Two New States Criminalize Mail-Order Abortion Drugs

Oklahoma and Iowa recently enacted laws banning the distribution of dangerous chemical abortion drugs through the mail expanding protections for women and unborn children. The two states join at least one other state, Mississippi, which enacted a similar law last month criminalizing sending the two-drug abortion pill regimen of Mifepristone and Misoprostol through the mail in the state.

Signed by Governor Kevin Stitt, Oklahoma’s House Bill 1168 makes abortion pill trafficking a felony offense. The law applies to individuals who deliver or possess the drugs with an intent of causing an illegal abortion under the state’s near-total abortion ban. Violations of the law would be punishable by up to 10 years in prison, up to a $100,000 fine, or both. The law will take effect November 1, 2026.

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In Iowa, Governor Kim Reynolds signed House File 2788, which also prohibits mail-order abortion pills and requires women to obtain such drugs only through an in-person visit with a doctor. Iowa currently has a six-week “heartbeat” abortion law protecting women and unborn life after six weeks or pregnancy. Out-of-state providers who mail abortion drugs into Iowa could face civil liability while in-state doctors could face licensing discipline. The measure also clarifies that treatments for miscarriages and ectopic pregnancies are not considered abortions under the state’s “heartbeat” law. The law will take effect July 1, 2026.

Both new state laws slightly differ, with Oklahoma’s measure focusing on enforcement and criminal penalties tied to mail distribution, while Iowa’s law directly regulates the clinical process requiring the drugs be dispensed in direct interaction with a medical provider.

State actions to more strictly regulate abortion drugs comes as chemical abortion pills account for about 63 percent of all abortions nationwide. Studies show that nearly 11 percent of women who ingest Mifepristone experience serious health complications after just one dose. The mail-order process is one way abortion providers have been using to circumvent pro-life state laws.

On the national level, Louisiana is challenging the U.S. Food and Drug Administration’s Biden-era relaxation of regulations allowing the sending of abortion drugs through the mail which undermines its own near-total abortion ban. Earlier this month, the U.S. Supreme Court voted 7-2 to keep mail-order access to Mifepristone available while Louisiana’s challenge proceeds in the Fifth Circuit Court of Appeals. The Fifth Circuit preliminarily ruled that the FDA must reinstate the in-person requirement for dispensing Mifepristone that would have blocked mail-order access nationwide, but the Supreme Court’s intervention blocks that ruling for now.

Justice Clarence Thomas, who dissented from the decision to keep mail-order access available, stated that the Comstock Act bans using the mail to ship any “drug…for producing abortion.” He noted that drug companies who traffic in abortion pills operate a “criminal enterprise” and blocking mail-order access would not harm these companies for it would only make “it more difficult for them to commit crimes.”

Liberty Counsel Founder and Chairman Mat Staver said, “Oklahoma and Iowa have taken commendable measures to curb mail-order abortion drug access that has been circumventing pro-life laws. Tragically, mail-order abortions kill thousands of precious unborn babies. These state legislatures have recognized human beings in the womb have the inalienable right to life. Chemical abortion drugs cruelly kill defenseless children and harm women, and abortion pill providers must be held accountable. Every state should stop the mail-order murder of babies.”