As the country awaits a Supreme Court decision on Roe v. Wade, Tennessee Governor Bill Lee signed a bill on Thursday (May 5) criminalizing abortion pills that are delivered by mail.

According to the law, known as HB 2416, “a manufacturer, supplier, pharmacy, physician, qualified physician, or other people may not provide an abortion-inducing drug via courier, delivery, or mail service.”

The law prohibits any distribution of abortion medication except when prescribing is done in person by a physician. The physician is not required to monitor a patient during or after taking the medication, except for a required follow-up appointment within two weeks.

“An individual who intentionally, knowingly, or recklessly violates this bill commits a Class E felony and, upon conviction, will be fined an amount not to exceed $50,000, be imprisoned for a term not to exceed 20 years, or both,” according to the law.

A medicated abortion is a very common method to terminate early-term pregnancies. The use of abortion pills has increased in the U.S. when the Food and Drug Administration (FDA) approved mifepristone, the main pill used in medicated abortions in 2000. More than half of U.S. abortions are done with pills, rather than surgery, according to the Guttmacher Institute, a research group that supports abortion rights.

Two pills are required for the abortion. The first pill, mifepristone, blocks a hormone that needs to maintain the pregnancy. A second pill, misoprostol, which has to be taken one to two days later, empties the uterus. Both pills are available as generics and are also used to treat other conditions.

In 2018, more than 75% of Tennessee abortions occurred within the first 10 weeks of pregnancy, according to the most recent available state data. The American College of Obstetricians and Gynecologists has endorsed medical or chemical abortion as a safe procedure.

The bill will go into effect on Jan. 1, 2023.