How to Safely Access Abortion Pills Online
Ensuring that people access only safe websites for abortion consultation and prescriptions is critical to reproductive health. Though abortion itself is currently legal in all 50 states, state restrictions on the procedure and clinics are commonplace. “Teleabortion” allows patients to obtain a prescription for medication abortion (more colloquially referred to as “abortion pills”) from the comfort and safety of their homes. While abortion itself continues to decline in the U.S., the use of abortion pills as a method to induce miscarriage is on the rise: According to the Kaiser Family Foundation, medication abortion accounts for 41% of abortions at eight weeks or under.
In addition to ever-shifting laws governing medication abortion, particularly regarding distribution via online pharmacies, cost is a huge potential barrier for those who seek to utilize medication abortion. Medication abortion is often not covered by insurance and, as a result, can easily run you around $600 out-of-pocket. Do not let this deter you if you are seeking abortion services; there are ways to access safe medication affordably. In fact, this point is extremely important: Medication abortion is the safest way to perform an abortion at home.
Resources for Safe and Affordable Medication Abortion Access
The tangled state laws make abortion by mail, even by reputable organizations, difficult. And then, online pharmacies certainly can feel like a gamble — everything on the internet feels like a gamble. Despite these obstacles, there are legitimate operations that offer abortion pill services online. Here are some organizations that are doing a great job to ensure people have safe and affordable access to critical medication:
A team of public health advocates, researchers, and social justice activists, the organization Plan C has endorsed websites that provide safe access to abortion pills. The information they provide is incredibly comprehensive and easy to navigate. Safety, cost, methods, regulations, legal protection — it’s all there.
According to its website, the nonprofit Aid Access works to “improve the health status and human rights of women who do not have the possibility of accessing local abortion services.” According to a 2021 JAMA study, the cost of in-person care has been a major driver of people flocking to the internet for abortion services. From 2018 to 2020, 50,000 people in the U.S. requested self-managed medication abortion through Aid Access.
This well-respected watchdog organization works to protect the health of all women through its advocacy and support of consumer decision-making.
Legality of Medication Abortion
There is no legal risk to people who get abortion pills from a health care provider who is licensed to provide services in the United States and take those pills as instructed by the provider. Legal risk arises if you find and use abortion pills on your own, without a prescription from a licensed health care provider. This is termed “self-managed abortion” — abortion performed at home without medical supervision.
State Laws Vary on Medication Abortion
The Guttmacher Institute has a handy chart that can help you find out the specifics of your state’s rules. Of the U.S. territories, 32 states require clinicians who administer medication abortion to be a physician. Nineteen states require a physician to be present when medication is taken; this law is extremely prohibitive, as it restricts medication abortion to those who live near a medical clinic.
States Where a Physician Must Be Physically Present When You Take the Abortion Pill
Can I order mifepristone online?
The federal government says yes, but states can still impose their own restrictions. On April 12th, 2021, the FDA announced that, effective immediately, both medication abortion and miscarriage patients are able to access mifepristone via delivery from their providers or through mail-order pharmacies. However, the states can still limit access, depending on state laws.
Teleabortion is the act of using telemedicine to obtain and use abortion pills. Initially, telehealth in general was viewed as a great way to reach rural and otherwise remote populations; in the wake of the coronavirus pandemic, we’ve seen a more universal need for telemedicine. As for teleabortion, only the states that do not require a practitioner to be in the room with you would allow for a telemedicine abortion. According to the Kaiser Family Foundation, only a “handful” of clinics allow teleabortion. These clinics are bypassing the “in-person testing” rule, however implicit, to get medication abortion in the hands of the people. A 2020 study published in Contraception explored various “no-test” models in an effort to improve availability in the wake of the COVID-19 pandemic. The authors conclude:
Omitting unnecessary use of ultrasound, examination, and laboratory tests before [medication abortion] can reduce barriers to this essential service by decreasing cost and enhancing convenience and comfort. The no-test approach can enable provision of abortion in new venues and by new categories of providers, and it can facilitate new service delivery models, such as synchronous or asynchronous telehealth, stationary or mobile ‘mini-clinics’, pill pick-up arrangements, or dispensing via lockboxes or, potentially, by mail.”
No website accredited through the PharmacyChecker Verification Program offers telemedicine services.
Should you face legal trouble....
Abortion advocates have pointed out that legal trouble rarely occurs in the wake of online self-managed abortion. According to the nonprofit IfWhenHow, a group that offers legal assistance to those facing reproductive injustice, no one has faced legal consequences for the sole act of ordering abortion pills online. Plan C claims that at least 24 people have been prosecuted for engaging in self-managed abortion. More often, medication abortion comes up in legal cases as evidence toward a different criminal offense. In one highly-publicized case, a woman’s internet search history helped prosecutors build a case for second-degree murder after the baby was stillborn. In 2014, in a case more directly related to self-managed abortion, a mother went to prison for obtaining prescription abortion medication for her sixteen-year-old daughter, per the New York Times.
