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US drug regulators have approved mail-order abortion pills, making permanent a temporary rule change that was approved this year during the pandemic.
The decision from the US Food and Drug Administration (FDA) will open abortion access to women in remote places unable to visit clinics to get them in person.
But the move will be overridden by 19 states that already have rules banning mail-order abortion pills.
It comes as judges consider overturning the ruling that legalised US abortion.
The medication, mifepristone, is approved for up to 10 weeks of pregnancy, and is one of two pills used to end pregnancy and treat miscarriage.
Restrictions on the drug, which was first approved in 2000, were lifted earlier this year due to pandemic lockdown measures.
The change is now permanent, allowing women to receive the pill by post from a certified medical worker or pharmacy and receive abortion consultations on the internet.
"The FDA's decision will come as a tremendous relief for countless abortion and miscarriage patients," said Georgeanne Usova of the American Civil Liberties Union (ACLU).
But anti-abortion advocates say the decision puts women at risk.
Some 24 out of 3.4 million women who took the branded version of the drug to terminate a pregnancy have themselves died between 2000 and 2018, according to FDA records.
The change comes as the US Supreme Court considers a case that could overturn the 1973 Roe v Wade ruling that legalised abortion in all 50 states.
A decision on Mississippi's law banning abortion after 15 weeks is due by the end of June.
Medically induced abortion involves two drugs, taken over the course of several days.
Mifepristone blocks a hormone necessary for pregnancy, while the second drug, misoprostol, induces contractions. Misprostol is already available with a doctor's prescription.
The method now makes up 54% of all abortions performed before nine weeks, according to the Kaiser Family Foundation.