On Thursday, May 5, Tennessee Gov. Bill Lee signed a bill criminalizing abortion-inducing drugs that are provided through telehealth or by mail.

The measure, HB2416, establishes criminal penalties for offenders, but would not apply to the patient who was provided with the abortion drugs. 

Medicated abortions have become an increasingly common method to terminate early-term pregnancies up to 10 weeks. Last year, the FDA approved the drugs for distribution through telehealth and mail delivery due to access concerns during the pandemic. 

According to the Guttmacher Institute, an abortion rights think tank, more than half of U.S. abortions are done through medication rather than surgery. 

Tennessee already has multiple existing requirements that create barriers to care, including a 48-hour waiting period, mandatory in-person ultrasounds and anti-abortion counseling, and bans on insurance coverage for the procedure through the Affordable Care Act. 

The legislation sets strict limitations around abortion-inducing medications. The drugs may be provided only by a qualified physician, and they cannot be provided by “courier, delivery or mail service.”

The bill also states that patients must be examined in-person and the patient must be informed that they may see the remains of the unborn fetus in the process of terminating the pregnancy. The medical provider must schedule a follow-up appointment within two weeks, and none of these drugs can be provided on elementary, secondary, or high school facilities. 

"An individual who intentionally, knowingly, or recklessly violates this bill commits a Class E felony and, upon conviction, will be fined an amount not to exceed $50,000, be imprisoned for a term not to exceed 20 years, or both," the bill reads. 

Tennessee is one of several states with ‘trigger laws’ that could immediately restrict abortion access if the Supreme Court overturns Roe v. Wade, which is very likely. 

Thirty days after Roe is repealed, all abortions in Tennessee would be prohibited, with an exception of those that would prevent the death of the pregnant person. If in violation, medical providers could be charged with a felony. 

Kristen Moore, director of the EMAA project, which seeks to improve the way the abortion-inducing drugs are dispensed in the U.S., told Healthcare IT News that it’s “frightening” to see lawmakers continue to pile on abortion restrictions, especially one that concerns FDA-approved medications. 

"The practical effect of these laws will be to push patients to self-source the medication and then deny them access to the support of licensed healthcare providers as they manage their abortion," Moore said. 

Following the recent leaked draft majority opinion from the Supreme Court regarding the status of Roe v. Wade, health experts warned that the maternal mortality rate, an issue that already impacts women of color disproportionately, will increase in states with abortion restrictions. 

According to the CDC, for every 100,000 live births in the United States, 20 mothers die. In Tennessee, 98 women died within a year of pregnancy in 2020. 

Data from The Turnaway Study found that people who are denied abortions are more likely to experience major complications towards the end of their pregnancy and experience poor physical health in the years following. 

In the wake of the Roe news, several companies that offer abortion via telemedicine reported an increase in interest in their services. 

For instance, the online abortion clinic Hey Jane, told Politico that it noticed a 24% to 34% increase in the number of people seeking the pills in recent weeks, and overall site traffic had quadrupled. 

"Medication abortion by mail and telehealth was already banned in Tennessee; this new law, which increases penalties, is nothing more than a ploy by Gov. Lee to gain attention in this fraught moment," Ashley Coffield, president and CEO of Planned Parenthood of Tennessee and North Mississippi, said in a statement.