Why Red States Like Tennessee Can’t Stop Abortion Telemedicine
A new group is building legal armor for blue state providers
Last month, Julie F. Kay launched Reproductive Futures, an organization working to strengthen and expand shield laws—the legal protections in blue states for doctors who mail abortion pills into states where abortion is banned. Kay is an internationally recognized human rights lawyer and co-author of Controlling Women: What We Must Do Now to Save Reproductive Freedom.
I wanted to talk with Kay, not because Tennessee is a blue state, but because we are a state that will rely on the strength of those shield laws. Surgical abortions in Tennessee have fallen sharply since Dobbs v. Jackson Women’s Health Organization, largely due to the growing use of medication abortion. Now, one in every four abortions nationwide happens through telemedicine.
Tennessee lawmakers have already been hard at work to fight that trend. The 2022 Telehealth Abortion Ban Act made it a felony to prescribe abortion medication remotely, although there is no penalty for the person receiving the pills. During the last session, Rep. Gino Bulso proposed adding civil penalties for out-of-state providers who send abortion pills into the state. Attacking telehealth will be a major priority when the legislature reconvenes in January.
Those realities are exactly what civil-rights attorney Julie F. Kay wants to confront through her new organization, Reproductive Futures. “Our organization was started because we believe access to reproductive health care is a fundamental human right,” she told me. “With the overturn of Roe v. Wade, we’re seeing that right erased. We’re using creative legal strategies to make sure care remains safe and available.”
Reproductive Futures aims to untangle legal confusion for doctors so they can provide safe, timely, and critical care. The group focuses on three areas: telemedicine abortion, emergency-room care, and post-abortion treatment. Its priorities are not aspirational. They are operational. They address the needs of patients today.
Years before Dobbs, in a landmark case before the European Court of Human Rights, Kay represented a woman with cancer who was denied lifesaving abortion care in Ireland, where the procedure was illegal. The court ruled that Ireland’s ban violated her client’s human rights—a decision widely celebrated as a major win for women.
But that victory, Kay said, “existed only on paper.” Years later, the death of Savita Halappanavar, who died of sepsis after doctors refused to end her failing pregnancy, revealed the deadly cost of legal uncertainty. “By the time they went to treat her, it was too late. She had sepsis and died. We’ve seen this happen again and again.”
Kay views medical confusion created by law as an unacceptable cost. “Nobody goes into medicine looking not to treat patients,” she said. “The criminalization of abortion has deadly effects. These laws are real, but there shouldn’t be unnecessary delays or uncertainty.”
Her goal is to create legal resources that prevent those delays before they happen. “We shouldn’t have doctors calling lawyers from the emergency room. That’s a systems failure,” she said. “Doctors and medical practitioners are well able to make these decisions, but we’ve created such a chilling environment.”
Reproductive Futures offers direct guidance to physicians and hospitals on interpreting state laws and documenting emergencies. “It’s about getting clarity in the law,” she said. “Getting the lawyers out of the operating room.”
Kay said her team is ready to help anyone in medicine better understand their legal options so they can do their jobs. “The law can be a real barrier to providing care, and when a lawyer says, ‘You can’t do something,’ it shuts things down.”
In addition to providing legal resources to providers in red states, Reproductive Futures is also working to strengthen legal protections for providers in blue states.
“Telemedicine abortion is safe, legal, and effective,” she said. She explained that several states have begun defining the procedure as taking place where the doctor is located—a legal framing that limits red states’ ability to target those providers.
This means that if a doctor in New York prescribes abortion medication to a patient in Tennessee, similar to the ongoing case in Texas, the prescriber would have legal protection against Tennessee’s 2022 Telehealth Abortion Ban Act, which makes it a felony to prescribe the pills remotely.
Kay believes telemedicine will continue to expand access even under hostile state laws. “We’re looking toward the future. Telemedicine abortion as the modern house call,” she said. “The doctor will see you now through Zoom or online. It’s safe, legal, and effective.”
The message that access is possible is one Kay wants Tennessee doctors and patients to hear most clearly. “It is not illegal to self-manage your pregnancy anywhere in this country right now,” she said.
Her advice to advocates and physicians in Tennessee and other red states is pragmatic: start where you are. “It’s important to operate in the space you know, in what’s possible,” she said. “Listen to the people who’ve been in the trenches for years.”
Want to take action? Here’s how.
Support the work:
Learn more about Reproductive Futures, the new organization providing legal guidance to doctors and hospitals navigating abortion bans and shield laws.
Know your options:
Visit Plan C to find reliable, up-to-date information on how to safely access abortion pills by mail and telemedicine.
Share the facts:
Post, talk, and write about it. Tell people that telehealth abortion is still legal and protected, even in states with abortion bans.