EXCLUSIVE: A pro-life group has released a new report calling on the Trump administration to take action against mail-order abortion drugs, arguing that it can enforce a 19th-century federal law to crack down on abortion pill shipments.
In the report obtained by Fox News Digital, the Restoration of America Foundation (ROAF) said Democrat-led states’ shield laws â adopted to protect providers in blue states from being prosecuted by GOP state governments â allow providers to ship, or are being used by providers to ship, the abortion pill mifepristone into red states “with no in-person exam or verification of who takes them or whether they take them willingly.”
ROAF attributed the growth in mail-order abortions in part to FDA policy changes that suspended the in-person dispensing requirement during the COVID-19 pandemic before making the change permanent, allowing abortion drugs to be prescribed through telehealth and mailed to patients.
The report said nearly 15,000 medication abortions each month were provided under blue state shield laws by June 2025. It also said that by the end of 2024, about 15% of all U.S. abortions were through medication mailed to women in states with abortion restrictions.
ROAF also cited an insurance claims analysis that the organization said found serious adverse health events following 10.9% of drug-induced abortions from 2017 through 2023, roughly 22 times the rate reported on the FDA-approved label for the abortion pill regimen. The group said the rate reached 11.2% in 2023 as the drugs were used more broadly.
According to the report, ROAF estimated that mail-order drugs were “directly responsible” for more than 300,000 abortions in 2025 alone.
This comes just ahead of the 110th anniversary of Planned Parenthood in the U.S., as the nation’s largest abortion provider will be commemorating its Oct. 16, 1916, founding later this month.
The ROAF report is urging Attorney General Todd Blanche to enforce the Comstock Act, an 1873 law criminalizing sending certain abortion-related materials that the pro-life group argues should be used by the to stop shield laws from protecting mail-order medication abortions.
“As we come up with this anniversary for Planned Parenthood, we think it’s a good moment to release this paper. We really want to talk about the Comstock Act and the impact it could have on abortions going forward in this country,” ROAF CEO Doug Truax told Fox News Digital.
“The Comstock Act says it’s illegal to put these drugs in the mail, so we’re just asking them to enforce the law,” he continued.
After the Supreme Court overturned Roe v. Wade, which returned the power to make abortion laws to the states, the Justice Departments Office of Legal Counsel under the Biden administration in December 2022 issued an opinion that concluded that the Comstock Act does not prohibit mailing mifepristone or misoprostol when the sender lacks intent that the recipient use the drugs unlawfully.
The Biden administration’s Office of Legal Counsel concluded in a December 2022 opinion that the Comstock Act does not prohibit mailing mifepristone or misoprostol when the sender lacks the intent that the drugs be used unlawfully.
But Blanche said during his confirmation hearings over the summer that he would review how the DOJ interprets the Comstock Act. ROAF says the department should withdraw the Biden administrations opinion, investigate providers and organizations involved in mailing the drugs and enforce the 150-year-old federal law, which the group argues would effectively ban the mailing of abortion drugs nationwide.
“We are asking the admin
