[Update: This post was originally written in March 2021. More recently the FDA has approved distribution of abortion pills via mail, though there are still restrictions on who can prescribe and receive these pills.]
Medication abortion is a process in which a woman takes one or more pills to expel an embryo in the first trimester. This process is sometimes referred to as “medically induced miscarriage,” which should not be confused with “medical management of miscarriage.” In the latter case, an embryo has died due to natural causes outside of a woman’s control, and she uses medications to ensure the remains are fully expelled from her body. In the former case, the embryo is typically healthy and would be expected to develop normally absent these medications.
In the U.S., the FDA has approved medication abortion in the form of a two-pill regimen (mifepristone followed by misoprostol) but requires the pills be administered only “in certain healthcare settings, specifically, clinics, medical offices, and hospitals, by or under the supervision of a certified prescriber.” [See update above.] The healthcare providers who prescribe medication abortion pills must be able to date pregnancies, diagnose ectopic pregnancies, provide any necessary surgical intervention (either themselves or through another party), and ensure women have access to medical facilities for emergency care if needed. The FDA emphasizes:
[These products] are not available in retail pharmacies and are not legally available over the Internet. The FDA warns consumers they should not buy Mifeprex or GenBioPro, Inc.’s approved generic version of Mifeprex, Mifepristone Tablets, 200 mg., over the Internet because they will bypass important safeguards designed to protect their health.Questions and Asnwers on Mifeprex, accessed March 27, 2021
When people provide these pills illegally online, they risk sending the pills to women with unidentified ectopic pregnancies or who are farther along in pregnancy than they realize. They also risk sending these pills to people who hope medically induce miscarraige in pregnant women without their knowledge or consent.
Still, some abortion rights activists view the FDA safeguards as unnecessary restrictions, and they subtley or openly advocate for online abortion pill access. For example, the website Plan C exists to connect women who want abortion pills to providers legal and illegal alike.
If you are aware of people or organizations offering abortion pills illegally online, you can report the situation to the FDA here. Whether the FDA will take action may depend on the current political climate, so consider setting reminders for yourself to check back in coming months and ask for follow up on your reports.