Silver Lining: How the Pandemic Revolutionized Abortion
Since the start of the pandemic, self-managed abortions using abortion pills have been on the rise. In the US, the FDA stopped enforcing “in-person” dispensing of mifepristone to patients (1), recognizing the restrictive nature of the previous abortion pill regulations altogether.
Abortion pills are known to be safe — when taken correctly, they are about 98% (2) effective and account for about 40% of abortions in the US (3) Despite the recent progress in access to mifepristone, the FDA has maintained restrictions on its distribution. Mifepristone can only be dispensed in specific facilities by special providers, and physicians have to apply for this designation specifically.
COVID has shifted the way that people can access mifepristone + misoprostol abortions, and for the first time in US history — safe and vetted — abortion pills can be ordered by mail, with the support of telehealth specialists.
The Soon-To-Be-Overturn of Roe
The impacts of the imminent overturning of Roe v. Wade will only begin to fully show in a few years’ time. We will be able to monitor the impacts through increasing birth rates in those states that have no abortion providers, as well as from the stories of people forced to carry pregnancies to term because abortion wasn’t available, too expensive, or too far to travel to an available facility, or because the pregnancy was potentially “too far along”. Consequences stemming from the end of Roe will result in spikes in US Maternal Mortality rate as pregnant women die trying to end their pregnancies. History has shown this to be the case (4).
At the end of the day, children deserve to be born into families that want them, and individuals have the right to decide how they will co-create life onto this planet.
If everyone had an intentional birth, with wanted pregnancies, society would transform from this simple aspect. At the root of all human desire is to be loved, to belong, and to feel wanted. This blueprint is formed in each of us while we are in the womb and has lasting effects on a person through adulthood.
The consciousness we put into creation endures through lifetimes and generations.
The time, manner, and context in which we choose to become parents is extremely personal, as is the choice to have an abortion.
The Rise of the Abortion Pill
For the moment, there is still access to abortions in clinics in most states in the US. A surgical abortion is performed in a clinic by a doctor, nurse, or midwife and generally lasts around 15 minutes. An instrument is inserted into the uterus to remove the contents. It is safe, and at the end of the appointment, there is peace of mind that the abortion is complete.
A medical abortion, or a medication abortion, is an abortion with pills.
There are two main methods of inducing an abortion with pills:
One option is mifepristone + misoprostol: a combination of pills that are considered to be the most effective (98%)(5) in completing an abortion.
The second option is with misoprostol alone which is 84% to 96% (6) effective in completing an abortion.
Both methods are effective and are used by people worldwide to end their pregnancies. In countries where mifepristone has not been registered by the FDA, misoprostol alone is the most common method of medication abortion.
Misoprostol is not as heavily restricted as mifepristone. This means that it is more widely available. It has a number of different medical uses and is often used under the brand name Cytotec. In the event that abortion does become more heavily restricted in the US, misoprostol alone medication abortions will be increasingly in demand by Americans in need of an abortion.
The New Kids On the Block: Innovations in Access
In the last 24 months, innovations in the medication abortion landscape have proliferated, as abortion advocates and online abortion pill providers continue to implement groundbreaking strategies to make abortion pills available to most Americans by mail.
If you currently need an abortion and choose to self-manage at home with pills, there are a number of organizations listed below that can assist you in getting safe and quality pills. In many communities across the US, there are local abortion funds allocated to help pay for transportation, childcare, hotels, and sometimes part of the cost of an abortion.
PLAN C The most up-to-date and comprehensive resource on pills-by-mail access, and other resources you will need to access medication abortion in the US.
Hey Jane! (NY, CA, WA, IL, or CO) Get fast, safe, and affordable abortion care from home. Chat with a caring doctor within 24 hours. Medications are shipped daily.
Carafem The leader in client-centered medically-supported telehealth abortion care provided in Iowa, Georgia, Connecticut, Virginia, Illinois, Maryland, New Jersey, and the District of Columbia
Choix A sexual and reproductive healthcare-focused Telehealth Clinic run by a team of nurse practitioners, doctors, and engineers in California. They offer abortion care, birth control, emergency contraception, and urinary tract infection (UTI) care, to patients assigned the female sex at birth regardless of insurance or documentation status, in California and Illinois.
National Network of Abortion Funds is a collective of member organizations working to remove financial and logistical barriers to abortion access.
Reprocare is a reproductive justice organization that centers communities that are at the intersection of racism, classism, and sexism, with an anti-racist, economic justice, and feminist approach to healthcare and access to care. They provide a healthline that shares medical information about medication abortion, supports low-income callers in accessing funding for reproductive healthcare, and offers culturally appropriate doula support to callers.
AidAccess is a committed team of doctors, activists, and advocates for abortion rights. The purpose of the website and the service is to create social justice and improve the health status and human rights of women who do not have the possibility of accessing local abortion services.
Women Help Women are a global telehealth service that provides information, support, and abortion pills to women around the world and partnerships with local feminist groups around the world to support increased access to abortion pills.
There are many sites that are unlicensed to sell abortion pills Generally, what they are selling should theoretically be mifepristone and/ or misoprostol, but it may not be a registered brand/manufacturer in the country you are living in. For this reason, the medication is considered a black market, and if detected, could be confiscated by the mail service.
Studies done by Gynuity have shown that many of these pills are in fact mifepristone + misoprostol (7) and that the pills are of good quality. However, if you are buying from a non-vetted website, it’s not 100% sure in terms of quality.
While it is generally advised to get medication in your country from a trusted clinic, provider or pharmacy, if you DO acquire pills by mail from an unverified source, there are a few important things to consider.
How to inspect your abortion pills:
Do you see a brand name? If you do, google the name of the pills (i.e. Mifegyn, Medabon, Mifepack, etc) and see where the pills are sold legally on the market
Expiration date: Are the pills within the expiration and safe to take?
Did they arrive in a blister pack? Normally pills should arrive each individually protected in a blister-pack-foil. Mifepristone + misoprostol packs are normally 5 pills, and misoprostol generally comes in packs of 3 or 4 per box.
Is the packaging damaged or re-sealed in any way? Some unlicensed companies have been known to crush pills in order for customs not to be able to detect a blister pack (8).
Misoprostol is generally quite sensitive to heat and can degrade easily. For this reason, you must ensure that the pills arrive in blister packs without punctures or damage.
As the US Supreme Court will likely uphold Mississippi’s law to ban abortions (9), chances are, abortion access in America will transform as we know it. Luckily, this is at the same time that access to safe abortion pills has never been more accessible. Some organizations like AidAccess are discussing “advance-prescribing” pills to people, which means that abortion pills could be kept just in case they were needed by an individual in a State that has no abortion access. But if the laws passed in Texas are any indicator , the future of American abortions could include everyday citizens as informants, ready to turn individuals in who seek abortions and anyone who agrees to assist them.
In this way, abortion pills could be tiny keys to liberation, hidden and passed between hands. Revolution can come gently — in the form of tiny pills, and in complete innovations in the way that abortion is accessed and experienced not only in the US, but globally.