‘Giving Women a Chance to Choose When the World Didn’t’: Massachusetts Doctors Provide Telehealth Abortion in States with Bans

Massachusetts doctors with The MAP are defying abortion bans by providing low-cost, life-saving telehealth abortion care to tens of thousands across the U.S., showing how shield laws and solidarity can outpace state-imposed cruelty.

Originally published in the Daily Hampshire Gazette.

As abortion bans have swept the country, Massachusetts doctors are stepping up by providing thousands with lifesaving telehealth abortion care, regardless of their ability to pay. 

On July 12, reproductive health advocates and local office holders filled the common room of a Northampton, Mass., co-housing community to celebrate and support the vital work of The Massachusetts Medication Abortion Access Project (The MAP). Based in Cambridge, the MAP is one of a handful of medical practices in the U.S. providing telehealth abortion care to patients in states with abortion bans or severe restrictions. Each month, MAP provides abortion pills to 2500 patients—nearly a third from Texas—using an asynchronous telemedicine platform built to provide prompt, private and convenient abortion care that is affordable to all.

Behind the numbers is a team of Massachusetts doctors determined to meet the growing need for abortion. Dr. Angel Foster, the MAP’s medical director, laid it out bluntly: “In 2024, our team cared for 10,861 patients, most of whom lived in states with severe restrictions or total bans on abortion. In the first five months of 2025, we have provided abortion pills to over 12,000 patients. Nearly two-thirds of our patients cannot pay full price for their care—being able to offer subsidized care is only possible because of supporters like you! Every dollar we bring in goes out in packages shipped all over the country.”

The MAP provides abortion care on a sliding scale fee. For patients who are currently pregnant, The MAP offers a pay-what-you-can model, with a minimum fee of $5, which they will waive if even that poses a hardship. Patients receive screening for eligibility, the medications, shipping, support and follow up care. For those planning ahead, the MAP also offers advance provision abortion pills for $150, so when the need arises, there are no delays or barriers to care. Abortion pills, which last two years, are highly effective, easy to use and safer than Tylenol.

As abortion bans multiply and need continues to rise, The MAP is scaling up and expects to serve 30,000 patients in 2025. “We have strengthened our operations, hired another clinician, retained terrific legal counsel, and conducted research to improve our service,” said Foster.

Despite the overturn of Roe v. Wade and abortion bans in many states, the number of abortions has actually increased over the last several years, due in part to increasing access to telehealth abortion, which now makes up one quarter of all abortions, no doubt due to the privacy, convenience and affordability of telehealth abortion.

Three of The MAP’s five prescribing physicians live in Western Massachusetts and attended the July 12 fundraiser. One shared patient responses to the service, offering a glimpse into just how important The MAP’s services are in a post-Roe world:

• I want to thank The MAP from the depths of my soul. You have saved me. 
• Thank you for giving women a chance to choose when the world didn’t. 
• I appreciate more than you know giving me my voice back, thank you. 
• Having access to abortion care in a red state has saved my life. Thank you for helping women and keeping them safe. 
• Thank you for the pricing scaled down so I could afford it and thank you for checking on me. I start college in the spring. Never stop helping the ones the world forgets. 
• Thank you so much. I am appreciative beyond belief at how accessible you’ve made this for me. The nearest abortion clinic to me is over fifty miles away, I don’t have a car, and it’s $1,000, it has been banned after 6 weeks and there’s no way I could have made the money and gotten to the appointment in time. I’m truly appreciative for what you do. 
• The kindness, respect, and support I felt throughout the process made me more confident in my and my partner’s decision and made me feel I wasn’t alone. Thank you all so, so much. 
• Thank you guys so much for doing what you do…The hand written note I received with my package was the kindness and care I needed during this hard time. 
• Your team are angels, thank you for the work you do and the patience you have for people in vulnerable positions. Love u endlessly! 
• It was a very difficult and upsetting situation for me to be in and I appreciate having this avenue accessible to me when others rejected me due to being a trans individual. Thank you, to everyone who makes this possible for people like me. It really saved my life. 
• With my last pregnancy I suffered from severe preeclampsia and toxemia. At 7 months I was placed in a medically induced coma because my organs were shutting down.  My daughter was delivered by emergency c section 2 months early and I stayed in a coma for an additional 2 weeks. I was told if I got pregnant again my body most likely wouldn’t be able to go 9 months without myself or my unborn child dying first… So being pregnant right now is a huge risk to my life.  
• I don’t know what I would have done without you. 
• You truly are the heroes in so many women’s stories and the answer to an otherwise terrible predicament. Discovering The MAP 100% saved my life. 
• As a woman in rural Texas, I see what an incredible service this is. Even in the past I would have had to go to Austin (5 hours) or Houston (3 hours) to be seen at a clinic, further disrupting my life and my privacy. Thank you from the bottom of my heart for the confidence you gave back to me and the option you are providing so many other women. 
• Keep fighting to help women choose. No government should be able to make life changing decisions for us.
• Thank you guys so much. Making a huge difference in lives.
• I am very appreciative for this organization and how quickly the medication came and the low cost. Thank you for all that you do.
• HUGE thank you. Thank you for caring about my body and my decision.
• I really appreciate your service. I couldn’t pay PP prices and appreciate this and hope that more ppl know about this!!
• I thank y’all so much for everything! I don’t know what would happened if I wasn’t informed of the company!
• Thank you for the service you provide and for making the service so affordable!
• I truly appreciate what you have done for me and other women. You are real freaking heroes!
• The packaging from you guys was discreet and I felt really good from the lil handwritten well-wishes note. It was my first abortion & I’m grateful the MAP made it something i could afford & schedule into my life. Thank you ×100000000
• I appreciate this service and told every other person in my life who is capable of reproduction!
• Thank you for caring about my choice!
• Just thank you. Seriously. Thank you.

