Women Turn to Web as Abortion Access Is Curtailed

Alabama just passed a state law that would effectively ban abortion, setting up a Supreme Court battle.

For some women, the rise of telemedicine has changed their access to abortion services. Getty Images

Traditionally speaking, if a woman wanted to get an abortion, she’d visit a local health clinic or hospital. She’d meet with a physician who’d go over her medical history and walk her through the different procedures available.

But getting an abortion isn’t always so easy in the United States. Issues with access, costs, and domestic violence have made it extremely difficult for many women in specific states to have safe, effective abortions.

As a result, several women have turned to a new, more discreet, abortion provider: the web.

Certain websites now prescribe abortion pills — otherwise known as medication abortion — to women who want to safely and effectively terminate their pregnancies in the comfort of their home. And many health experts say they’re a helpful option for those looking to quickly access safe abortion care.

“Research has confirmed that telemedicine for medication abortion is safe, effective, and accepted by patients,” Dr. Jennifer Karlin, a board-certified family physician and research fellow with the Bixby Center for Global Reproductive Health at the University of California, San Francisco, told Healthline.

“Telemedicine also has the ability to markedly improve access to [reproductive] care, especially in locations where clinics are sparse,” Karlin added.

Here’s how to use them

Though there are a handful of websites that offer abortion pills, Aid Access is considered to be the most well-known and affordable option out there. It’s also the only one with physician oversight, according to the self-managed abortion advocacy group Plan C.

Aid Access’ process is fairly simple.

First, you must undergo a medical consultation that looks at your medical history, reasons for abortion, and length of pregnancy.

Not everyone will qualify for the pills. You must have been pregnant for fewer than 9 weeks and live within 60 miles of a hospital in the event of complications or an emergency.

If you do qualify for a medical abortion, a physician will prescribe you the medications, which will immediately be shipped to you.

According to the founder of Aid Access, Dr. Rebecca Gomperts, a registered physician based in Austria, the site prescribed 2,581 medical abortions out of the 11,108 women who reached out for a consultation last year.

In the last six months, nearly 21,000 women ordered abortion pills online via Aid Access, The Guardian reported Wednesday. The majority of the women who reached out live in areas with strict abortion laws, including Alabama, Georgia, and Mississippi.

Although they suggest a payment of about $90, the services Aid Access offers are based on a sliding scale fee. Most of the women who contact her are living in poverty and couldn’t afford an abortion, Gomperts said in a statement released last week.

Women who live in Colorado, Georgia, Hawaii, New Mexico, New York, Maine, Oregon, or Washington state may also qualify to get abortion pills through the mail via the TelAbortion study.

This project involves all the same steps as a standard medical abortion (think a medical evaluation, blood tests, and an ultrasound) without the need to ever step foot in an abortion clinic, the website claims.

Here’s how the medications work

There are two medications these services prescribe: mifepristone and misoprostol.

“The first drug you take is mifepristone, which blocks progesterone, a hormone that’s needed to maintain a pregnancy,” Karlin explained.

“Misoprostol is taken later either through letting the pills dissolve in the mouth or by placing in the vagina. It makes the uterus contract, opens the cervix, and helps to pass the pregnancy,” Karlin added.

The medications, when combined, are considered to be the most effective type of abortion. If taken within the first trimester, they’re up to 98 percent effective, according to Plan C.

In addition, they’re extremely safe. Less than 1 percent of women will experience a serious complication, such as hemorrhaging or an incomplete abortion, says Karlin.

It’s worth nothing that because these online services aren’t regulated — with the exception of the TelAbortion Study — there’s no way to know for sure what the authenticity or quality of the pills are, Plan C stated.

What will happen to telemedical abortions now and in the future?

It’s far too early to know exactly what will happen to telemedicine services if Roe v. Wade — which protects women’s constitutional right to safe, legal abortions — were overturned.

However, experts say policies would vary from state to state.

“If Roe v. Wade is overturned, states will determine how abortion is regulated and what potential repercussions people who provide and have abortions will face in places where it is made illegal,” Jill E. Adams, JD, the executive director for the advocacy group If/When/How: Lawyering for Reproductive Justice, told Healthline.

That said, even with Roe v. Wade in place and abortion legal in all 50 states, women who have gone through with self-managed abortions have been arrested or prosecuted, Adams noted.

Currently, there are seven states that currently ban self-managed abortions and 17 states that exclude telemedicine services for abortion care.

Although criminal action is rare, it’s not unheard of. Since 1973, there have been at least 21 arrests for self-managed abortions in 20 states, according to Karlin.

Still, the people behind the online abortion services are determined to continue providing women affordable access to abortion care.

In March 2019, the Food and Drug Administration (FDA)Trusted Source attempted to order Aid Access to stop providing online abortion services. According to the organization, Aid Access is in violation of federal law for selling “misbranded and unapproved new drugs.”

“When U.S. women seeking to terminate their pregnancies prior to 9 weeks consult me, I will not turn them away. I will continue to protect the human and constitutional right of my patients to access safe abortion services,” Gomperts stated.

Online reproductive care is important now more than ever, especially for women living in poverty and survivors of domestic abuse, explains Dr. Tristan Emily Bickman, a board-certified OB-GYN based in Santa Monica, California.

“With the risk of losing the access to surgical terminations, online care will provide women with the ability to terminate unintended pregnancies,” Bickman said.

Thanks to their safety, efficiency, and immediacy, online providers of reproductive care have the ability to help thousands of women who might otherwise be unable to access safe abortions and avoid unintended pregnancies.

The bottom line

Online abortion care has helped thousands of women who don’t have access to, or can’t afford, safe surgical abortions at a hospital or clinic.

Medical abortions are considered to be extremely safe and effective 98 percent of the time. While it’s too soon to know exactly what would happen to these services if Roe v. Wade were overturned, physicians seem determined to continue helping women access safe, effective medical abortions.

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