People Get Creative By Getting Abortion Pills Online

Nearly 20 states have laws banning telemedicine abortion, so people are getting creative with mail forwarding, international healthcare providers, and other strategies to access abortion pills.

Green states allow telemedicine abortion and have providers offering this service. In gray states, people are finding workarounds to access abortion pills. (Created with Mapchart.net)

While the Supreme Court allowed the Texas abortion ban to stand and is now on the verge of overturning it Roe vs. Wade This summer, residents of states with restrictive abortion laws are finding creative ways to obtain abortion pills online, facilitated by a recent increase in the number of telemedicine abortion providers in many states.

In December, the FDA permanently lifted a longstanding requirement for in-person distribution of the abortion pill mifepristone. In many states, this has opened the door to telemedicine abortion, where providers screen patients online or over the phone and then mail them abortion pills. People in 25 states can now legally access telemedicine abortion from providers in their state for as little as $150, with some services reducing the price to zero, if necessary.

But 19 states have laws banning telemedicine abortion. In these states, evidence suggests people are finding new ways to access abortion pills, says Elisa Wells, co-director of Plan C, an organization that conducts research and publicly shares information about how people access the pills. abortions in the United States.

“As politicians continue to pass unfair laws that restrict access to these safe and effective medicines, we know people are finding other ways to access them,” Wells said. “We have a section on our website about creative ways people are accessing pills when living in restricted areas to help people understand what we know people are doing and how to do it. There’s absolutely no reason why modern telehealth abortion care should be limited based on your zip code, and these people are finding effective workarounds to get the care they need.

Many people obtain abortion pills outside the United States by ordering them directly from online pharmacies. Plan C researchers reviewed several of these online pharmacies by ordering abortion pills from them and testing the quality of the pills. On their website, Plan C lists websites that ship quality medications, along with cost and shipping time, including Secure Abortion Pills (for $200, 14-day delivery), Abortion Rx ($239 , eight days), Generic Abortion Pills ($291, six days), Buy MTP Kits ($301, six days), Abortion Privacy ($380, five days) and Abortion Pills Online ($480, four days). These pharmacies do not require a prescription to obtain abortion pills.

Another option that many people use is to order abortion pills through Austria-based healthcare provider Aid Access, run by Dr. Rebecca Gomperts. Aid Access offers doctor-supervised telemedicine appointments using online forms, then ships abortion pills to patients in the United States. In states that restrict telemedicine abortion, the pills are shipped from India, which can take several weeks. In these states, Gomperts charges a sliding scale fee of up to $110.

A third option that people in restrictive states use is mail forwarding services to access telemedicine abortion care from health care providers located in US states that allow it. Since vendors are only allowed to send pills to patients who have an address in states where the vendor is licensed to practice, people rent a mailing address from mail forwarding services such as iPostal1.com or Anytime Mailbox to use for telemedicine consultation. Then they ask the service to send them the pills to their home country.

There’s absolutely no reason why modern telehealth abortion care should be limited based on your zip code, and these people are finding effective workarounds to get the care they need.

Elisa Wells, co-director of Plan C

“We actually did our own investigation to see if mail forwarding was possible, you know, the same way we order and test pills from online pharmacies to see what that entails,” Wells said. They found mail forwarding to work.

On their website, Plan C details the process of using mail forwarding to order abortion pills. People rent an “address” in a state that offers legal online abortion services for around $8-10 for a month plus a $25 online notary fee to get set up. They then do an online consultation with a supplier in the state where they rented the mailbox and indicate the address of the forwarding service as the delivery address.

Since clinicians are only authorized to serve people in the states where they are licensed, if asked, patients say they are in the state where the clinic is located during the online consultation, by video or telephone. Those using a credit card for payment say they need to provide the correct billing address associated with their credit card. This did not affect their ability to have the pills shipped to the return service address.

When the mail forwarding service tells them that a package has arrived at their “address”, they ask for it to be forwarded to their home address. Sometimes there is a small charge for this, around $5. The rental is only necessary for one delivery, so it can be canceled after one month.

Through this method, people living in states with restrictions on abortion-related health care were able to access abortion pills in the mail through licensed clinicians in the United States.

“You have to jump through a few hoops to get a mailing address,” Wells said. “You need to provide two pieces of ID and you need to have an electronic notarization done. Everything is online, so you don’t have to travel. You only need to download a few documents and you have to pay a fee, about $40 in total to install it and rent the address for a month. This adds a little delay, about four to five days. »

As an alternative, some people ask friends who live in a state that has access to telemedicine abortion if they can have the pills shipped to the friend’s address and then picked them up. People who do this list their name followed by “c/o friend’s name” and then the full address. This prevents the package from being marked “recipient unknown” or “return to sender”.

Others use “general delivery” at a US post office at the state border to reduce the distance they have to travel. “General delivery” means that the mail is sent to a person at a specific US office and the person receiving the mail goes there in person to pick it up with an ID that matches the name on the package. It is not necessary to install a post office box and this service is free.

To use general delivery, people identify a nearby state that offers pills by mail. For example, if they live in Tennessee, they can order from a service in Georgia, Virginia, or Illinois, depending on which state is closest to their location. Then they look at a map to find the nearest border town in the other state. For example, someone living in Chattanooga, Tennessee might identify Rossville, Georgia as the closest town with a US post office. Not all post offices offer general delivery, but many do. People can check if general delivery service is offered at a particular post office by searching for the city name on the US Postal Service website.

After verifying that a post office will accept a general delivery package, they then contact an in-state provider who offers telehealth abortion and schedules a consultation. If asked, they say they are located in the same state as the supplier at the time of consultation. They provide the “general delivery” address to the clinic. They track the delivery through the information provided by the clinic and show up in person at the post office when the package has arrived. They make sure to take ID that matches the name on the package.

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There have been no successful prosecutions of women who self-administered abortions using pills in early pregnancy, but prosecutors disproportionately target low-income women using Medicaid, immigrant women and women of color. with these kinds of accusations. (Creative Commons)

Wells warns that using creative ways to access pills without having to travel to another state can expose people to unfair lawsuits.

“Lawyers have told us that a person does nothing wrong when they access pills in some of these creative ways, but we know that some people have been criminalized for obtaining and taking pills on their own, and we know that criminalization in general is the heaviest. on people who are already marginalized by our systems,” Wells said. “We always advise people to check with the Repro free legal helpline if they have any questions about their legal risk. We want people to have as much information as possible so they can make the best decision for their situation.

As people find creative ways to access abortion pills in states that restrict access, reproductive health advocates are expressing their frustration at having to do so.

“Our whole system is broken,” Wells said. “Our medical system is broken. Our justice system is broken. We have modern medical health care available to us in the form of these pills and telemedicine. There is absolutely no reason why they should not be made available to people on the other side of the borders by competent doctors who are willing to provide the service.

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