Abortion access in rural areas: What to know and how to get care

If you live in a rural area, getting abortion care can be difficult due to fewer clinics, long travel distances (sometimes even across state lines), and privacy concerns in tight-knit communities. In fact, in 2020 the Guttmacher Institute found that nearly 90% of U.S. counties didn’t have a single abortion provider—a number that has only grown since Roe v. Wade was overturned in June 2022.

If you live in a rural area, know that you still have options for accessible abortion care through virtual clinics like Hey Jane. Telehealth abortion care helps bridge that gap by making secure, private abortion access possible from wherever you are. 

In this guide, we’ll explain how telehealth abortion care works, what to expect when using abortion pills at home, and how people in rural areas can safely access care.

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What are abortion pills, and are they safe to use at home?

Abortion pills are actually two FDA-approved medications—mifepristone and misoprostol—that are used to safely end pregnancies up to 10 weeks. They’re up to 98% effective when used together, and are safe to take at home.

With telehealth providers like Hey Jane, you’ll meet with a licensed clinician online (over chat, phone, or video call), receive clear instructions, be able to message our team through your patient portal, and have access to our nursing 24/7 line for support.

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How telehealth abortion works for people in rural areas

Hey Jane’s process is simple—and designed to work no matter where you live:

1. Complete our online intake form: Answer a few questions about your health, available 24/7.
2. Consult with a provider at home: Connect with a licensed clinician over secure chat, phone, or video call to make sure treatment is safe for you, and to ask any questions you may have.
3. Receive your medications: Your provider will get your abortion pills delivered to your door in discreet packaging—plus comfort medications for pain and nausea.
4. Get ongoing support: You can message us anytime through the secure patient portal or call our 24/7 nursing line with health concerns.

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Your clinical team will continue to follow up through the patient portal to ensure that treatment went smoothly and that the abortion was successful. If you need, or prefer, to get in-person follow-up care, your team can help recommend abortion-friendly providers in your area.

To find out if abortion pills may be an option for you, use our pregnancy calculator to see how far along you are and what types of abortion care you may be eligible for.

Why abortion pills by mail helps people in rural areas

1. Accessibility and convenience

When the nearest clinic is hundreds of miles away, getting an appointment can mean taking unpaid time off, finding childcare, and arranging travel. Hey Jane helps to remove those barriers by providing telehealth abortion care that meets you where you are and that allows you to take treatment on your own schedule.

“I received such quick and compassionate care through Hey Jane. Though my state is not restrictive, my area of the state is. Unfortunately, the nearest in-person clinic was more than 200 miles away. I’m not sure what I would have done without Hey Jane.” - Hey Jane patient, February 2025

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2. Privacy and discretion

In small towns, privacy can be hard to find. When everyone knows everyone, visiting a clinic or local hospital can feel stressful. If you’re looking for an extra layer of privacy, Hey Jane is a discreet and judgment-free option. Medication arrives in plain packaging, and your care team supports you online every step of the way.

“I live in a rural community, and needed to use Hey Jane to avoid a pregnancy. I filled out a form through their questionnaire, received several abortion options, follow-up care, and very detailed instructions, as well as what to expect. Everything was shipped to my door discreetly, and it was an extremely fast process from start to finish.” - Hey Jane patient, May 2024

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3. Affordability

Cost shouldn’t be a barrier to abortion care, which is why Hey Jane is committed to making treatment affordable—with or without insurance. Insurance can bring the cost of care as low as $0 out-of-pocket. If not using insurance, we offer income-based pricing and flexible payment options including debit and credit card, Apple Pay and Google Pay, a ‘buy now, pay later’ option, and financial assistance from our abortion funds partners to help lower costs.

“As someone with no health insurance, Hey Jane offered a quick and surprisingly affordable abortion method. I would highly recommend them for anyone seeking help!” - Hey Jane patient, X

“Incredibly simple and at no cost to me with insurance, which was a huge relief.” -  Hey Jane patient, X

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4. Comfort of home

Being in your own space can be more comfortable than an unfamiliar clinic setting. In fact, many people say at-home abortion care feels calmer, more private, and supported.

“Hey Jane made an uneasy process feel less heavy and less stressful. I always felt cared for and supported. It was nice having this process in the comfort of my home and Hey Jane was there for me through it all.” - Hey Jane patient, July 2024

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Are abortion pills legal in rural states?

It depends on where you’re located as abortion laws vary widely by state. To learn more about local abortion laws and access options, check out our state guides.

Hey Jane currently providers care in the following states (residency not required: California • Colorado • Connecticut • Delaware • Hawaii • Illinois • Maine • Maryland • Massachusetts • Michigan • Minnesota • Nevada • New Hampshire • New Jersey • New Mexico • New York • Ohio • Oregon • Rhode Island • Vermont • Virginia • Washington • Washington, D.C.

If you are unable to access abortion care locally, you can still travel to a nearby state for care. If you need help with the cost of travel (including gas and airfare), lodging, or meals on-the-road—an abortion fund may be able to help.

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Tips to prepare for an at-home abortion in a rural area

If you’re planning an at-home abortion and live somewhere remote, a little prep can make the experience smoother and more comfortable.

Here’s a simple checklist to help:

• ✅Check your phone and internet connections to stay in touch with your care team.
• ✅Create a safety plan in the unlikely event you need emergency medical attention. Identify the closest emergency room and how you would get there—its not safe to drive yourself in an emergency situation.
• ✅Plan for mail delivery: If you don’t have reliable mail service, consider mailing to the closest Fedex pickup location or a trusted friend’s home nearby.
• ✅Stock up on supplies: Gather pain relief medication, heating pads, snacks, and water.
• ✅Prep your space: Set up a quiet, comfortable spot at home with a blanket or pillow.
• ✅Have support ready if you need it, whether it’s a friend, partner, talk or text line. 

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The bottom line

Living in a rural area shouldn’t limit your ability to make decisions about your body. Telehealth abortion care makes safe, affordable, and private care possible—no matter your ZIP code.