Can Women Still Get Abortion Pills Through the Mail?

Plan B contraceptive — a.k.a. the morning-after pill — prevents the fertilization of an egg and can be taken within 72 hours after unprotected sex. But if Plan B doesn’t work out… it helps to have a Plan C. And Plan C involves abortion pills.

The Abortion Pill

Although surgical abortions still occur, abortion pills have become an increasingly common alternative. More than half of the abortions that occur in the U.S. are now medication abortions.

A medication abortion includes a regimen of two drugs: mifepristone (Mifeprex) and misoprostol (Cytotec). The — is approved by the FDA to end a pregnancy at up to 10 weeks’ gestation. Patients first take

A medication abortion includes a regimen of two drugs: mifepristone (Mifeprex) and misoprostol (Cytotec). First, the mifepristone blocks progesterone which is key to maintaining a pregnancy. Then, the misoprostol is taken to induce contractions, this clearing the uterus to clear its contents. Similar to an early miscarriage, the result, most often, mimics a heavy period. Medication abortion is FDA-approved within the first 10 weeks of a pregnancy.

And since the FDA regulates mifepristone, states cannot ban it. “States may not ban Mifepristone based on disagreement with the FDA’s expert judgment about its safety and efficacy,” Attorney General Merrick Garland said in an official statement on June 24.

But abortion, broadly, has already been officially banned in eight states with many others expected to follow suit. So, to help women in those areas attain abortions, Plan C has stepped in.

Plan C is a public information campaign that aims to normalize the dissemination of at-home, self-directed abortion pills — through mail. Run by public health advocates, researchers, and digital strategists, the organization has been featured heavily on the news in the weeks following the upheaval of Roe v. Wade.

Navigating the Plan C website, women can select they state they are in to view potential pill options. For example, those living in Florida will see a disclaimer: “You live in a state that restricts access to abortion, but alternate routes of access may still be possible.” Those alternate routes include the private initiative Aid Access, online pharmacies, and mail forwarding.

But can women be prosecuted for using those options?

The Legality of Plan C Options

One core avenue to abortion presented by Plan C is Aid Access: a private initiative based in Europe. For years, this abortion rights group has sent abortion pills through the mail to American women with limited access. And though they were threatened by FDA officials during Donald Trump’s administration, the practice continued. And for now, it’s legal.

“Because Aid Access is not based in the United States, U.S. enforcement — whether private, state, or federal — cannot reach them,” Elisabeth Smith, JD, director of state policy and advocacy at the Center for Reproductive Rights, explained to MedPage Today, as reported by ABC News.

Aid Access relies on the postal service to carry out its mission. And in fact, the mail is already one of the nation’s largest abortion providers. American telehealth companies like Hey Jane, Just the Pill, and Choix also send out abortion pills by mail, in accordance with state laws. And though 19 states prohibit the use of online appointments for abortion purposes, VPNs can easily be used to navigate around those laws.

Similarly, checking every mailbox for abortion pills is simply not an option. To truly detect and criminalize all pills-by-mail is too tall an order for a country that can hardly curb its ongoing opioid crisis. “You can’t protest every mailbox; you can’t create that type of regulatory regime,” Amanda Allen, senior counsel at the Lawyering Project, explain to Curbed last month.

However, there are possibilities for avoiding the mail. Pill pick-up points are springing up around the borders of pro-choice states. Just the Pill is also a fleet of organizing mobile clinics in Colorado. The future of these workarounds, though, remains unclear.

Almost certainly, prosecutors states where abortion is illegal will begin building cases against providers. The Plan C website also admits that using their services can have legal consequences.

In 2015, Purvi Patel, an Indiana woman, was sentenced to 20 years in prison for allegedly inducing her own abortion. The case was built upon on Patel’s digital trail, with texts to friends cited as evidence. And though her own conviction was eventually overruled, it stands as an example for how future trials may look, particularly under increasing levels of mass surveillance.