Thousands of American women have obtained abortion pills online over the past year, according to figures that highlight the growing difficulty of accessing safe abortions on the ground.
Data shared with the Guardian reveals that 21,000 women sought abortion medication between March 2018 and March this year from charity Aid Access. Between a third and a half of the women who made the requests subsequently received abortion pills in the mail. The majority of recipients live in states with hostile abortion policies.
Women who obtained pills online described their desperation at not being able to access affordable medical services locally, with some saying they had considered extreme measures to terminate their pregnancies.
“The reality on the ground is already so desperate,” said Rebecca Gomperts, founder of Aid Access, which provides online prescriptions for abortion pills that are shipped to the United States by mail. “If a woman cannot access a normal abortion in the United States, she will do anything to terminate her pregnancy.”
Last week, Alabama passed the first near-total ban on abortion, with four other states passing bans during the first few weeks of gestation, before most women know they are pregnant. threatening women’s constitutional right to abortion in America. However, the latest figures suggest that clinic closures, prohibitive financial costs and requirements for in-person abortion counseling followed by a waiting period have already caused a drastic erosion of health services for women.
Abigail Aiken, an assistant professor at the University of Texas at Austin who analyzed the Aid Access data, said, “We’re talking about this idea that Alabama could overthrow Roe v Wade. But even now, there are so many women who have the right to abortion but they cannot exercise this right.
Abortion is legal in all 50 US states. Abortion bans in US states are an effort by activists to overturn Roe v Wade, a US Supreme Court decision that granted women the right to an abortion up to the point where a fetus can live outside the uterus, about 24 weeks.
Since 2006, Gomperts has run the charity Women on Web, which enables women in abortion-banning countries to terminate their pregnancies through online consultations. The charity’s doctors prescribe the two pills – mifepristone and misoprostol – which will end a pregnancy within the first 10 weeks. The pills are sent to women from a pharmacy based in India.
Gomperts launched the US Aid Access operation last year after seeing a steady increase in demand, with around 6,000 requests for abortion pills between October 2017 and August 2018. Three-quarters of requests came from states that introduced strict anti-abortion laws, such as Alabama, Georgia and Mississippi.
The charity said it also heard women say they were considering extreme measures, such as drinking alcohol or having someone punch them in the stomach.
In some states, anti-abortion legislation has resulted in the closure of a majority of clinics. In Texas, there were 44 clinics in 2013, but only 19 clinics remained two years later after restrictive laws were passed reclassifying abortion centers as surgical centers, meaning they had to have wide hallways and large operating rooms. Last year, six states had only one operating abortion provider.
“For low-income people, the legal right to abortion is almost a moot point,” Aitken said.
Medical abortions before 10 weeks of pregnancy are similar to a spontaneous miscarriage and usually do not require follow-up care. The first pill (mifepristone) blocks the pregnancy hormone and the second (misoprostol), taken 24 hours later, causes the uterus to contract.
Testimonials from women who allegedly had access to abortion pills, published by the charity in a letter last week, cover a range of situations, from young women in relationships who could not afford the $900 charged by their local clinic, to mothers who did not want to have another child, to women in abusive relationships.
The US Food and Drug Administration (FDA) has issued a warning letter stating that Aid Access violates federal law by selling “mislabeled and unapproved” drugs.