It turns out that much of the story comes down to a small network of medical providers who find ways to prescribe and ship abortion pills across the country from places where they are still legal.
This was only possible due to significant measures taken by the Food and Drug Administration during the Covid pandemic to allow the distribution of pills via telemedicine. Then, after Dobbs v. Jackson Women’s Health, eight states passed laws protecting providers from being sued for actually prescribing abortion pills to people from other states.
“The barriers are actually lower than before Dobbs,” he said. “For people who don’t have the financial resources or the infrastructure, the logistical structures to go to the clinic … I think the picture is better now.”
Outrage over the Dobbs decision also led to a wave of donations and education campaigns that helped expand access to in-person abortions at clinics. Foundations that provide financial support to people who want to end their pregnancies have used the money to reduce or cover travel and lodging costs for abortions, including those who cross state lines. Abortion providers, meanwhile, received an influx of funding that allowed them to build new clinics and extend hours in states where abortion is still legal.
“After Dobbs, it was kind of on board to get people to have information and access to make sure that these abortion bans don’t prevent people from getting care,” said Serra Sippel, executive director of the Brigid Alliance. a service that provides support for travel, food, accommodation and childcare for abortion seekers.
The victory of Donald Trump in the elections can change this new status quo. Abortion pills are the target of anti-abortion activists who hope the incoming administration could repeal provisions that allow the drugs to be prescribed via telehealth and mailed across the country.
When asked about the possibility, Trump-Vance transition spokeswoman Caroline Leavitt told NBC News that “President Trump has long been consistent in supporting states’ rights to make abortion decisions.”
Still, the lawyers of both sides of the issue said that they are preparing for the fight.
“We were under no illusions that Dobbs was going to solve the problem,” said Randall O’Bannon, director of education and research for National Right to Life, which opposes abortion. “There’s still a lot of work to be done, and we don’t expect the other side to give up or give up on the effort.”
How the Pill Protected Access to Abortion
Raised in a Dutch port town, Gomperts dedicated her life to protecting access to abortion. Over coffee during a visit to New York, he spoke about the subject with clinical sensitivity—perhaps because of his background as a doctor, perhaps because of how often he had to express his point of view.
In 1999, Gomperts founded an organization that transported women from restricted areas to ships in international waters to obtain abortions. It launched a global telemedicine abortion service six years later, then in 2018 launched Aid Access, headquartered in Austria.
“We know people are scared,” Gomperts said. “Because of all the misinformation out there, they think they’re breaking the law, but they’re not. It is legal for women to have their own abortions.
To get the pills through Aid Access, people fill out a form, sign a consent form, email a photo ID and pay $150 — though the bill is adjusted on a sliding scale. The pills usually arrive within five days of being prescribed.
Since the Dobbs decision, Gomperts said Aid Access has seen a tenfold increase in demand.
The group’s operating model is based on several FDA policies. In 2016, the agency allowed mifepristone, one of two pills used in medication abortions, to be used up to 10 weeks of pregnancy instead of seven. Three years later, he approved a generic form that increased the supply.
Then came the biggest change: In 2021, the FDA eliminated the requirement to administer mifepristone in person.
Last year, medication abortions accounted for 63% of abortions nationwide, up from 53% in 2020, according to the Guttmacher Institute. The institute doesn’t say which providers are represented in its estimate, but it doesn’t account for some medication abortions, including states with bans, so the numbers are likely low.