Previous sound research has consistently shown that abortion does not cause or increase risk of mental health problems, and that mental health symptoms decrease from before to after having an abortion. However, this research was conducted before the overturning of Roe v Wade and before remote provision of medication abortion (RPMA) was available. The proposed research aims to understand the mental health experiences around RPMA in the current US context, what factors (ie, social locations, logistical and economic experiences, service delivery modality experiences, intrapersonal processes, and interpersonal experiences) contribute most strongly and consistently to different mental health experiences around RPMA, and whether there are differences in mental health experiences around RPMA compared to clinic provision of abortion. To achieve these aims, we will build from an ongoing prospective cohort study that is examining mental health from 2-7 days before to 1 year after an abortion for those having clinic provision abortions (n = 592) and those having RPMA in states where abortion is banned (n = 300). We will recruit an additional 600 people having RPMA (150 in states where abortion is banned and 450 in states where abortion is not banned) and follow them from 2-7 days before to 1 year after their RPMA. Knowledge gained from this research will lead to evidence-based practices by mental health specialists, post-abortion emotional support organizations (eg, All-Options; Exhale: Pro-voice), RPMA providers, and abortion funds’ organizations in order to most effectively and efficiently promote mental health around RPMA.