In October 2018, Rebecca Gomperts, the founder of the abortion-by-mail service Women on Web, confirmed she had branched out to the United States. Gomperts had long avoided doing so for fear that the anti-abortion movement would go after her work, but said that the need for the service was ultimately too great. “I got an email from a woman who was living in a car with two kids,” she told the Atlantic. “Something had to be done.”
Gomperts said at the time that the online sale of abortion pills was legal because people are allowed to import prescription drugs (this is also Women on Web’s thinking for providing abortion-by-mail in other countries, per its website). But the Food and Drug Administration also told the Atlantic that one of the drugs sold by Gomperts’s Aid Access—mifepristone—isn’t available online in the U.S., and that the agency was “evaluating the allegations to assess potential violations of U.S. law.”
On Tuesday, as reported by Vox, Gomperts and another online abortion pill provider received warning letters from the FDA. The letter states that the FDA has not approved the online sale of mifepristone and misoprostol in the U.S., and asked Aid Access to stop selling it. “Failure to correct these violations may result in FDA regulatory action, including seizure or injunction, without further notice,” the letter states.
But the fact remains that the abortion medication is legal in the U.S. and typically available through clinics. The problem is that mifepristone falls into a category of drugs outside of the FDA’s risk evaluation and mitigation strategies (REMS) program, which makes it incredibly difficult to access in the U.S. Per the Guttmacher Institute:
Unlike virtually any other medication, mifepristone cannot be distributed to or dispensed at pharmacies. As a result, anyone seeking a medication abortion must locate a registered provider who has a supply of mifepristone—a task made more difficult because the stringent registration and stocking requirements limit the number of providers willing and able to offer mifepristone.
That much regulation can “delay—and ultimately prevent—an individual from accessing a medication abortion altogether, especially in underserved communities such as those in rural areas,” according to Guttmacher.
Which is the promise of Women on Web and Aid Access: that anyone with an internet connection could access safe and legal abortion pills after an online consultation. (Mifepristone and misoprostol are considered very effective and safe for terminating pregnancy before 10 weeks, and are also safe and effective when used at home.)
Aid Access and Women on Web have not responded to the FDA’s letter. Less is known, as Vox reports, of Rablon, the other online abortion pill provider targeted by the FDA.