Although the mifepristone pills contained the expected amount of the medication, most of the misoprostol pills contained less than the labeled dose. (They might still work, even at a lower dose, Raymond says.) What’s more, none of the pills came with instructions for use.
Still, says Daniel Grossman, a professor of obstetrics and gynecology at the University of California, San Francisco, “it doesn’t appear that women are having serious complications” from these DIY regimens. If the pills are taken late, they could still work, but are less likely to. Mifeprex, the brand name for mifepristone, has been used by more than three million women in the United States and has caused 19 deaths, a rate of adverse events that’s lower than that of Viagra.
Pro-life groups, meanwhile, insist that the pills are not safe. Because of the risk of ectopic pregnancy, among other reasons, “the practice of obtaining abortion pills over the internet is risky, and it ought to be illegal,” says Steve Aden, chief legal officer at the pro-life group Americans United for Life. (Grossman says that while attempting to self-abort could delay the diagnosis of an ectopic pregnancy, the pills don’t affect ectopic pregnancies or make them worse.) The people held accountable, Aden says, should be the companies providing the pills, rather than the women themselves.
If Roe is overturned, Raymond says, the abortion landscape will roughly look like this: “In some states, abortion will still be legal, so people will travel to those states. Some people won’t get abortions. Some people will get abortions, but later. And more people will probably use these alternative methods for getting the service.”
Women on Web, a Canada-based service, ships the abortion pills to patients who live in countries where abortion is illegal. Rebecca Gomperts, the organization’s founder, says the organization gets 10,000 emails each month asking for help and staffs a help desk that speaks 17 languages. The service asks women to fill out an online form about their health status, which doctors in various countries review, then fill prescriptions for the abortion pills. In 12 years, she estimates they’ve helped 70,000 women perform their own abortions.
Women on Web doesn’t ship pills to the United States, however, because as Gomperts told me, in America “there’s such an aggressive anti-abortion movement that will do anything they can to close down services. It could potentially jeopardize all the other work of Women on Web.”
The United States, she said, “should be able to solve its own problems” regarding abortion access. “It’s a very rich country,” she added. “The problem there is caused by the huge inequality in the society. There’s no reason the situation in the U.S. should be the way it is.”
If women do start turning to web-based services in greater numbers, it raises the question of whether they’ll face legal risks. Gomperts says it’s legal, in most countries, to receive medicine through the mail for personal use. But other experts I spoke with were not so sure.