Abortion rights have seen some setbacks in state legislatures across the country in recent months. For people seeking to end a pregnancy, getting abortion pills by mail is an increasingly compelling option; at least 21,000 people in the country have requested abortion pills this way in the past year, according to a report in The Guardian. There are, however, things to know if you choose to go about this route to obtain an abortion in the United States.
Currently, a number of websites offer abortion pills by mail, but its legality, which depends on where you are in the country, can be complicated. A number of states have restrictions on access to medication abortion (which entails taking Mifepristone and Misoprostol medication), especially via telemedicine. According to Guttmacher, 34 states mandate that only licensed physicians can perform medication abortion procedures, and 17 states (including Alabama, Missouri, Indiana, and Tennessee) have laws that bar medication abortion through telemedicine because it requires that the clinician providing a medication abortion must be in the room during the process. Providers like Planned Parenthood, however, say medication abortion through telemedicine is a safe and effective method.
If/When/How: Lawyering for Reproductive Justice, a coalition of lawyers working on abortion advocacy, provides legal advice to people who get abortion pills online. Its website has a helpline that you can call to get legal advice if you're considering ordering abortion pills online, and its lawyers work to ensure that self-managed abortions will become less legally risky.
"Even though abortion is legal here in the United States, people who self manage and those who assist them can risk unjust arrest, investigation, and even time in prison," Kebé, the group's program coordinator, and Rebecca Wang, J.D., a legal fellow, wrote in an online guide on self-managed abortions.
An If/When/How report entitled "Fulfilling Roe’s Promise" covers some of the legal obstacles people who obtain abortion pills by mail might face. The 2019 update to the report found that 21 people have been "accused of a crime for ending a pregnancy or helping a loved one do so" in the United States since 2000. This includes, but isn't limited to, those who obtained abortion pills by mail. At least one woman, Purvi Patel, has served time for self-inducing an abortion; Patel spent 18 months in jail, according to Rewire News.
According to the report, in South Carolina, Oklahoma, Idaho, Nevada, and Arizona, there are laws that criminalize self-induced abortions, so people there should take particular caution. But those are not the only laws that prosecutors can use to charge people who self-manage their abortion and those who help them, according to If/When/How's report. Pre-Roe abortion regulations and fetal harm laws, which according to the ACLU criminalize the so-called "homicide" of a fetus, can also be used against people suspected of ending their own pregnancy.
There are websites that work to make the process of obtaining abortion pills through mail easier and safer. Plan C has a report card that rates sources for abortion pills based on the price, ship time, product quality, and whether or not a physician is involved in the sale. Only one website receives an "A" grade from Plan C: Aid Access, a website run by a physician in Austria that for about $90 will provide you with a consultation, a prescription, and order you the pills from a pharmacy in India.
The FDA, however, has requested that Aid Access stop "causing the introduction of these violative drugs into U.S. commerce." The FDA letter, written in March continues, "Drugs that have circumvented regulatory safeguards may be contaminated; counterfeit, contain varying amounts of active ingredients, or contain different ingredients altogether."
The agency also issued a general warning about Mifeprex, the brand name of Mifepristone, on its website. "You should not buy Mifeprex over the internet because you will bypass important safeguards designed to protect your health (and the health of others)," the FDA website reads.
Dr. Rebecca Gomperts, the Austrian physician who runs Aid Access, has pushed back against the FDA's request that the group stops its operations in the U.S. Gomperts told CNN that abortion pills by mail "is the only safe abortion alternative for some of the most vulnerable people." She added, "As a physician, I have the obligation to provide medical care to people in need."
For now, the website Aid Access is still up and running, and continues to send abortion pills to the United States. The Guardian reports that between a third and half of the people who request a consultation are then sent abortion pills, with the majority of these requests coming from people in states with "hostile" abortion laws.
If you're considering ordering abortion pills through the mail, make sure to read up on other options available to you and what the specific laws are in your state.