Plan C recommends a legal hotline called the Repro Legal Helpline for assistance. You may also try IfWhenHow.
Understanding Medication Abortion
Medication abortion refers to using the abortion pill, which can be taken by mouth up to 10 weeks into pregnancy. According to Plan C, there are two medication abortion methods to safely and effectively end an early pregnancy.
Mifepristone and misoprostol, taken together
Misoprostol, taken alone
Let’s compare the two methods.
Mifepristone + Misoprostol
Misoprostol (taken alone)
|FDA Approval||The FDA first approved Mifeprex (the brand name mifepristone, used in conjunction with misoprostol) in 2000 for the termination of early pregnancy. At the time, the drug was only available for those under day 49 of pregnancy. In 2016, the FDA revised the drug’s labeling to extend the grace period to 70 days. According to the Guttmacher Institute, this expanded the U.S. pool of potential users from 37% to 75%.||Although misoprostol is used around the world in gynecology and obstetrics, it is not approved for such use by the United States FDA.|
|How it Works||You take one mifepristone first, followed by 4 misoprostol pills 24-48 hours later. Mifepristone prevents the body from absorbing progesterone while misoprostol inhibits prostaglandin activity. The result is a miscarriage.||Misoprostol, taken alone, affects pregnancy hormones, inhibiting prostaglandin activity. You will take 8-12 200mcg pills as directed by your healthcare provider. This method works by causing the uterus to cramp and expel what’s inside. The result is a miscarriage.|
|How effective is it?||95-98% of abortions are successful.||85% of abortions are successful.|
|Out-of-Pocket Costs of Method (medication only)||$51.85 - $123.35 Cost Breakdown: Generic: $51.85 with a local discount coupon. $100.84 out-of-pocket at your local pharmacy. Brand: $99.77 with a local discount coupon. $123.35 out-of-pocket at your local pharmacy.||$8.28 - $89.43 Cost Breakdown: Generic: $8.28 for 12 pills ordered internationally. $40.35 for 12 pills out-of-pocket at your local pharmacy. Brand: $8.64 for 12 pills ordered internationally. $89.43 for 12 pills out-of-pocket at your local pharmacy.|
|What to Expect||A few hours of heavy bleeding. Cramps. Several days of lighter bleeding.|
|Side Effects and Risks||The most common adverse reactions to medication abortion are as follows: nausea, weakness, fever/chills, vomiting, headache, diarrhea, and dizziness. One of the reasons you should see a medical provider — at the very least on a video chat or phone call — is that medication abortion may not be able to terminate an ectopic pregnancy (a pregnancy outside the uterus). If you are ectopic, the abortion pill may not have an effect.|
A Closer Look at Medication Abortion Costs
|Drug (generic name) Strength Quantity||U.S. Average Retail Price||PharmacyChecker U.S. Discount Card Price||Accredited International Pharmacy Price|
|Mifepristone (generic of Mifeprex) 200mg One tablet||$87.39||$42.40||Not available to order internationally.|
|Mifeprex (Brand mifepristone) 200mg One tablet||$93.54||$73.37||Not available to order internationally.|
|Misoprostol (generic of Cytotec) 200mcg Four tablets||$13.45||$9.45||$2.76|
|Cytotec (Brand misoprostol) 200mcg Four tablets||$29.81||$26.40||$2.88|
Sources: Average U.S. Retail Price provided by PharmacyChecker.com; U.S. Discount Card Price based on availability at pharmacies near San Antonio, Texas listed on PharmacyChecker.com. Lowest Accredited International Pharmacy Price based on prices listed on PharmacyChecker.com.
Can I order abortion pills online from an international pharmacy?
Due to Mifeprex (mifepristone)’s REMS designation, international pharmacies in the PharmacyChecker Verification Program are not permitted to fill prescriptions for Mifeprex (mifepristone). Abortion advocates argue the REMS designation prevents people from easily accessing medication abortion.
That being said, you may see prices listed for misoprostol (not approved as medication abortion in the United States). Misoprostol is primarily prescribed to treat stomach ulcers, which makes it more accessible than mifepristone. With a valid prescription from your healthcare provider, pharmacies accredited by PharmacyChecker can ship this medication. However, the savings involved may not be completely worth the hassle: It is around $10 to get it locally vs. $3 shipped from abroad.
Where are Mifeprex (mifepristone) and misoprostol manufactured?
FDA data of Mifeprex indicates it is manufactured for Danco Laboratories, LLC, which is headquartered in New York, NY. We called Danco and a representative asserted that the drug is manufactured in Western Europe. GenBioPro, Inc., one of several manufacturers of the generic mifepristone, has a P.O. Box in Las Vegas, NV. Misoprostol labeling shows manufacturing in the United Kingdom, India, and New Jersey (USA).