What Clinicians Want You to Know About Getting Abortion Pills in Anti-Abortion States

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What Clinicians Want You to Know About Getting Abortion Pills in Anti-Abortion States
3/14/2023 by Carrie N. Baker
“We want to help you, but we can’t know that you’re doing mail forwarding,” said one telehealth clinician. Another summed it up concisely: “Don’t ask, don’t tell.”



Mifepristone is one of two pills used in a medication abortion. (Phil Walter / Getty Images)

Women living in states restricting or banning abortion are finding creative ways to access abortion pills. Tens of thousands have ordered abortion pills from websites that sell pills and healthcare clinicians located outside of the country. But multiple-week delays for international shipping has led many to seek pills from inside the country, which can be obtained much more quickly. Some are ordering pills from community-based organizations such as Red State Access and Las Libres, which mail free abortion pills quickly to people living in states with abortion bans. (The Plan C Guide to Pills indicates which states each group serves.) These services do not provide medical supervision, although people can reach experienced volunteer clinicians for medical questions through the M+A Hotline.

But for those who want to receive prompt care directly from U.S.-based clinicians, many are turning to telemedicine abortion providers in states that allow it and using mail forwarding, as detailed on the websites of advocacy groups such as Plan C and Mayday Health. U.S.-based telemedicine abortion clinicians offer consultations by videoconference, telephone or online forms (asynchronously) and then mail abortion pills to patients to states where they are licensed and abortion is legal. Some clinicians ask patients to check a box on an online form confirming they are physically located in a state they serve, but do not confirm the patient’s physical location during the consultation. Others do not ask for or confirm the patient’s location; they just require a mailing address in a state where they are licensed and abortion is legal.

Patients living in states restricting abortion access are having pills sent to friends or family members in states where clinicians are licensed, then asking their friends and family to forward the pills to them. Alternatively, they obtain an address from a mail forwarding service in a state where the clinician is licensed and then have the pills forwarded to them in their home states. But if patients reveal to clinicians that they are located in a state banning abortion or that they are using mail forwarding, telemedicine clinicians may not serve them.
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While some telehealth clinicians are careful to stay within the most conservative interpretation of the law, others are less worried about trying to insulate themselves from any potential legal repercussions, especially when women are desperate for medical care in the face of unjust restriction on abortion access. “There’s too much time spent worrying about the ‘what ifs?’ instead of ‘what now?’” said one telehealth abortion clinician. “It comes down to risk tolerance. We all have different risk tolerances. The way I look at risk is, ‘What’s the worst thing that can happen if I get caught, and how likely is it?’ Those two things make me do things that a lot of people would be too nervous to do.”

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Free and confidential legal advice relating to abortion is available for provides at the Abortion Defense Network (https://abortiondefensenetwork.org/) and for patients at Repro Legal Helpline (https://www.reprolegalhelpline.org/).

https://msmagazine.com/2023/03/14/getting-abortion-pills-in-anti-abortion-states/