UPDATE, September 9, 4:04 p.m.: Rebecca Gomperts, founder of Aid Access, filed a lawsuit Monday against the U.S. Food and Drug Administration, claiming the government has stopped some payments to Aid Access and seized up to ten doses of abortion pills provided by Aid Access.

Four months after the U.S. Food and Drug Administration (FDA) warned online service Aid Access to stop shipping abortion pills to patients in the United States, dozens of reproductive rights advocates have come out against unnecessary regulation of medication abortion by mail.

In an open letter released Monday, the organizations and experts explained the online service’s importance as states continue to pass laws putting abortion care out of reach for many. More than 100 anti-choice members of Congress encouraged FDA officials in May to continue its crackdown on Aid Access and other overseas online providers of medication abortion pills.

Aid Access has prescribed and mailed mifepristone and misoprostol, commonly known as abortion pills, to people seeking to end their pregnancies in the United States since 2018.

“We stand against punishing people for seeking health care, and we stand against using the FDA as a pawn to advance a political agenda that aims to deprive people of their dignity and humanity as well as their constitutional right to make intimate decisions about their pregnancies,” the letter says. “We urge the FDA, state legislators, and all policy-making bodies to be guided by the science and support the removal of unnecessary regulatory barriers that make safe and effective abortion medications inaccessible to people who need them.”

The open letter characterized restrictions on medication abortion as part of a larger anti-choice agenda to end legal abortion across the country: “The anti-abortion politicians and activists who propose and enact abortion restrictions are attempting to legislate legal abortion out of existence. They are well aware that the FDA’s restrictions and actions are a key element in the success of their own efforts to make abortion inaccessible.”

The letter pointed out that five states have laws criminalizing self-managed abortion, or abortions conducted outside a medical facility. At least 21 people have been arrested in the United States since 2000 “for ending their own pregnancy or helping someone who has made the decision to do so.”

Reproductive rights advocates said anti-choice misinformation campaigns have largely stymied efforts to make medication abortion pills more accessible in the United States.

“I don’t think the public knows very much about medication abortion in the United States, or how available it is worldwide,” Dr. Ghazaleh Moayedi, a fellow with Physicians For Reproductive Health who signed the open letter, told Rewire.News. “Just to the north of us, Canada approved mifepristone many years after it was available in the U.S., but it is much easier to access since it is available through pharmacies without the restrictions we have in the U.S. It is an encouraging example of how scientists, health-care providers, and activists were able to use research to dramatically change abortion access. Now Canada is now leading the way in expanding access to medication abortion.”

In Ireland, where Aid Access’ founder has provided a similar online service, research found patients “are able to safely use the medications as directed and self-refer to a health care provider when needed,” according to the open letter.

Abortion rights advocates told Rewire.News the recent passage of near-total abortion bans in several states make access to medication abortion more critical than it was even a couple years ago.

Yamani Hernandez, executive director of the National Network of Abortion Funds—one of the letter’s signatories—said medication abortion is “over regulated” across the United States, contributing to abortion stigma. “There isn’t enough access to clinical care in this environment where restrictions on abortion are increasing,” Hernandez said, adding that 90 percent of U.S. counties don’t have an abortion clinic. “We know people will turn to services like Aid Access, and [medication abortion] should be as legal and accessible as possible.”

Traveling—sometimes hundreds of miles—for abortion care isn’t feasible for many people who lack the resources and time off work to make such a trip, Hernandez said. That makes Aid Access and sites like it all the more important for people in the United States.

“We know not everybody is going to be able to travel for myriad reasons,” Hernandez said. “Our main aim is having decriminalization [of self-managed abortion] as part of our agenda, to make sure folks are getting the care they need while not being criminalized in the process.”