Even as courts and politicians attempt to restrict abortion access, medication abortion remains widely available through international telehealth providers, community networks and vetted online sources.
As legal battles over abortion pills continue to play out in the courts, many people across the United States are asking the same urgent question: If the Supreme Court or lower courts restrict access to mifepristone by mail, how can American women still get abortion pills?
The short answer: There are still multiple ways to safely and affordably access abortion medication.
How to Get Abortion Pills in Any U.S. State
More than one in four people in the U.S. who have abortions already use telehealth and mail delivery for medication abortion. Mifepristone has been approved by the FDA for more than 25 years and has been used safely by millions of people in the United States and around the world.
The World Health Organization recommends two evidence-based medication abortion regimens: mifepristone plus misoprostol, or misoprostol alone.
Some U.S. clinicians will continue to provide the mifepristone plus misoprostol regimen via telehealth, while others have said they would pivot to a misoprostol-alone protocol—which is very safe and effective, but has more side effects.
International Telehealth Providers
One of the most reliable ways people are accessing abortion pills is through international telehealth organizations that prescribe and mail medication directly to patients in the United States.
The two international telehealth providers currently serving the United States are:
1. Women on Web
Based in Canada, Women on Web connects abortion seekers with prescriptions for mifepristone and misoprostol and pharmacies that mail the medications to patients up to 14 weeks pregnant. The organization charges on a sliding scale, typically $120 or less, with delivery generally arriving within seven days.
In an interview with Ms. last year, executive director Venny Ala-Siurua said: “No matter what the U.S. does as far as restricting mifepristone, Women on Web will continue to provide mifepristone and misoprostol to people in the U.S.”
Abortion Pills in Private uses a doctor-supervised telehealth model designed for privacy and accessibility. The service provides care through 11 weeks of pregnancy, charges approximately $95, and typically delivers pills within seven days.
A co-founder told Ms. in December: “If mifepristone is further restricted … we are able to scale up if we suddenly have a lot more people ordering.”
Another option: Women Help Women
Ms. interviewed international organization Women Help Women‘s co-executive director Berro Pizzarossa last December. At the time it did not serve the United States—but Pizzarossa indicated it is prepared to expand services if restrictions deepen in the United States.
When asked whether they would consider expanding their services to the U.S. if the Trump administration restricts access to mifepristone, she was unequivocal: “I don’t see why not. If restrictions deepen, we should be ready together with the networks already doing this work. Let’s create normalcy in the steady abundant provision of abortion medicines.”
Community Networks Providing Free Pills
Another growing avenue for access is community-based abortion pill networks that distribute medication for free, particularly in states with abortion bans or severe restrictions.
There are now five verified and listed by Plan C and INeedAnA.
Four are affiliated with Red State Access, and collectively serve 3,500 people across 38 states and territories each month:
The fifth listed community network is DASH.
These networks often provide high-quality pills manufactured in India and mailed in discreet packaging. Some also offer abortion doulas and support for people throughout the process.
Websites Selling Abortion Pills
The third way people are obtaining abortion pills is through vetted online pharmacies and websites that sell pills without additional support services.
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.
Support Resources
Several organizations provide medical, emotional and legal support for people using abortion pills:
- Miscarriage and Abortion Hotline: free, confidential medical support from clinicians.
- Reprocare Healthline: peer-based support for getting and using abortion pills.
- Repro Legal Helpline: confidential legal information from attorneys specializing in abortion law.
- Aya Contigo: free Spanish-language abortion doula support.
- INeedAnA.com: search tool for finding abortion options by state and circumstance.
A Back-and-Forth in the Courts
On May 1, the Fifth Circuit Court of Appeals issued a sweeping ruling seeking to prohibit telehealth prescribing of mifepristone, forcing women to see a provider in-person to acquire the first pill in the standard two-drug medication abortion regimen. The decision would have blocked U.S. clinicians from mailing abortion pills after telehealth consultations nationwide.
On May 4, however, the U.S. Supreme Court temporarily paused that ruling, preserving current telehealth and mail access while the justices consider next steps.
The Court’s temporary ruling was set to last until 5 p.m. ET on Monday, May 11, giving the justices time to decide whether to extend the pause or let the lower-court ruling take effect.
Then, on Monday afternoon, the U.S. Supreme Court briefly extended its temporary order preserving telehealth and mail access to mifepristone while the justices continue deliberating over the emergency appeal. Justice Samuel Alito extended the Court’s administrative stay through Thursday, May 14, at 5 p.m. ET, keeping on hold the Fifth Circuit’s May 1 ruling that would have required patients nationwide to obtain the medication through in-person visits. The order means that, for now, people can still access mifepristone through telehealth consultations and mail delivery under the current FDA rules.
But regardless of what the courts ultimately decide, abortion access advocates, international telehealth providers and community networks say they are prepared to continue helping people access abortion pills.
Either way, the infrastructure for medication abortion access already exists—and it is not disappearing anytime soon.
