by John Hanna
A Nurse Practitioner works in an office at a Planned Parenthood clinic where she confers via teleconference with patients seeking self-managed abortions as containers of the medication used to end an early pregnancy sits on a table nearby Friday, Oct. 29, 2021, in Fairview Heights, Ill. Women with unwanted pregnancies are increasingly considering getting abortion pills by mail. Credit: AP Photo/Jeff Roberson
Before her daughter's birth, she spent weeks in bed. Another difficult pregnancy would be worse as she tried to care for her toddler.
Faced with that possibility, the 28-year-old Texas woman did what a growing number of people have considered: She had a friend in another state mail her the pills she needed to end her pregnancy. She took the pills, went to bed early and describes the experience as "calm" and "peaceful."
"If people can have births at birthing centers or in their own homes, why shouldn't people be able to have abortions in their own homes?" said the woman, who spoke on the condition of anonymity because she worries about legal reprisals as Texas moves to join several other states in disallowing mail delivery of abortion medications. "It's a comfort thing."
The COVID-19 pandemic and Texas' near-ban on abortion fueled increased interest in obtaining abortion medications by mail. But with the legality in doubt in several states, some people looking to get around restrictions may not see it as worth the risk. The matter is taking on new urgency with the Supreme Court set to hear arguments next month in Mississippi's bid to erode the Roe v. Wade decision guaranteeing the right to an abortion.
"We don't think that people are doing anything wrong to order medication from an online site," said Elisa Wells, co-founder and co-director of Plan C, which provides information about medical abortions. "I mean, that's how men get Viagra. They order it online, and nobody's talking about that and asking, is that illegal?"
"We just didn't want women to use these medications and not have any protections, any guidance, any consultation," said Oklahoma state Sen. Julie Daniels, a Republican and lead sponsor of her state's law banning delivery of abortion medication by mail, which is on hold amid a legal challenge.
Aid Access, which helps women get abortion pills and covers costs for those who can't afford them, says it can't yet provide data from recent months. It saw a 27% increase in the U.S. in people seeking abortion pills as states instituted restrictions early in the COVID-19 pandemic, according to a University of Texas study. The biggest increase was in Texas, which had limited access to clinics, saying it was necessary to check the coronavirus' spread.
"I don't think that any state level regulation is going to stop Dr. Gomperts from what she's doing," said Christie Pitney, a California nurse-midwife who is Aid Access' provider for that state and Massachusetts.
Containers of the medication used to end an early pregnancy sit on a table inside a Planned Parenthood clinic Friday, Oct. 29, 2021, in Fairview Heights, Ill. Women with unwanted pregnancies are increasingly considering getting abortion pills by mail. Credit: AP Photo/Jeff Roberson
"In Missouri, we don't actually provide medication abortion because of the state requirement," said Dr. Colleen McNicholas, chief medical officer of the regional affiliate.
Abortion opponents don't expect the FDA restriction on abortion medication to be reinstated under Biden. GOP lawmakers in Arkansas,Arizona, Montana and Oklahoma already were working on new laws to ban mail delivery when the FDA acted. Texas' mail-delivery ban takes effect Dec. 2. South Dakota GOP Gov. Kristi Noem issued an executive order in September.
"Obviously it would be a lot easier if we had the cooperation of the federal government," said John Seago, Texas Right to Life's legislative director. "There's no silver bullet yet identified of how we're going to approach this kind of next frontier of the fight."
Pregnant people seek telemedicine consultations and abortion pills by mail because they don't want to or can't travel or can't arrange time off or child care, abortion-rights advocates said.
"Just because somebody can't access an abortion doesn't mean that they're going to all of a sudden want to continue a pregnancy that originally was not desired, right?" said Dr. Meera Shah, chief medical officer for the Planned Parenthood affiliate outside New York City, who also does abortions in Indiana.
A person in Ohio who identifies as nonbinary said they used an herbal remedy to self-manage an abortion alone in their college dorm room in 2016, before Aid Access launched its site, telling their roommate they had the stomach flu. They said they didn't have a car and didn't know they could get financial help, and called the Aid Access model "fantastic."
"Any avenue to help pregnant people facilitate their own abortions and have that experience in whatever way best suits them is a great way to give bodily autonomy back to a wider range of patients," they said, speaking on condition of anonymity because they fear harassment from anti-abortion protesters.
The new laws in Montana, Oklahoma and Texas say people can't face criminal penalties for having medication abortions. Yet those provisions—and assurances from abortion foes that their goal is not to prosecute people who have ended pregnancies—don't comfort some abortion-rights advocates.
Some abortion-rights advocates said prosecutors also can use child endangerment or manslaughter charges against people who have had abortions—or who have had miscarriages that authorities deem suspicious. They worry that the poor and people of color are especially vulnerable.
"They can't get drugs where they are, and so they may purchase pills from informal networks or online sites," said Melissa Grant, chief operating officer of carafem, which operates clinics in four states and provides abortion medications in nine. "But that's riskier in this country than actually taking the medicines."
Study: Abortion ban may lead to a 21% increase in pregnancy-related deaths
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Citation: More turn to abortion pills by mail, with legality uncertain (2021, November 13) retrieved 20 January 2022 from https://medicalxpress.com/news/2021-11-abortion-pills-mail-legality-uncertain.html
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