Stanford Social Innovation Review: Reproductive Health Care by Mail

Reproductive Health Care by Mail

It is time to give US women the convenience, confidentiality, and autonomy of birth control and abortion pills that women elsewhere enjoy.

From the article:

For more than 10 years, women around the world have been able to self-diagnose their pregnancies and order highly effective and safe early-abortion pills online or obtain them from a local pharmacy, often without a prescription. Services such as Women on WebWomen Help Women, and, more recently, safe2choose offer online consultations and express delivery of abortion pills directly to women in their homes, all without a physical exam. These sites also offer information and support to women about what to expect during the abortion process. Not surprisingly, research has found that women value the convenience and privacy of online services. Research has also demonstrated that the safety and effectiveness of this model are comparable to those of services delivered through clinics.

Unfortunately, none of the services that supply pills in other countries will ship them to the United States, despite receiving nearly 10,000 requests per month from women here. These pills are the same ones given to women who choose a medication abortion at Planned Parenthood and other abortion clinics. But because abortion is so highly politicized in the United States, access to these pills has been severely restricted since the day that mifepristone (RU-486, also known as the French abortion pill) was approved by the US Food and Drug Administration in 2000. Unlike the vast majority of medications, which clinicians prescribe and patients pick up at a pharmacy, mifepristone can only be shipped to doctors who have specially registered with the manufacturer.

Chicago Tribune: Women can already receive abortion pills by mail in 4 states, what's next?

by Nara Schoenberg

Hailed in the 1990s as “the pill that changes everything,” the abortion pill mifepristone (also known as RU-486 and Mifeprex) got off to a slow start after Food and Drug Administration approval in 2000.

But now, the pill is at a crossroads, with 31 percent of American abortion patients choosing pill-induced abortion over surgery, and bold new initiatives dangling the prospect of dramatically increased access. The Gynuity study is allowing women in Maine, Hawaii, Washington and Oregon to confer with a doctor from home via video chat, and then get the pills delivered to their homes by mail. In California, women may soon be offered an even more streamlined medication-by-mail option. In Hawaii, the American Civil Liberties Union recently filed a lawsuit that could open the door to ordinary doctors nationwide prescribing the pill, and women picking it up at their local pharmacies.

“I feel optimistic,” said Francine Coeytaux, co-director of Plan C , an abortion-rights project that hopes to offer pills by mail in California soon via a demonstration study, and then expand to other states as well. Plan C offers a website with information about pill-based abortion and anticipates that established international telemedicine-abortion initiatives, such as Women on Web, will find a way to ship pills to women in the U.S.

“It’s not about what we’re doing. It’s a fact. It’s happening. It has so much potential, and there are so many ways in which it’s beginning to happen, that nobody’s going to be able to stop this,” Coeytaux said.

 

Read the full article on the Chicago Tribune website here. 

 

Cycles+Sex Podcast // Politics in our Privates

On November 4, Plan C cofounder Francine Coeytaux spoke on a panel about reproductive rights and politics at the Cycles+Sex conference in Los Angeles.

Participants:

Lauren Bille, founder Cycles+Sex

Jennifer Weiss-Wolf, founder, Period Equity

Francine Coeytaux, cofounder, Plan C

Assembly Member Cristina García

Ruth Dawson, ACLU
 

The panel was captured as a podcast. You can listen and read more here.

"Mystery Shopper" Report Card now live

CLICK HERE to view our "Mystery Shopper" Report Card: The results of our study with Gynuity Health Projects.


Photos of Abortion Pills Obtained Online

All of the pills pictured here contained real active ingredients as determined by chemical assay. Two brands (Pregout and Pregnot) contained considerably less misoprostol than indicated on the label, which may make them less effective.

  MIFEGEST KIT   Manufactured by Zydus Healthcare (Fortiza)  Contains: 1 mifepristone tablet (200 mg), 4 misoprostol tablets (200 mcg)  Quality: Acceptable

MIFEGEST KIT

Manufactured by Zydus Healthcare (Fortiza)

Contains: 1 mifepristone tablet (200 mg), 4 misoprostol tablets (200 mcg)

Quality: Acceptable

  PREGOUT KIT    Manufactured by Akums Drug and Pharmaceuticals  Contains: 1 mifepristone tablet (200 mg), 4 misoprostol tablets (200 mcg)  Quality: the mifepristone pills contained acceptable levels of active ingredient; the misoprostol pills contained low levels of active ingredient.  Note: each blister bubble on the package was pricked with a pin, which could account for the low level of misoprostol content (it degrades when exposed to air)

PREGOUT KIT 

Manufactured by Akums Drug and Pharmaceuticals

Contains: 1 mifepristone tablet (200 mg), 4 misoprostol tablets (200 mcg)

Quality: the mifepristone pills contained acceptable levels of active ingredient; the misoprostol pills contained low levels of active ingredient.

