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Special Delivery: Abortion Pills By Mail

 

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When my mail carrier handed me the small brown envelope, I’m sure she had no idea she was handing me the means to have a safe, private abortion at home. I had ordered the pills a week and a half earlier off a somewhat sketchy website and, frankly, was wondering if they would ever appear. I say “sketchy” in that the offer seemed too good to be true — abortion pills for less than $200, no prescription needed. The “Whoa, trouble ahead!” warning from my McAfee security system certainly gave me pause, but by the time I received the fraud alert call from by credit card company (at the same time that Western Union was calling my other line to warn me) it was too late to turn back; I had already placed the order.

I wasn’t too worried about being scammed, though. You see, I wasn’t actually pregnant. I was doing this as part of a mystery shopper study to see if the many sites that popped up when I Googled “buy abortion pills online” would actually send a real product to my US address. And, surprise, surprise…they did.

All in all, five of us sitting in four different states ordered 22 sets of pills. All but two arrived in our mailboxes. And, when we had them assayed, all of them were the real deal.

I get mixed reactions when I tell people about this. A few people, eyes wide, say they would only get an abortion from a doctor. Others ask me for the URLs.

Though the news that it is possible to get real abortion pills shipped to your US mailbox is new, the option of “mail order abortion” has been available in other countries, quite successfully, for more than 10 years. Women on Web (www.womenonweb.org) pioneered this model, and now Safe2Choose (www.safe2choose.org) and Women Help Women (www.womenhelp.org) also serve women in more than 100 countries (but not yet in the US).

What do those who have used these services think of mail-order abortion? It should come as no surprise to anyone with a uterus that the response is very positive. People are relieved to have a convenient way to access this important health care service, find it straightforward to use, and value the privacy that the home ordering service provides. And, studies have shown that it is as safe and effective as clinic based care for abortion up to 10 weeks gestation.

But it is important to note that the online sites we ordered from are not quite the same as these international services, which ask buyers questions about the date of their last period and whether they have any medical conditions that might be contraindications to using the pills. They also provide clear instructions for use, which none of the online sites we ordered from supplied. But, given what we know about peoples’ ability to date their own pregnancies — they are fairly accurate — and the overall safety of the medications — which some doctors say are safer than Tylenol — the medical risk of buying pills from these online pharmacies seems small.

Whether there is a legal risk to buyers is unclear. To date, there have been 19 criminal cases involving people who have bought and used pills off the internet. While no one should be prosecuted for providing their own medical care, the risk of falling victim to an overzealous prosecutor is definitely something that potential buyers need to think about. This is particularly true for those who already feel they are under increased surveillance due to their skin color or immigration status.

At a time when abortion access is under continuous attack, and even the prospect of getting insurance coverage for contraception is in jeopardy, it seems likely that some people will take a calculated risk and choose to access abortion in this way. Let’s not leave these brave souls hanging in the wind as they demonstrate a new vision of what abortion access could be in the United States. Let’s do the studies — that will invariably show the safety of an online service delivery model — and change the laws to make it possible for people to access these safe and effective pills conveniently, privately, and legally. It’s high time that we override the politics and stigma that have limited abortion access in the United States and demand that our service delivery model be updated to reflect the safety of the method and the convenience that modern online technology makes possible.

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Plan C is a multidisciplinary team that includes veteran women’s health advocates and a cutting-edge millennial advisory. We envision a world in which the ability to end an early pregnancy is in the hands of the person who needs it the most. We work towards this vision by publicly sharing information about the safe and effective pills that exist; mobilizing a generation to take action in support of greater access; and laying the groundwork for putting these pills directly in the hands of women. Learn more at www.plancpills.org.

Top photo: Flickr Creative Commons/Ron Reiring

 

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Elisa Wells, MPH, is a longtime reproductive health advocate and Co-Founder and Co-director of Plan C (www.plancpillls.org). 

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