As patient stories shared at the Northampton event made clear what this care means, state and local officials stood with The MAP providers to assert what every person deserves: the right to safe, affordable abortion care. Among them were Northampton Mayor Gina-Louise Sciarra, state Reps. Lindsay Sabadosa and Mindy Domb, and Northampton City Council member Deborah Pastrich-Klemer. They were joined by Allyson Slater, director of the Massachusetts attorney general’s Reproductive Justice Unit, who described the AG’s work to enforce and strengthen the state Shield law protecting MAP providers and patients from investigation and prosecution by antiabortion state law enforcement.

Mayor Sciarra—a veteran of the ACLU’s Reproductive Freedom Project—emphasized the collective effort to keep abortion care accessible and praised The MAP as central to that fight. “I am extremely grateful for your work and that of many in this room, including the work of our legislators to enact the shield law and work of the Attorney General’s office to protect the access the law ensures, and, of course, the critical work that The MAP does to provide protected, safe telehealth services across the country.”

Massachusetts made The MAP’s nationwide service possible by passing a groundbreaking abortion provider shield law—just one month after Roe v. Wade was overturned. Since then, seven other states have followed Massachusetts’ lead and passed similar legislation.

The Massachusetts shield law defines telehealth as occurring where the provider is located rather than where the patient is located— meaning Massachusetts law applies, even if the patient lives in a state with an abortion ban. As a result, Massachusetts clinicians can legally provide abortion care to patients in all 50 states and to members of military living abroad. The shield law protects clinicians from criminal and civil penalties for care allowed under Massachusetts law, and preserves their licenses and insurance. Along with protecting providers, the law draws a clear line on patient privacy—precluding government officials from turning over a patient’s medical information to other states. 

To put the city’s commitment into practice, Sciarra issued an executive order on Nov. 18, 2024, directing all city officials to comply with the shield law by protecting those seeking reproductive healthcare from federal, state or private efforts to investigate individuals for receiving such healthcare services.

“That order affirms that Northampton is a welcoming city … and recognizes that the horrible cascade of other states’ laws blocking or limiting reproductive healthcare … is resulting in many being forced to turn to states like Massachusetts,” said Sciarra.

This summer, Massachusetts state lawmakers are working to strengthen the shield law. The House recently passed the Shield Act 2.0 to expand protections for personal data of patients and providers and to prevent insurance discrimination and legal action against patients and providers based on other states’ laws. The state Senate passed a similar bill in June. Advocates are now urging the House and Senate to reconcile the two bills and send the Shield Act 2.0 the Governor’s desk to secure additional protections for telehealth abortion providers and patients as soon as possible.  

Telehealth abortion providers are not only creative and determined, they are courageous. When the Texas attorney general civilly sued a New York telehealth abortion doctor who served a patient in Texas, New York courts refused to enforce a judgement against her because of their telehealth provider shield law. When Louisiana prosecutors criminally indicted the same doctor, New York Gov. Kathy Hochul refused to extradite her. A lawsuit challenging New York’s law is likely, but in the meantime courageous clinicians continue to offer this service.

Jenifer McKenna, Northampton event co-organizer and senior advisor to the Reproductive Health and Freedom Watch, described the work of telehealth abortion providers like The MAP as “existentially critical” to our “health, lives, and futures” as well as American democracy for two reasons.

“First, stigmatizing abortion, shaming and silencing people who seek and have abortions is a core right wing project,” said McKenna, an expert on antiabortion crisis pregnancy centers. “Standing together for abortion rights and access, supporting the MAP, and asking others to join us supporting this work, is a concrete and powerful way of saying NO to abortion stigma, no to the shaming and the silencing.”

She continued: “Second, controlling women’s bodies is core to the authoritarian project. So what we are doing here is also critical to resisting the juggernaut of authoritarianism, White supremacy, and Christian Nationalism rolling over our country. Abortion bans and authoritarianism and Christian Nationalism are the same project. The ICE violence and the violence of abortion bans are the same project. And we know they aren’t stopping at abortion—they’re going after birth control and all our reproductive care. So standing together for abortion rights and access, and supporting the MAP is also a concrete and powerful way of saying NO to anti-democratic forces seeking to control our bodies and take over our country.”

To learn more about The MAP, see this Ms. magazine interview with Dr. Angel Foster, listen to her on WHMP radio or watch this video on their work by Reproductive Equity Now.