How Mail Order Abortion Could Bypass Texas Law

Updated 6 p.m. ET October 15, 2021

So many states have so severely restricted access to abortion that people in large swaths of the country feel they have no options if they want to terminate a pregnancy. But technically, those who want an abortion still have options. It’s just that few have heard of it.

Pregnant women in Texas, or any other US state, can visit an array of websites that will send them two pills – mifepristone and misoprostol – that will cause miscarriage when used in the first trimester of pregnancy. and maybe even later. So-called self-directed abortion is therefore an option at least six weeks later in a pregnancy than the controversial new Texas law that provides a six-week window for an abortion in a clinic. Although residents of other states have several websites to choose from, Texans can visit Aid Access, a website that provides the pills for $105 or less depending on income.

However, only 5% of Americans have heard of Aid Access and only 13% have heard of Plan C, a website that provides information on different mail-order abortion services by state, according to a new report. Atlantic/Leger survey. Some people may vaguely know that medical abortions exist, but don’t know the names of the organizations that send them. However, most survey respondents said they were unaware of any back-up options for abortion if a clinic is not accessible. The poll polled a representative sample of 1,001 adults across the country from Sept. 24-26, and its results reflect my experiences recently interviewing two dozen random young Texans: None had heard of access help, and the few who had heard of Plan C were confusing it with Plan B, the morning after pill.

The results are also consistent with the experiences of the Plan C founders. know that the biggest challenge is trying to get this word out,” says Francine Coeytaux, one of the site’s co-managers. -founders. The doctor behind Aid Access, Rebecca Gomperts, told me that according to her own research, 60% of her clients were unaware of abortion pills before finding her service.

Across the country, opponents of abortion rights appear to be winning. Although a federal judge temporarily blocked enforcement of Texas’ new “heartbeat” law, Texas appealed and the law remains in effect, at least for now. Texas Governor Greg Abbott recently signed another bill that cuts the window for medical abortions from 10 weeks to seven weeks and prohibits the shipment of abortion-inducing drugs. The Supreme Court is made up mostly of abortion-rights opponents, and states have passed 106 different abortion restrictions this year, the most in a year since 1973, according to the Guttmacher Institute for Human Rights. ‘abortion.

Many people in these states, after becoming pregnant, will simply find a mail-order abortion service through the Internet. But the picture is more worrisome for those without internet access or skills. “Being in that state of desperation and feeling like you have no options” takes a mental toll, says Abigail Aiken, a University of Texas professor who has researched self-managed abortion. A number of these people could harm themselves in a misguided attempt to terminate the pregnancy. “It would be remiss of us to underestimate how far people will sometimes go when they don’t have access to the care they really need,” says Aiken.

Abortion pills work best in the first trimester of pregnancy, but it takes time to find the service and order the pills, and for them to arrive and clear customs. This is one of the reasons Aid Access now allows people who are not pregnant to order the pills to have on hand and use them later if they experience an unwanted pregnancy. The pills do not expire for about two years.

Aiken wants Texas schools to start teaching abortion as part of health classes. However, this is unlikely to happen in a state that still does not mandate any type of sex education.

Coeytaux, of Plan C, suggests that something darker is at work: that abortion clinics and funds are not promoting self-managed abortion enough, either because of a lack of trust or because they fear it will stifle the sense of urgency about the war on reproductive rights. Indeed, when I recently visited the website of an abortion fund in Texas, it stated, “We do not provide advice on self-managed abortion care.” (The fund did not respond to a request for comment.) Whole Woman’s Health, an abortion clinic with locations in Texas, has a self-managed abortion page, but in an email, its CEO, Amy Hagstrom Miller, said that because Texas does not allow abortion pills to be mailed out, medical professionals “cannot advise Texans on how to obtain self-administered abortion medication in Texas.”

The fight for abortion rights has been about proving that restrictions are an “undue burden” on women – a burden that mail-order abortions arguably alleviate. “The strategy of lawyers and providers and all those who fight for our rights … is ‘Oh my God, look what happened. In Texas there are no more options”, says Coeytaux. “If you come in and say, ‘Maybe your access issues have just been resolved, because you don’t have to travel, you don’t have to pay so much’, that undermines the Oh my god this is really awful.”

Of course, other factors could discourage people from pursuing self-managed abortions. The procedure involves severe cramping and profuse bleeding, and in the most abortion-unfriendly states, women who self-induce their own abortions must rely on hotlines and text support from doctors. away if they are frightened or have complications. Aid Access is based in Austria, beyond the reach of Texas law enforcement and the new abortion drug measure, but the site still inhabits a legal gray area: four states have criminalized the management of one’s own abortion, and about two dozen people have been prosecuted for self-directed abortion since 2000. Mainstream medical research generally suggests that self-directed abortions are safe and effective, but anti-abortion groups vehemently disagree and have published their own reports saying they are dangerous. Whatever the reason, far fewer women in the United States have medical abortions than in some other countries: medical abortions accounted for 40% of all abortions in the United States in 2017, compared to more than 90% in Finland and more 80% in Mexico City, according to the Guttmacher Institute.

Sites like Aid Access are fast becoming sworn enemies of abortion opponents. “At a minimum, the FDA should warn women, as it has done in the past, that it is not safe to use imported drugs purchased over the Internet that have not been tested. careful review and evaluation of purity, safety and efficacy,” Randy O’Bannon, the director of research at National Right to Life, told me via email. “And those entities that illegally import and sell these unauthorized drugs should be prosecuted for these violations and they should certainly be held criminally and financially responsible for any injuries associated with their products.”

Aiken and others, however, doubt that US laws affect access to help, as the organization already operates in countries where abortion is illegal. When I asked Gomperts if she felt threatened by Texas laws, she replied, “Aid Access serves women who need access to safe abortions. It doesn’t matter where they live or what the legal situation is in that country. Unfortunately, few Americans know that she is available to serve them.

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This article previously reported that five states have criminalized managing one’s own abortion. Four states have done so.