Medication abortion will be a lifeline, but it tees up new legal battlesJuly 25, 2022
A host of state laws may be used as weapons against people who use, or are suspected of using, medication to induce abortion. The so-called abortion pill is actually a combination of two drugs—mifepristone and misoprostol—and the FDA has approved it for use up to 10 weeks of pregnancy, though the World Health Organization recommends it up to 12 weeks for self-managed abortions, and in some places, the medications have been used safely much later.
So if you can get mifepristone and misoprostol from a reliable source, sent through the mail in an unmarked package, that’s a significant way around abortion bans. And there are people ready to help with that. The group Aid Access was founded by a Dutch physician to help people in countries where abortion was banned—which now means much of the United States.
For about $110, The New York Times reports, “To receive pills, women contact a European doctor through Aid Access’s website. Then, a doctor will often fill the prescription using a pharmacy in India, which will send the pills by mail. They typically arrive in one to three weeks and can be taken safely up to the 12th week of pregnancy.”
There are also overseas pharmacies that will sell pills without a prescription. The question is whether they’re sending out authentic medications, but the group Plan C has a list of pharmacies whose products it has tested. “We had them analyzed in the lab and they were the real thing,” Elisa Wells, Plan C’s co-founder, told the Times.
And, of course, people in need of abortions can get pills mailed from a U.S. pharmacy to an address in a state where abortion remains legal and have them forwarded.
Some states, though, have specific laws trying to prevent all of this: Texas law requires people to visit clinics to get abortions, even though the medication can safely be taken at home; self-managed abortion is illegal in Oklahoma, Nevada, and South Carolina. There’s a very real danger that some prosecutors will go after people suspected of having taken mifepristone and misoprostol—and the people targeted are likely to be those who are most vulnerable and least able to fight prosecution. People having spontaneous miscarriages could also be targeted, because of this key fact: “From a medical perspective, there is no physically significant difference between a medication abortion and a spontaneously occurring miscarriage,” according to the National Women’s Health Network. In fact, the group goes on to note (correctly, I can attest as someone who’s had the option offered to me by a doctor), “the medicines used in medication abortion are used to help safely manage an incomplete miscarriage.”
The indistinguishability of medication abortion and miscarriage mean that many people can have abortions without anyone noticing—medication abortion is overwhelmingly safe, with 95% of people at up to 12 weeks gestation not needing further medical intervention—while some people may come under legal suspicion for miscarriages, all depending on where they seek care, who they are, and how abusive the local prosecutors are.
But while it’s not without risk, in many places, out-of-state or overseas pharmacies and the mail are likely to be a key to getting many people safe abortions without the need to resort to the back alleys and coat hangers that became so notorious before Roe.
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