250 Ads for Self-Managed Abortion Pill Info Launch in NYC Subway System

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Plan C and If/When/How advertise abortion pill information in the Nassau Ave subway station in New York City. (Elisa Wells / Plan C)

Reproductive health, rights and justice advocates have teamed up to plaster New York City subways with information about how to find abortion pills and access free legal advice about using them. From Queens to the Bronx, in Brooklyn and Manhattan—including Times Square—over 250 posters are now sharing abortion pill information in English and Spanish with the millions of people passing through subway stations and riding the trains each day.

“As politicians and courts continue their assault on abortion access, we are spreading the word that these medically safe and effective pills are available by mail in all 50 states,” said Elisa Wells, co-founder and co-director Plan C, which organized the ad campaign. “Everyone deserves access to this modern medical technology, and we provide the information that people need to take back control of their reproductive autonomy.” 

At each location there are two posters—one with information about how to access abortion pills through Plan C’s online Guide to Abortion Pills, and another poster with information on how to access free legal help for questions about abortion pills through the website of If/When/How: Lawyering for Reproductive Justice, an organization fighting to halt the criminalization of pregnant people, including those who self-manage their abortions.

“Side by side, we have the information about how you get abortion pills and a resource for finding out about legal issues involved in self-managed abortion. We wanted to highlight both of those things together.”

Self-managed abortion is when someone obtains abortion pills and uses them outside of the formal U.S. healthcare system.

As we face the Supreme Court decision in June, we want to raise awareness that there is something that people can do and are doing to get around these unjust laws and that is obtaining pills by mail through a variety of sources.

Elisa Wells, Plan C

Plan C’s website has state-by-state information about how people can access abortion pills by mail, both through mainstream telehealth services currently operating in 24 states and D.C. and through online services in all 50 states. If/When/How has a free and confidential legal helpline which provides free legal information and advice to help people understand their rights and potential legal risks when self-managing an abortion. If/When/How also has a Repro Legal Defense Fund to support people who are investigated, arrested or prosecuted for self-managing abortions.

“We don’t want people to be alone or confused about their legal rights or possible legal risk if they are thinking about self-managing their abortion,” said Rebecca Wang, J.D., legal support counsel at If/When/How. “Criminalization of pregnancy outcomes thrives when abortion is restricted, stigmatized and isolated, and the helpline is a resource to provide people with the support and legal information they need to make fully informed decisions about what is best for them and their families.”

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English and Spanish ads displayed in NYC subway stations. (Elisa Wells / Plan C)

Plan C organized the campaign ahead of a Supreme Court decision in June that is likely to overturn constitutional abortion rights established in 1973 in Roe v. Wade. In anticipation of the decision, states are passing a record-breaking number of abortion restrictions, including bans. Guttmacher Institute predicts that a Roe reversal could result in 26 states certain or likely to ban abortion.

“As more and more states are enacting restrictions on access to abortion care, which should be basic, accessible medical care, we want people to know that there are alternative routes of access to these pills in all 50 states,” said Wells. “And we also want them to know that there’s a potential legal risk in some states and that If/When/How is a great organization to help people understand that risk so that they can make decisions about what’s best for them.”

Advocates say they designed the ads to be shared on social media and seen by New Yorkers and out-of-state visitors alike. “New York City is a hub of people from all over the place. So I’m sure there are people from other places that are coming in, that could see those ads and know that this is a thing,” said Wells.

New York state allows telemedicine abortion and New York City has wide availability of telemedicine abortion providers, but advocates say people may still be interested in self-managed abortions and may be seeking information about options and resources. 

“We want people in New York to know that abortion pills by mail are a thing,” said Wells. “A lot of people don’t even know about abortion pills, let alone that they can be available very conveniently and quickly through an online consultation that may or may not involve a video visit, and with the pills mailed directly to your home.”

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Green states allow telemedicine abortion and have providers offering this service. In the yellow states, people are finding workaround ways to access abortion pills. (Created with Mapchart.net)

“Even in a state that has mainstream telehealth medication abortion services, there might be some people who prefer to obtain pills from alternate sources—maybe they’re undocumented, maybe they don’t want any record of this on their credit card or they don’t want parents knowing about it for whatever reason,” said Wells. “There might be people who just prefer to keep it more private and self-managed. So we want them to know about this.”

