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With the Supreme Court’s decision on Friday to repeal Roe V. Wade, and thus allow states to ban abortion, federal protections around abortion will leap back half a century. The reality of how people access abortions, though, has evolved in those 50 years. The majority of U.S. abortions are now induced with medication instead of done surgically, and telemedicine providers of these pills will play a crucial role in serving patients who live in states that sharply limit or ban abortions.

It was only in December that the Food and Drug Administration made permanent a rule change allowing patients to receive abortion pills by mail instead of having to visit specially certified providers in person. Now telemedicine abortion providers will have to grapple with how to serve patients across the country as more states are expected to restrict and criminalize abortions.

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