A family physician explains how to handle self-managed abortion issues

“Self-sourced medication abortion,” refers to an individual finding or sourcing medications to induce an abortion on their own, without going through their primary care provider, OB-GYN or other clinic like Planned Parenthood. Globally, abortion pills might be found without prescriptions at neighborhood pharmacies or by accessing local community networks. In the U.S., even prior to the fall of Roe v. Wade, someone could order abortion pills online. Even in the setting of legal abortion, some people are self-managing their abortion because they don’t have a nearby abortion provider, because they cannot get a timely appointment or because they want control of their abortion experience.

Research and Trends

Research shows that when there are more restrictions around care, demand for online abortion pills increases. For example, one study looked at requests to a common online source of abortion pills the week after enactment of Texas’ Senate Bill 8 – legislation that banned abortion after the detection of embryonic cardiac activity. That study found a mean daily increase of 1,180% over the baseline before the legislation took effect. We can only expect a larger surge given the new legal landscape in the post-Roe world.

What are the abortion pills?

There are two medications that are commonly used for medication abortion: mifepristone and misoprostol.

• Mifepristone blocks the hormone progesterone and stops the pregnancy from continuing.
• Misoprostol is a prostaglandin – a compound that has hormone-like effects on the body – that helps soften and dilate the cervix to expel the pregnancy.

Both options are safe and highly effective. In the U.S., medication abortion is approved by the Food and Drug Administration as the combination of mifepristone with misoprostol. However, mifepristone can be difficult to obtain because of prescribing restrictions. Misoprostol is more readily accessible and available over the counter in many countries.

How do you get abortion pills online?

There are lots of places where you can get abortion pills online; however, not all sites have been vetted for legitimacy. One reliable “one-stop shop” is plancpills.org. This is a private advocacy organization that provides information on how to get pills. It identifies the options that are available depending on someone’s location as well as basic information like the cost, delivery time, age restrictions and financial assistance availability.

Handling Restricted Abortion Access

You can still buy the pills in states with restricted abortion access, but it may take longer to get them and there may be some legal risks. One option is Aid Access, a private organization with clinicians inside and outside the United States. When requests are made by people living in states with abortion bans, prescriptions are written by non-U.S. physicians and pills are mailed from international sources.

Delivery Time Comparison:

• Standard Domestic Process: Two to three days to receive the abortion pills.
• International Sourcing (via Aid Access): Two to three weeks to receive the abortion pills.

Those considering abortion pills should plan to rest and remain at home on the day they take misoprostol. As more people look to the internet to find abortion pills, it is important to know what resources are available to stay safe.