Dana Johnson,
University of Wisconsin–Madison
Teens in the U.S. are obtaining medication abortion pills through telehealth, and young people age 18 to 24 are ordering medication abortion at much higher rates than older adults.
Those are the key findings of a new study my colleagues and I published in JAMA Health Forum. We examined requests made to an online telemedicine service operating in all 50 states without age restrictions, comparing weekly rates before and after the Supreme Court overturned Roe v. Wade in June 2022. We analyzed trends across age groups (15–17, 18–24 and 25–49) and by the severity of state-level restrictions.
After Roe was overturned, many expected abortion numbers to fall, given the spread of state laws restricting clinic access. But research from the Society of Family Planning’s #WeCount project shows the opposite: abortions have increased nationwide, including in states that ban the procedure.
A key driver is the rise of telehealth medication abortion, which has expanded access for tens of thousands. As of early 2025, an estimated one in four abortions occurs via telehealth. Until now, research and media attention have largely focused on adults rather than teenagers.
Understanding this trend among adolescents matters because minors face a distinct legal landscape. More than 7 million girls aged 13 to 17 live in states with abortion bans, and the policy environment continues to shift.
In most states, adolescents must navigate parental involvement laws requiring consent or notification. These rules can make access difficult or impossible, even in states that otherwise protect abortion rights. Some teens turn to judicial bypass procedures to avoid parental involvement.
Beyond legal hurdles, practical barriers persist. Teens may face stigma around pregnancy, lack access to transportation, or be unable to afford clinic-based care, which can cost US$600 or more. These constraints compound the difficulty of obtaining services through traditional channels.
Our findings suggest that minors are turning to telehealth at higher rates in states with parental involvement laws than in states with fewer restrictions. This pattern points to the significant barriers created by such laws and suggests that minors often face a more restrictive policy environment than adults, especially where additional measures – such as waiting periods or gestational limits – are in place.
At the same time, important questions remain. More research is needed to understand why teens seek online providers and how they navigate access. Such insights could help clinicians and advocates better support adolescents using telehealth services.
Legal risks are also a concern. Teenagers ordering abortion pills online may face prosecution, and some have already been criminalized. Anti-abortion lawmakers and prosecutors have increasingly targeted minors. Idaho, for example, has passed an “abortion trafficking” law that makes it illegal to help minors obtain abortion care.
At the federal level, efforts to revise the Food and Drug Administration’s approval of the abortion drug mifepristone have included attempts to restrict access for minors, alongside continued claims questioning the drug’s safety for teens.
Taken together, these developments highlight a growing reliance on telehealth among young people navigating a fragmented and increasingly restrictive abortion landscape.
[Abridged]
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