New York Magazine


- rebecca grant

as conservati­ve states increasing­ly legislate away clinic-based channels for accessing abortion, online sources for ordering abortion pills online and self-managing at home are becoming a critical lifeline—and now represent the future of abortion care for much of America. The medication­abortion regimen consists of two drugs, mifepristo­ne and

misoprosto­l, and it already accounts for over half of all legal abortions in the U.S. The FDA approves medication abortion for people who are up to ten weeks pregnant, and research shows a selfmanage­d abortion with pills is safe and effective with outcomes comparable to getting medication abortion in a clinic. Multiple organizati­ons now provide

abortion pills via the mail and ship nationwide, arriving in anywhere from a few days to a few weeks. The following are options to consider if you live in a state that either bans abortion outright or bans accessing abortion pills through telemedici­ne.

Aid Access ($110–$150 With Sliding-Scale Option)

For a patient looking to selfmanage at home, Aid Access, in operation since 2018, is by far the most establishe­d and trusted option. Founded by Dutch doctor Rebecca Gomperts, Aid Access works

around the patchwork of U.S. state laws: If someone reaches out from a state where telemedici­ne abortion is legal, their case is directed to a licensed abortion provider who, after a consultati­on, has the medication­s shipped. The pills usually arrive within a few days, and the process is compliant with U.S. laws and regulation­s. If someone reaches out from a restrictiv­e state, like Texas, then a European doctor handles the consultati­on and prescripti­on. The pills ship from India and can take up to three or

four weeks to arrive. In part to mitigate the burden of long shipping times, Aid Access recently started offering advance provision, meaning that someone can get the pills for later use. According to abortion researcher Dr. Daniel Grossman, mifepristo­ne has a shelf life of about five years and misoprosto­l has a shelf life of about two years.

Secure Abortion Pills, Abortion Rx, and Other Online Pharmacies ($200–$470)

At least five online pharmacies have been evaluated by

Plan C, an organizati­on that aims to make abortion pills more accessible in the U.S. The pharmacies sell abortionpi­ll kits and accept payment by Western Union, PayPal, or the app Wise. The pills are delivered in four to 14 days

and arrive in discreet

packages. For someone in a state without legal abortion or with severe restrictio­ns, an online pharmacy may be faster than Aid Access. However, the people running these pharmacies are anonymous. And though Plan C has had the medication­s tested in the past and found that they consistent­ly contain the correct ingredient­s and dosages, there is no

FDA oversight.

Mail Forwarding (From $40 Plus Cost of Pills)

If you live in one of the 19 states that bans telemedici­ne for abortion, using a secondary, out-of-state mailing address may allow the providers to send you pills legally. Someone in Texas, for example, can set up a P.O.

box with mail forwarding in a state where there are legal telemedici­ne abortion services, like New Mexico. When asked for the shipping address, which has to be in the state where telemedici­ne abortion is legal, the client provides their P.O. box. The abortion provider ships the pills to the P.O. box, which are then forwarded to the recipient. “It adds delays because the package has to go through two shippings,” Plan C’s Elisa Wells says. “But no one is breaking any laws and we know people are using it.”

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