International telehealth providers, community networks and websites selling pills are ready to ramp up services to fill the needs of Americans.
Late on Friday, May 1, judges on the Fifth Circuit Court of Appeals—notorious among abortion-rights advocates and legal commentators for being highly conservative and hostile to abortion access—entered a nationwide ban on U.S. clinicians dispensing the abortion pill mifepristone by mail after a telehealth consultation.
The court’s ruling reimposes a medically unnecessary requirement lifted by the FDA in 2021 that patients must pick up the medication in person from a clinician—overriding a lower court’s ruling from April, as well as the advice of medical experts. The ruling applies across the United States.
More than one in four people in the U.S. who have an abortion do so using telehealth and mail.
While some clinicians in the U.S. have said they will shift to a misoprostol-alone protocol—which is very safe and effective, but has more side effects—women can still obtain abortion pills with mifepristone and misoprostol from international telehealth providers for a sliding fee, community networks for free and websites selling pills, starting at $85. The organization Plan C lists reliable providers on their website at plancpills.org.
In a statement following the ruling, Plan C called the case “a political attempt by the antiabortion movement to prevent access to telehealth abortion,” noting that opponents are “presenting widely disputed science … to discredit mifepristone,” a medication backed by more than 100 studies.
The two international telehealth providers currently serving the United States are Women on Web and Abortion Pills in Private.
Based in Canada, Women on Web connects abortion seekers with prescriptions for abortion mifepristone and misoprostol and to pharmacies that will mail abortion pills to people up to 14 weeks of pregnancy. They charge on a sliding scale of $120 or less with delivery in 7 days or less.
Abortion Pills in Private uses a simple, doctor-supervised telehealth model designed for easy access and confidentiality, serving patients through 11 weeks of pregnancy. They charge $95 and deliver in 7 days or less.
Five community networks are now verified and listed by Plan C and INeedAnA.
Four are affiliated with Red State Access: AccessMA, MidWestAccess, IdahoAccess and ARTogether.
These four networks now serve approximately 3500 people across 38 states and territories each month.
The fifth listed community network is DASH.
Red State Access-affiliated networks offer high-quality pills manufactured in India and mail them in discrete packages. Clients can choose between receiving them in foil blister packs or as loose, unidentifiable pills, depending on their security concerns and community provider stock. Community networks serve people of all ages and at all gestations, and offer trained doulas to assist with using abortion pills.
The third way people are obtaining abortion pills is via websites that sell pills without additional support. Plan C conducts research using mystery shoppers to test the reliability of these websites and tests the medications received in a lab to verify the medications.
Plan C lists support services, including:
- Miscarriage and Abortion Hotline provides free and confidential expert medical support for people using abortion pills.
- Reprocare provides peer-based support on getting and using abortion pills.
- Repro Legal Helpline provides free, confidential legal information from expert lawyers.
If/When/How, legal experts on abortion pills, says using abortion pills is legal across the United States and is not impacted by the Fifth Circuit’s ruling.
Advocates are hopeful that the Supreme Court will stay the Fifth Circuit’s extreme decision, but in the meantime, mifepristone is still widely and affordably available across the United States.