Note: each blister bubble on the package was pricked with a pin, which could account for the low level of misoprostol content (it degrades when exposed to air)

  PREGNOT KIT   Manufactured by Akums Drug and Pharmaceuticals  Contains: 1 mifepristone tablet (200 mg), 4 misoprostol tablets (200 mcg)  Quality: the mifepristone pills contained acceptable levels of active ingredient; the misoprostol pills contained low levels of active ingredient.  Note: each blister bubble on the package was pricked with a pin, which could account for the low level of misoprostol content (it degrades when exposed to air)      Compiled by Plan C , November 27, 2017

PREGNOT KIT

Manufactured by Akums Drug and Pharmaceuticals

Contains: 1 mifepristone tablet (200 mg), 4 misoprostol tablets (200 mcg)

Quality: the mifepristone pills contained acceptable levels of active ingredient; the misoprostol pills contained low levels of active ingredient.

Note: each blister bubble on the package was pricked with a pin, which could account for the low level of misoprostol content (it degrades when exposed to air)

 

Compiled by Plan C , November 27, 2017

BUST Magazine: Special Delivery: Abortion Pills By Mail

 photo via BUST

photo via BUST

by Elisa Wells

When my mail carrier handed me the small brown envelope, I’m sure she had no idea she was handing me the means to have a safe, private abortion at home. I had ordered the pills a week and a half earlier off a somewhat sketchy website and, frankly, was wondering if they would ever appear. I say “sketchy” in that the offer seemed too good to be true — abortion pills for less than $200, no prescription needed. The “Whoa, trouble ahead!” warning from my McAfee security system certainly gave me pause, but by the time I received the fraud alert call from by credit card company (at the same time that Western Union was calling my other line to warn me) it was too late to turn back; I had already placed the order. 

Read the full article HERE.

Read original study in Contraception Journal:

Study: Exploring the Feasibility of Obtaining Mifepristone and Misoprostol from the Internet 

Commentary: Self-Sourced Online and Self-Directed at Home: A New Frontier for Abortion in the United States


American Women Are Reclaiming The "Plan C" Abortion Method: A Comic

The Plan C team recently collaborated on an info comic featured in Bust. 

from Bust: 

Many people don’t know that it was women in Brazil who “invented” abortion pills in the 1980s. After seeing the “do not use while pregnant” warning labels on a common ulcer medication, Cytotec, women began taking these pills when they didn’t want to be pregnant. The pills worked well to induce abortion in the early weeks of pregnancy and proved far safer than other methods that were available (abortion was highly restricted in Brazil and therefore often unsafe). Word of mouth helped spread the news of this revolutionary technology, with women helping themselves and each other to self-manage this important health need.

Fast forward to the United States in 2017 and you will find that abortion pills are highly medicalized, over-regulated, and politicized, making them out of reach of many who need them. But, the global marketplace and the internet are turning abortion access on its head, with some women starting to order pills for delivery directly to their mailboxes. As part of a Comics for Choice fundraiser for the National Network of Abortion Funds, Artist Nomi Kane and the Plan C Team tell the story of how women in the United States are starting to reclaim this safe and effective technology for self-use.

New York Times: Spreading Plan C to End Pregnancy

Plan C was recently featured in the NY Times. 

by Patrick Adams

From the article:

The F.D.A. warns against purchasing the drugs from online vendors, but women in the United States are doing it anyway. Increasingly, advocates of access to the drugs say, women are turning to the internet to procure the pills for use in their homes. 

Plan B, a form of emergency contraception made available over the counter in 2013. Plan C piggybacks on that popularity, and hints at how the pills can be used: not necessarily after a pregnancy is certain, but as a medicine a woman can take if she misses her period, without being sure of the reason. In other words, just in case.

Read the full article here.