As abortion bans continue throughout the country, community support networks have developed alternate ways for people to obtain safe abortions. Community support networks are now providing free abortion pills to those living in states with bans, and dozens of companies are now offering abortion pills online for as little as $37, with prompt delivery in all 50 states.
“After Dobbs, we saw a major increase in access opportunities through informal supply sources, like community-based networks and websites that sell pills,” said Elisa Wells of Plan C, which conducts research and shares up-to-date information on its website about how people in the U.S. are accessing abortion pills online.
“The community-based networks were able to ramp up their distribution capacities and asked to be listed on the Plan C website for greater visibility. The websites that sell pills also proliferated, resulting in competition among sites that has led to significant price reductions.”
Medication abortion uses two FDA-approved oral medications to end a pregnancy: mifepristone and misoprostol, commonly referred to as “abortion pills.” Mifepristone interrupts the flow of the hormone progesterone that sustains the pregnancy. Misoprostol causes contractions to expel the contents of the uterus. These pills are used in combination, or misoprostol is used alone to end a pregnancy.
Before the Supreme Court overturned abortion rights, websites selling abortion pills charged hundreds of dollars for a combination pack of mifepristone and misoprostol pills. Today, several websites sell these pills for less than $50.
Websites Selling Abortion Pills
Plan C has tested websites selling abortion pills, including conducting product testing of the medications. On their website, Plan C lists the top 25 online suppliers in order of cost. The top three are:
- MTPPharmacy.com, which delivers in three days for $37.
- PrivateEmma, which delivers in three to four days for $49.
- Safeabortiononline, which delivers in four days for $50.
Plan C regularly updates the list with the latest prices, which has led to price competition.
“They’re all looking at our list and they’re saying, ‘How can I get a higher ranking above this other one,’” said Wells. “So they set their price just a little bit below and then the next one contacts us and says, ‘Okay, well, I want to be a little bit below that price.’ It got really outrageous at one point, where one went down to like $25.”
None of these suppliers require a prescription and many provide abortion pills in advance so people can have them on hand in case they experience an unintended pregnancy.
“We welcome these price reductions by the online retailers because we know the base cost of the product is quite low,” said Wells, who estimates that the pills cost the suppliers about $2 to $3. Online sellers were charging hundreds of dollars. “We recognize the price gouging [by websites selling pills] that was going on previously, so we’re glad that competition in the marketplace is resulting in more affordable products for people who need them.”
Wells notes that several of the companies are long-standing websites selling pills that offer many medications, whereas others are newly formed, independent, mission-driven companies created by reproductive health advocates wanting to ensure access to abortion pills, such as PrivateEmma, An Idle Timer, Medside 24, and ybycmeds. While most websites selling pills do not do any sort of medical screening of customers for eligibility to use the medications, one claims they do: PrivateEmma.
Everyone is risking something to be involved in this organization, to be able to make these medications more affordable and accessible.
An employee of PrivateEmma
PrivateEmma was formed in November 2022 by a charitable organization based outside the U.S. that had for years provided sanitary products to women in Africa. The company says they have a medical director who screens each customer to ensure they are eligible to use abortion pills. By July 2023, PrivateEmma had mailed mife/miso combo packs to almost 8,000 people in the United States.
The company mails the medications from inside the country so their customers can receive the medications promptly. Their medications come from India and are brought into the country by mail or courier. In their first nine months of operations, they had 5,000 combo packs confiscated during shipment.
An employee of PrivateEmma described the risks they faced doing this work, “People are putting their livelihoods on the line because people could go to prison for doing something like this. We’ve got people involved in India, in Africa and in the States. Everyone is risking something to be involved in this organization, to be able to make these medications more affordable and accessible.”
Community-Based Networks Offer Abortion Pills for Free
Plan C and Red State Access lists community-based networks providing free abortion pills to people in states banning abortion. These networks send one 200-milligram dose of mifepristone and 12 200-microgram doses of misoprostol.
- AccessMA serves Alabama, Louisiana, Missouri, Texas, Wisconsin, Utah and all U.S. territories (AccessMA@proton.me).
- WeSaveUs serves Indiana, Kentucky and Ohio (WeSaveUs@proton.me).
- Idaho Access serves Idaho, Nebraska and North & South Dakota (IdahoAccess@proton.me).
- ARTogether serves Arkansas (ARTogether@proton.me).
- OKAccess serves Oklahoma (OKAccess@proton.me).
- Las Libres, which sends one mifepristone pill and six misoprostol pills, serves Georgia, Mississippi, North Carolina, Puerto Rico, South Carolina, Tennessee and West Virginia (Request@laslibres.org).
Depending on their supply and people’s preferences, these networks will mail the pills in blister packs or loose, sealed in bubble pill bags, mylar pill bags or medicine bottles, and sometimes vacuum sealed. They offer doula support, either in person or virtually by phone, text or email. They provide detailed information about how to use the pills by email, with e-learning tools, and ensure that people are within thirty minutes of emergency care in the rare event that they need it. People are encouraged to use encrypted apps. In the first year, these organizations mailed abortion pills to over 20,000 people.
A regularly-updated list of which states are served by these networks is available at Red State Access and at Plan C.
For people self-managing abortions, advocates have created a wide range of support services, including the M+A Hotline for phone and text support from medical professionals; Reprocare Helpline for logistical and emotional support from peers and doulas; and Repro Legal Helpline for legal support. The Digital Defense Fund provides information about how to search for and order abortion pills online confidentially. There are other support services linked on Plan C’s website.
For people wanting medical supervision and FDA-approved abortion pills, Aid Access offers telehealth abortion for $150 or less to people in all 50 states with delivery in two to five days. A new company, Abuzz, offers telemedicine abortion for $0 to $150 to people in 30 states with delivery in one to five days. Both companies ship from inside the U.S.
Note: Ipas warns misoprostol begins degrading after 48 hours when exposed to air.
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