How an unmarked van quietly delivers abortion pills to the Colorado border

As abortion becomes increasingly restricted across the country, a nondescript mobile clinic operates on the Colorado border, where out-of-state women can pick up medication themselves.

“There is no signage on it,” said Dr. Julie Amaon, medical director of Just The Pill. “We don’t try to tell people what we’re doing to keep patients safe, because we know that even in more protected states like Colorado, there are still a lot of people who don’t agree with what we do.”

Just The Pill provides medical abortion, which is a two-pill dose that can be taken at home. Patients who live in restricted states can travel to Colorado to pick up medications at the organization’s only mobile clinic, which parks at various locations near state lines.

“We try to get as close to the patients as possible, depending on the method they use,” Dr. Amaon said. “Do they come by bus, by car, by plane? And so that gives us more flexibility to move around and meet patients where they are.

Just The Pill works with patients in the West and Midwest. Everyone starts with a telehealth consultation, with some joining the appointment from a hotel or car if this process is prohibited in their home country. Then the drugs are mailed or picked up by hand in Colorado, a state considered a safe haven for abortion access in the region.

Although Just the Pill’s mobile clinic is understaffed and often closed, the organization has served approximately 100 women since its launch in August. This small operation is one of many piecemeal efforts to increase access to care as states move to shut it down.

Planned Parenthood plans to launch a similar mobile operation later this year in Illinois. Other mail order and telehealth options already exist; Just The Pill goes one step further in driving abortion drugs to take places in Colorado.

“Obviously we’re trying to push the envelope as far as you know; how can we obey the law but push the boundaries and try to get patients care where they need it? But we also need to be able to continue to offer services to continue helping patients,” Dr. Amaon said.

During the pandemic, the Food and Drug Administration temporarily waived the requirement for women to obtain abortion pills from a provider in person, allowing them to mail them instead. In December, the FDA made the change permanent. Still, many states prohibit these telemedicine visits.

“What are these conservative states doing about their citizens who access abortion through other means? And the two big questions here,” said Josh Wilson, a politics professor at the University of Denver. “We’re leaving physically, aren’t we? Like going to another state and back. The other is the mail. And that’s actually a federal concern, that’s interstate commerce.

In 2019, almost half of all abortions were medical abortions, according to data of the federal government. It’s too early to tell how access has changed since the Supreme Court struck down the constitutional right to abortion in June, but research indicates the demand for medical abortion has increased during the pandemic.

Abortion pills are only approved for a maximum of ten weeks pregnant. Kate Coleman-Minahan, assistant professor at the University of Colorado College of Nursing, points out that this method of pregnancy termination will not always be applicable.

“There are people who don’t have private, safe spaces to manage medical abortion and don’t feel like they have the social support to do so,” Coleman-Minahan said. “And so, while increased access to medical abortion is extremely important, it does not replace the full range of evidence-based options for people to have their pregnancies.”

Just The Pill hopes to launch a procedural mobile clinic next year offering surgical abortions. To do this, they will have to find a place to park for hours and consider buying land. For now, staff are working with a handful of Colorado physical clinics, referring patients for blood work and ultrasounds and taking care of some of those clinics’ medical abortion patients.

“So the hoops that people have to jump through are pretty ridiculous for general medical care. But that’s the state we’re in right now,” Dr Amaon said.

Just The Pill is raising funds for another mobile clinic, just like the one stationed in Colorado. This unit will operate in Illinois, another state that has protected access to abortion, surrounded by states that restrict it.

Editor’s Note: This story has been updated to reflect the correct spelling of Kate Coleman-Minahan’s name.

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