In the remaining states where telehealth abortion is not available from healthcare providers located within the state, the Plan C Guide to Pills offers multiple ways to access abortion pills in a medically safe and convenient way.

“There is absolutely no reason why access to modern abortion medication should be restricted based on your zip code. Folks are finding effective workarounds to get the care they need,” said Wells.

Even in a state that has mainstream telehealth medication abortion services, there might be some people who prefer to obtain pills from alternate sources—maybe they’re undocumented, maybe they don’t want any record of this on their credit card or they don’t want parents knowing about it for whatever reason. There might be people who just prefer to keep it more private and self-managed

Elisa Wells

One option for obtaining abortion pills is from Dr. Rebecca Gomperts of Aid Access, which is based in Austria. Peer-reviewed research recently published in The Lancet shows that the Aid Access service is highly effective and extremely safe with patients reporting very positive experiences.

To obtain care from providers located within the United States, people can see a clinician located in another state and use mail forwarding services to obtain the pills, as described in a recent Ms. interview.

A third option is to order abortion pills directly from online pharmacies. The Plan C Guide to Pills lists vetted pharmacies providing abortion medications, with information about cost and shipping times.

Traffic to Plan C’s research-driven directory of services and information has risen by nearly 400 percent in the past six months, demonstrating the growing demand for information about where to find abortion pills by mail.

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Medication abortion uses two types of pills: mifepristone, which interrupts the flow of the hormone progesterone that sustains the pregnancy; and misoprostol, which causes contractions to expel the contents of the uterus. (VAlaSiurua / Wikimedia Commons)

Confidential medical support for using abortion pills is available through the Miscarriage and Abortion Hotline, also known as the M+A Hotline (1-833-246-2632). The hotline is staffed by volunteer physicians, midwives and nurse practitioners available from 8 a.m. to 2 a.m. EST, seven days a week, to answer texts and calls from people about abortion pills and miscarriage.

“People are doing this safely, but we’re just here to provide reassurance they’re doing what they need to do,” said Dr. April Lockley, medical director of the Miscarriage and Abortion Hotline, “and that it’s a safe process they can take care of at home.”

Medication abortion uses two different pills: mifepristone, which interrupts the flow of the hormone progesterone that sustains the pregnancy, and misoprostol, which causes contractions to expel the contents of the uterus. With or without medical support, people take abortion pills and pass the pregnancy on their own at home or another location they choose.

Extensive peer-reviewed research has shown that abortion pills are highly effective and extremely safe. The success rate is 95 percent or higher for pregnancies up to 10 weeks and only slightly less effective later in pregnancy. There are no serious adverse events in 99.7 percent of users. The American College of Obstetricians and Gynecologists, the American Medical Association and other leading medical associations support increased access to abortion pills, which they describe as “safe, effective medication.”

While abortion pills are medically very safe, people using them may become politically targeted by anti-abortion prosecutors and police. If/When/How has uncovered 18 arrests of people who ended their own pregnancies or those who support them. Prosecutors in these cases often use antiquated laws or laws meant to protect, not arrest, pregnant people, such as feticide laws that explicitly exempt pregnant women or other generally applicable laws such as child neglect, practicing medicine on oneself, or possession of a dangerous substance. People targeted are disproportionately BIPOC people and people living in poverty. The American Bar Association opposes the criminalization of self-managed abortion.

“As we face the Supreme Court decision in June, we want to raise awareness that there is something that people can do and are doing to get around these unjust laws and that is obtaining pills by mail through a variety of sources,” said Wells. “It’s not a perfect option and there is some legal risk associated with it. We want people to be informed and to make decisions based on accurate information.”

Sign and share Ms.’s relaunched “We Have Had Abortions” petition—whether you yourself have had an abortion, or simply stand in solidarity with those who have—to let the Supreme Court, Congress and the White House know: We will not give up the right to safe, legal, accessible abortion.

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About

Carrie N. Baker, J.D., Ph.D., is the Sylvia Dlugasch Bauman professor in the Program for the Study of Women and Gender at Smith College. She is a contributing editor at Ms. magazine. You can contact Dr. Baker at [email protected] or follow her on Twitter @CarrieNBaker.