No Picket Lines at the Virtual Abortion Clinic

With a Roe v. Wade reversal imminent and states passing abortion restrictions at a breakneck pace, women are increasingly going online to access abortion pills easily and safely.

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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)

On Dec. 16, 2021, the Food and Drug Administration lifted long-standing, medically unnecessary restrictions on the abortion pill mifepristone. As a result, an increasing number of healthcare providers across the country are offering telehealth abortion services—screening patients online and mailing abortion pills to them at home. Despite the FDA ruling, 19 states still have laws requiring patients to see clinicians in person to obtain abortion pills, so people in those states and others where the medication is not yet available are finding creative ways to access abortion pills by mail.

While some brick-and-mortar providers are starting to offer telehealth abortion, virtual abortion clinics are rapidly multiplying across the country. Just the Pill, Choix, Abortion on Demand, carafem, Forward Midwifery and Pills by Post are just some of the virtual abortion clinics offering this convenient and affordable alternative to in-clinic care.

At these virtual clinics, patients are screened for their eligibility to use abortion pills by doctors, midwives and nurses via videoconference, phone or even online forms. The clinicians then send prescriptions to the two pharmacies in the country that mail abortion pills directly to patients: Honeybee Health and American Mail Order Pharmacy.

Telehealth abortion is affordable, fast, convenient and private. While in-clinic medication abortion costs an average of $550 in the U.S., virtual providers charge as little as $110. Many virtual clinics work with abortion funds to offer sliding-scale fees, and some take insurance and Medicaid. It’s possible to get online appointments, if required, quickly—often within a day or two—and some providers offer evening and weekend appointments. Pills arrive promptly—usually within one to three days—and providers are available by phone or text to answer questions. In this manner, patients never have to cross hostile picket lines to access abortion healthcare.

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For an easy-to-use guide to finding abortion pills, go to plancpills.org.

Research has shown that telemedicine abortion is very safe and effective. More than 95 percent of those who use abortion pills successfully end their pregnancies, and serious adverse events, such as hemorrhaging or infection, occur in just 1 percent of cases. In fact, abortion pills are safer than Tylenol, according to researchers at the University of California, San Francisco.

The FDA has approved a regimen of one mifepristone pill and four misoprostol pills for up to 11 weeks of pregnancy. The World Health Organization has approved this regimen for up to 13 weeks. Abortion pills are effective later in pregnancy under a different regimen.


This article originally appears in the Spring 2022 issue of MsBecome a member today to read more reporting like this in print and through our app.


In states restricting access to telemedicine abortion, women are ordering abortion pills through Austria-based Aid Access, run by Dr. Rebecca Gomperts. For patients in all 50 U.S. states, Aid Access offers physician-supervised telehealth appointments using online forms. In states that restrict telemedicine abortion, the pills are shipped from India for a sliding-scale fee of up to $110 and are delivered in two to three weeks. Gomperts has provided abortion pills to more than 30,000 U.S. patients in the past four years.

In restrictive states women are ordering pills from U.S. providers and using mail-forwarding services. Because providers are allowed to mail pills only to patients who have a mailing address in the states where the provider is licensed to practice, women are renting a mailing address from mail-forwarding services such as Anytime Mailbox to use for the telemedicine consultation. Then they request the service to forward the pills to them in their home states. Alternatively, women ask friends in a state that allows telemedicine abortion to let them use their address, or they use “general delivery” at a U.S. Post Office in the closest neighboring state to reduce traveling distances.

A third option is to order abortion pills from online pharmacies based outside of the U.S. The organization Plan C has vetted online pharmacies by ordering abortion medication from them and testing the pills for quality. On its website, Plan C lists web addresses for pharmacies that have shipped medications reliably, along with cost and shipping time. These pharmacies do not require a prescription to obtain abortion pills.


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.


Guidance for using abortion pills is available from Plan C and from How ToUseAbortionPill.org. The M+A Hotline provides free confidential support from licensed health professionals by phone or text from 10 a.m. to 10 p.m. in continental U.S. time zones, seven days a week.

Anyone who obtains pills through alternate sources such as online pharmacies should be aware that some states have prosecuted women for self-managing their abortions. The Repro Legal Helpline is available for anyone who has questions about the legal risks. According to Gomperts, in the rare event that a woman has to go to the hospital with complications, she does not need to disclose that she took the pills and the treatment would be the same as for a naturally occurring miscarriage.

Monday’s Supreme Court leak made crystal clear that the Court plans to overturn Roe v. Wade outright, and states are passing new bans and restrictions at a record pace. But abortion pills offer a convenient and affordable way to end unwanted pregnancies in a medically safe way.

In the latest episode of “On the Issues With Michele Goodwin,” Goodwin is joined by Dr. Julie Amaon, a family medicine doctor working for Just the Pill, a nonprofit telemedicine abortion provider. Together, they break down what you need to know about abortion pills. How do they work? How long has medication abortion been available? Is it safe? (The answer’s yes!) Is it legal? (Yes!) Is it effective? (Extremely.) Tune in to find out.

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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.