Panic has begun as soon as Jaida took her test in early July. It was positive and a quick count showed she was seven weeks pregnant. It was a bad time. Her mother had just died, and Florida, the state where she lived, imposed restrictions on April which prohibited people from using telemedicine appointments to access abortion pills. Jayda, in her 20s and asked to use a pseudonym to protect her privacy, attempted to book a face-to-face meeting with Planned Parenthood, a non-profit organization that provides sexual health services in the US. But the waiting time was two weeks. “It felt like there was a lifetime left,” she says.
Instead, she turned to the unregulated world of websites selling abortion pills or MTP kits, a combination of two drugs, mifepristone and misoprostol, used to terminate the pregnancy. As restrictions tightened across US states, an intercontinental network of companies and non-profit organizations has sprung up to deliver these pills to places where access is restricted. Some are motivated by ideology, others by profit and opportunism. But they all fall into a legal gray area where regulators are unable or unwilling to assert their authority.
Jaida found out about the network after a frenetic googling led her to a website called Plan C, which lists online pharmacies that ship abortion pills to states in the US. She went through the options. “I was in a panic,” she says. “I wanted to get the pills ASAP and didn’t want to pay a fortune for them, but I also wanted them to be as legal as possible.”
One online pharmacy stood out, AbortionRX. Stock images of grinning women illustrated the website’s home page, and the text looked awkward, as if written by someone who didn’t speak English well. But AbortionRX promised to deliver the pills to Florida within eight days in exchange for $250. Women on Reddit shared their positive experiences. “The website looks a bit sketchy, but they are real,” one post said. It was the comfort Jaida needed. She clicked “order now” and paid.
AbortionRX’s web address was registered in Amsterdam. domain registrar details. The packaging said the pills Jaida received included one 200mg mifepristone tablet and four 200mg misoprostol tablets and were manufactured by the Indian pharmaceutical giant Zydus. They were sent from India to an unknown location in the US, where they were waiting for a buyer. AbortionRX did not respond to multiple requests for comment, but when WIRED asked a customer service rep where the pills were shipped from, the person replied, “We ship from the US to the US.” Jayda’s pills were shipped in a modest little brown envelope with a California return address.
“We do not own this product and do not currently sell it in India or any other geography,” a Zydus spokesperson said when asked about the company’s association with Zydus-branded abortion pills.
“Most of the pills we see are made by Indian manufacturers,” says Eliza Wells, co-founder and co-CEO of Plan C. “They may come directly from these companies, but I suspect they are not. I suspect that there is someone enterprising who created this pharmacy site and somehow buys pills in bulk and ships them.” Abortion pills can be bought in pharmacies for about $5 in many countries, she said.
One such entrepreneur is a man known by the pseudonym Chris Jones. Jones, who declined to give his real name in case his activities become illegal, runs the website Medside24, which is also on the Plan C list. He started his business in Moscow and then moved to the Kazakh capital Alma-Ata after how Russia invaded Ukraine. All of the company’s customers are in the US, he says, and most get recommendations from Plan C. Medside24 sells an average of 15 abortion kits a day, at a profit Jones calls 50 percent.
Where Medside24’s pills come from depends on their availability, says Jones. Sometimes Russian manufacturers, sometimes Vietnamese. The pills that Jones currently ships to the US are made by the Vietnamese pharmaceutical company Stella. Jones says he gets the pills from a local abortion clinic, which orders them in bulk from a local importer.
The payment system behind the site reflects the legal gray area in which these online pharmacies operate. Over the past three months, Medside24 has begun accepting payments through the Zelle money transfer service, Jones said. But for many years, the site only accepted bitcoins. “You can’t just go to a national bank and open a trading account and say I want to sell abortion pills,” says Jones.
The US Food and Drug Administration has been expressing concern about these sites for many years. In 2019 he posted abuse complaint Barbados-based hosting company Rebel.com to investigate “illegal activities” through its registered domain names, such as AbortionRX, and other online pharmacies selling abortion pills. “The FDA has a policy that restricts the personal importation of drugs that cover medical abortion, but historically the FDA really hasn’t given it much thought,” says Mary Ziegler, a law professor at the University of California, Davis. “There is a feeling that what these companies are doing is illegal, but there is also a feeling that nobody is going to do anything about it.”
Without official intervention, the job of reviewing these websites’ products fell to Plan C instead. Back in 2016, Plan C and the non-profit Gynuity Health Projects began buying abortion pills from 16 different sites and sending them to a lab for testing. “All the pills were real and it really hit people,” says Wells. “When we presented the study at a National Abortion Federation conference later that spring, all those abortion providers sighed in disbelief that we could just buy these abortion pills online.”
Since then, Plan C hasn’t done any lab testing, Wells says, but the organization removes pharmacies from its website if they receive complaints. “If we hear about a problem, we test the site using a mystery shopper model where someone buys pills and sees what comes in the mail, how much they cost, how long they take, if there are customer service issues. And then we could remove the supplier based on that,” she says. When customers told Plan C that Medside24 was selling abortion kits containing only three misoprostol tablets instead of the recommended four, Plan C removed them from its catalog. It was restored when a fourth tablet was added. “Now that’s fixed,” says Jones.
The FDA told WIRED that it does not recommend buying mifepristone online because it means patients are “bypassing important safety measures designed to protect their health.” And the women who use these online pharmacies complain about the lack of support after buying the pills. When Jayda took the AbortionRX pills, there was less bleeding than she expected, causing her to panic that the medication was not working. Since she had no one to consult with, she turned to a support group on Reddit. “Honestly, at a time when I was so scared and feeling very alone, without anyone to turn to, these women really helped me to persevere and develop a plan of action,” she says.
After five agonizing days, she was given a face-to-face appointment at the Family Planning Center, which confirmed that the pills had terminated her pregnancy. Jaida describes her experience with AbortionRX as good, but if she had to go through the process again, she would take advantage mail forwarding serviceso that she can use a US virtual clinic such as Hey Jane. “It would be great to be able to reach out to the designated person and tell him, ‘OK, here’s what’s going on.’
Aid Access is one of the non-profit organizations that is out of reach of the anti-abortion US authorities, but with a more formal clinic support system. Managed by Dutch physician Rebecca Gomperts, who He speaks it also purchases the pills from Indian pharmacies – website delivery times are slower than some commercial services, according to Plan C, taking between 14 and 21 days. popular even before the Supreme Court overturned Rowe vs. Wade. According to the data, between 2018 and 2020, 75 percent of Aid Access clients said they use the service because they cannot afford treatment at the clinic. one study published in Lancet.
The same study, which collected responses from 2,797 people, also found that access to care was safe. “We found that 96 percent of the women were able to terminate the pregnancy on their own, meaning they didn’t need to see a doctor in person for any additional help,” says Abigail Aiken, one of the study’s authors and a professor at the University of Texas. “Less than 1 percent of people reported being treated for what we would call a severe outcome, either bleeding when they needed a blood transfusion or an infection that would require antibiotics to treat.”
For Aiken, the international market for abortion pills seems resilient because it is outside the control of any one country’s authorities. “If someone is out of the country, it’s not clear exactly how to get them to comply with the law in another jurisdiction,” she says. “It is not clear what people who are very interested in banning abortion can do in response to this.”
Plan C’s Wells also believes these supply chains are solid. “We’re really worried that access paths might be cut off. But we live in the 21st century, in a global economy. And there are so many ways to bring goods into this country that we feel it is almost impossible to stop them,” she says. “If one of these companies closes, another will emerge.”
Credit: www.wired.com /