Years ago, we argued that medication abortion—the kind where you take pills early in pregnancy to cause a miscarriage—is so safe that it should be legal to do without leaving your house, perhaps via something like an online doctor visit and a package of meds that come in the mail. Now, that’s actually a reality in 20 states and Washington, D.C.
Formerly, the FDA required that mifepristone, one of the necessary medications, be given at an in-person clinic, even though you would afterward have the miscarriage at home. This led to unreasonable demands on people seeking abortions, like having to drive hundreds of miles—possibly on two separate days depending on state law—to get the pills.
In response to pandemic concerns about having to go to an in-person clinic, the American Congress of Obstetricians and Gynecologists petitioned the federal government last year to suspend the in-person rule. A series of court cases went back and forth, but the issue is settled for now: This week, the FDA replied to ACOG that “the overall findings [from studies they reviewed] do not appear to show increases in serious safety concerns (such as hemorrhage, ectopic pregnancy, or surgical interventions) occurring with medical abortion as a result of modifying the in-person dispensing requirement during the COVID-19 pandemic.”
As a result, the FDA will “exercise enforcement discretion,” meaning that even though they technically have a rule on the books requiring in-person prescribing, their official position is that nobody will get in trouble for violating it. In other words: mifepristone can be prescribed and shipped to you by mail.
And as a result of that, a company calling itself Abortion on Demand has launched the first large-scale telehealth service for abortion, Marie Claire reports. The website is not taking orders yet, but it explains that the process involves a video visit with a physician, followed by a package of medication being shipped overnight. The service “will check-in by text” afterward, and you have access to their physicians for after-care questions. The cost is $239.
The states where it’s available are Oregon, Washington, California, Nevada, Montana, Colorado, New Mexico, Minnesota, Illinois, Georgia, Maryland, Virginia, Delaware, New Jersey, New York, Vermont, Massachusetts, Connecticut, Rhode Island, Maine, and the District of Columbia. The company says that Alaska, Idaho, Wyoming, Michigan, Pennsylvania, and New Hampshire are “coming soon.”
Some states have more restrictive laws governing medication abortion than the ones enforced by the FDA, so Abortion on Demand currently only offers its service in these 20 states (plus D.C.), and it is limited to people over 18 and who are no more than 8 weeks pregnant. (You may still be able to get a telemedicine abortion from another provider if you don’t fit these criteria; check with your local clinic, such as Planned Parenthood, for more information.)