Care that can currently be delivered by a nurse-midwife via a brief video call or online questionnaire would revert to a time-consuming and costly series of clinic visits with a physician. Medication abortion could be offered for only 49 days from the start of a patient's last period, instead of up to 10 weeks as it is today. Those changes would also bar mifepristone prescriptions through telehealth, leaving some to rely on a less effective regimen with more unpleasant side effects.

Telehealth is the only viable option for patients who can't take a sick day, find a babysitter — data from the Centers for Disease Control and Prevention show the lion's share of abortion patients are already mothers — or catch a ride to a clinic that may be hours away on public transit, experts say.

"I've had patients tell me, 'I've got a job that won't let me take time off. I've got kids and no child care,'" said Dr. Michele Gomez of the MYA Network, a consortium of virtual providers, who has served many patients with Medi-Cal. "Lots of people talk to me while they're at work. I've had so many people [take appointments] with their kids crawling all over them."

Women who have relied on the medication say it felt like the most convenient — and safest — option.

"I knew the clinic locations, but actually getting there was hard," Lee said of her abortion. "It all felt so scary, on top of having to be in the situation."

Gomez said that in years past doctors were required to watch patients take the pill. Eliminating those and other rules helped propel medication abortion from the margins of care to the heart of reproductive rights within the last decade, the Bay Area provider and others said.

"I can send [pills] out by mail any time it works for me," she said.

The changes also paved the way for clinicians in California and five other states to prescribe and mail abortion medication to patients in jurisdictions where it's been banned, under so-called shield laws.

"Abortion care via mail is now the most viable form of access for most of the country," said Kiki Freedman, co-founder and chief executive of Hey Jane, an abortion telehealth startup. "Any change to the way mifepristone is prescribed is an attack on access, period."

Indeed, a growing number of experts believe the rise of telehealth could explain why abortions jumped in the wake of the Dobbs decision, even as 21 states have partially or completely outlawed the procedure.

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