Navigating Restrictions on Telemedicine Abortion

By making everyone nervous about going to a medical office, COVID-19 really put telemedicine to the test – and it passed. Even as pandemic restrictions ease up, it’s often a lot more practical and convenient to see a medical professional by videoconference in situations that don’t require a hands-on exam. And that’s been a massive benefit for dramatically expanding abortion access.

For example, people in the states of Colorado, Georgia, Hawaii, Illinois, Iowa, Maine, Maryland, Minnesota, Montana, Oregon, New Mexico, New York, or Washington, or the District of Columbia, are eligible for the TelAbortion program. This program lets someone seeking an abortion have a video consultation with a certified doctor, then get mifepristone and misoprostol mailed to them so they can use the medications in their own home.

But what about people in the other 37 states, especially those with increasing restrictions on abortion access?

We recently learned about a particularly ingenious way some people are getting abortion pills: subscribing to a mail forwarding service in a state where telemedicine abortion care is available, and then having the service forward the package to their home. Here’s what someone might do to take that approach:

1. They use a mail forwarding service, like iPostal1.com or Anytime Mailbox, with a location in a state that has legal online abortion services (see the list below). Setting this up requires the person to fill out a Post Office form and provide two forms of ID, which may be inconvenient for some people. The cost usually involves a one-time online notary fee of about $25 plus $8 to $10 monthly “rent,” but since they only need the mailbox for a single delivery, they can cancel after one month

2. They do an online consultation with a telemedicine provider. Here are some providers and the states they serve:

• Abortion on Demand (CA, CO, CT, DE, GA, IL, ME, MD, MA, MI, MT, NV, NJ, NM, NY, OR, RI, VT, VA, WA)
• Aid Access (AK, CA, CT, ID, NJ, NM, NV, NY, VT, WA)
• carafem (GA, IL, MD, VA, DC)
• Hey Jane (NY, WA)
• Hey Jane (NY, WA)
• Choix (CA)
• Just the Pill (MN)

3. They list the mail forwarding service address as their shipping address. If the provider asks, they confirm that at the time of the consultation, they are in the state the provider is allowed to serve.

4. If they use a credit card to pay the telemed provider, they use the billing address associated with their credit card. (People who have done this report that this has not prevented them from having the pills shipped to the mail forwarding service, even though the addresses are not the same.)

5. When the package arrives at their forwarding address, the mail forwarding service alerts them, and they ask for it to be forwarded to their home address. Sometimes this involves a small (about $5) fee.

6. The package arrives at their home.

We love how clever and resourceful people can be in finding ways to access the care they need! Once someone has acquired abortion pills, SASS counselors are available to provide support before, during, and after the process of self-managed abortion. They can also find accurate, up-to-date information about self-managed abortion (and more!) at AbortionPillInfo.org and on the Euki reproductive health app for iOS and Android.