- Around the world, mail-order abortions have kept abortions safe despite being illegal.
- In April, the FDA approved the mail distribution of abortion pills in the US.
- People are ordering abortion pills before they're even pregnant, to have the option if needed.
In several countries with some of the most restrictive abortion laws, mail-order abortions have been instrumental in keeping the practice safe. From Ireland to Argentina to Mexico, grassroots activists forged online networks where people can order abortion pills and have the procedure at home without having to step foot in a clinic.
After the recent passing of SB 8 in Texas - the most restrictive abortion law in the US to date - abortion experts and advocacy organizations are preparing for a future where abortions are sought online. Although the Texas ban was temporarily blocked by a federal judge, it has now been reinstated. And experts view the bill as a harbinger of the bans to come.
The pandemic has helped set the stage for mail-order abortion. This past April, the Food and Drug Administration began allowing the mail distribution of mifepristone - a medication taken along with misoprostol to induce an abortion up to 11 weeks. This ruling allowed for new research, which found that a self-managed abortion was equally as safe and effective as obtaining the pills from a clinic.
While medication abortion has long been recognized as safer than common medications such as Tylenol and Viagra, these two turning points, in tandem with the onslaught of anti-abortion bills, signal a future in the US in which mail-order abortions could become the norm.
A big player in this shift in US abortion is Plan C, a website that helps direct people to abortion pills online. Elisa Wells, the cofounder of the organization, told Time magazine that after SB 8 passed, the website's traffic went from 500 visits a day to over 25,000 - with around 35% of visitors from Texas.
It's not just pregnant people buying the pills
Some people are even ordering pills before they're pregnant - a process called advance provision - in case they one day find themselves carrying an unwanted pregnancy while living in an area with little to no access to an abortion clinic. For years, some experts have advocated for advance provision to become common practice, to prepare for the possible overturning of Roe v. Wade.
One woman in Texas, who asked to remain anonymous for privacy reasons, recently ordered pills through the website Aid Access in case her IUD ever fails to prevent a pregnancy.
She learned about the option to purchase pills online through "Vessel," a documentary about the doctor who runs Aid Access, as well as through the r/abortion subreddit.
She told Insider that she'd rather get a surgical abortion at a clinic, "where it's over in five to 10 minutes. But since that might not be an option, it's good for peace of mind to have any option at all on hand."
Another woman in Texas, who also asked to remain anonymous for privacy reasons, said, "The new law had me really concerned."
Once she learned on Twitter that Aid Access offers advance provision, she said, "It seemed like a good idea to have a set of pills in my medicine cabinet," in the event that she or a friend needed an abortion in the future.
Mail-order abortions are safe, and many prefer them
Long before SB 8, medication abortion was becoming a preference for pregnant people across the US because of the convenience and privacy of having an abortion at home in a country with widespread stigma.
But medication abortion does not replace access to surgical abortion since the pills are only recommended up to 11 weeks of pregnancy. While the vast majority of abortions occur early on, a person might seek an abortion later in their pregnancy because of unexpected health complications or financial barriers.
Avalon Gordon, a full-spectrum doula living in California, said ordering pills online for clients who were intimidated by in-clinic abortions had long been part of her practice. Gordon described online ordering as "easy," and she said the process helped her clients feel comfortable and empowered.
But after the Texas ruling, she noticed an increased urgency within the doula community around ordering pills online so that "it's not in the hands of the state anymore."
Now that websites are increasingly popping up to bring abortion pills to people across the country, we could see even more support for abortions outside the clinic - and perhaps policy changes that make this option more accessible and free of legal risks.
Andréa Becker is a freelance writer and Ph.D. candidate in sociology at the CUNY Graduate Center in New York.