Air Mail Abortion

The Protect Human Life Florida Committee is one step closer to its goal of a statewide, near-total ban on abortion. On Aug. 12, the Florida Department of State gave its initial approval for the political action committee’s proposed constitutional amendment to be included on the 2024 ballot.

That news comes on the heels of — and legal battle over — Florida’s a new 15-week abortion ban (reduced from 24 weeks), which went into effect July 1, shortly after the U.S. Supreme Court overturned Roe v. Wade. The lawsuit, brought by abortion providers, is currently before the state Supreme Court.
 
 Efforts to eliminate or severely restrict abortion in the state run counter to a University of North Florida poll, released earlier this year, that found that 57 percent of the state’s voters opposed the 15-week abortion ban. Still, public opinion isn't likely to dissuade Gov. Ron DeSantis and the Republican-dominated legislature from seeking to implement even greater abortion restrictions while the PAC goes through the process of qualifying their amendment for the 2024 ballot. The governor recently sidestepped commenting on which restrictions he would favor, but abortion pills are almost certainly in the crosshairs.
 

More than half of abortions in the U.S. now take place at home with a pregnant person* taking a combination of the medications mifepristone and misoprostol, according to the Guttmacher Institute.
 
 “These pills are safer than Viagra, penicillin and even Tylenol,” said Amy Weintraub, reproductive rights director for Progress Florida. “And they’re highly effective at ending a pregnancy without complications.”

Right now, in Florida, someone seeking to legally end a pregnancy must visit an abortion clinic (not their OB-GYNs or primary care physicians) to get a prescription for the medications, considered safe and effective when taken within the first 11 weeks of pregnancy. But that will change if the state legislature further restricts abortion access or the PAC’s proposed amendment passes.
 
 That proposed amendment intends to strip women of their state constitutional right to privacy. It would permit abortions only when a mother’s life is at risk and after doctors take “reasonable steps” to save the fetus, according to its text. The amendment includes no exceptions for pregnancies that result from rape, incest or human trafficking.
 

In the next legislative session — perhaps sooner if DeSantis calls a special session — lawmakers may model some of the more restrictive laws that other states have passed, such as bans after a fetal heartbeat is detected or abortion only if a mother's life is threatened or potentially a complete ban on abortion altogether.

"Gov. Ron DeSantis is committed to limiting the rights of women and limiting or fully overturning abortion, and he will not be satisfied until he does," said LaVon Bracy Davis, the Democratic candidate running in District 40 for the Florida House.
 

In those circumstances, people in Winter Garden, Ocoee, Oakland and Windermere will still be able to get abortion pills through online pharmacies based in other countries.

NO CLINIC REQUIRED

Organizations like the Austria-based AidAccess can ship abortion pills anywhere in the U.S. without requiring a clinic visit or a telehealth appointment. Its founder is the Dutch physician and women's health activist Dr. Rebecca Gomperts, formerly of Women on Waves, which dispensed abortion pills from a ship anchored in international waters off the coasts of countries where abortion was illegal, and, since 2005, Women on Web, which provides abortion care, contraceptives and a 24/7 help desk to people around the world

AidAccess, founded in 2018, just services the U.S. Because Gomperts is licensed to practice medicine in Austria, she is unhampered by U.S. laws that mandate medically unnecessary practices before abortion like waiting periods, ultrasounds and multiple clinic visits, Vox reported. According to AidAccess, it has provided abortion medications — filled through an India-based pharmacist — to more than 30,000 Americans across all 50 states.

“There are dozens of international medical practices and pharmacies offering this service, often at a fraction of what it would cost for a woman to get the same medicines through a U.S. provider,” said Weintraub. “For people with lower incomes, mail-order pills are a great lower-cost option even if your state doesn’t have an abortion ban.”

AidAccess, where pills cost $150, provides a sliding scale for people with limited (or no) resources.

Erica Bales, a spokesperson for the group National Women’s Liberation (NWL) in Gainesville, recommended that women also check out organizations like Plan C, which has information about online pharmacies that ship to Florida as well.

“This national public health initiative provides resources that help women access mail-order abortion pills,” she said. Plan C also vets mail-order providers, periodically reviewing the products for quality and safety issues.

Other initiatives to improve women’s access to abortion are the NWL’s AidandAbetAbortion.org and the global nonprofit Women Help Women’s AbortionPillInfo.org. Progress Florida offers monthly sessions to educate people about self-managed, medication-induced abortions. “The goal is to make this information available in every community,” said Weintraub.

“AN UNTESTED GRAY AREA”

Whether it’s legal to receive any type of prescription medication through an overseas company without a prescription is a bit of an untested gray area, said Timothy McLendon, a legal skills professor at the University of Florida Levin College of Law.
 
 “During the pandemic, we saw people obtaining medications like hydroxychloroquine and ivermectin in the mail from companies in Mexico and India even though the drugs weren’t FDA-approved to treat COVID,” he said.

McLendon said he’s not aware of anyone being prosecuted for using overseas channels to obtain these drugs, which American physicians use to treat autoimmune diseases, parasitic infections and other non-COVID conditions. [Both drugs used in medical abortions are routinely used for other medical conditions. Mifepristone is FDA-approved to treat Cushings syndrome and is being studied for post traumatic stress disorder and various cancers while misoprostol is used for treating ulcers.]
 
 “I think it’s unlikely that [the] current U.S. Attorney General from the Biden administration would prosecute a woman for mail fraud for obtaining abortion pills in a similar manner, but we don’t know what the future holds," he said.

Since the U.S. Supreme Court overturned Roe in June, AidAccess has been inundated with requests for abortion pills both from Americans seeking to end pregnancies and those who want to keep the medications on hand, just in case. With such high demand, the organization has temporarily stopped “future use” shipments and is only mailing medications to those who are pregnant. For now, people in West Orange County who are less than 12 weeks pregnant can still get abortion pills through a state abortion clinic.

“OUT OF TOUCH”

Meanwhile, the PAC seeking the constitutional amendment needs to submit 891,589 verified petition signatures — with 8 percent coming from at least 14 of the state’s 27 congressional districts — by Feb. 1, 2024, to get the measure onto the 2024 ballot.
 
 At least 60 percent of Florida voters must approve the amendment for it to pass. But state Sen.-elect Geraldine Thompson doubts the amendment will get much traction. The group gathered only 3,051 signatures for the proposed amendment it tried to get onto the November ballot to ban abortion after cardiac activity is detected.
 
 “This particular committee is clearly out of touch with what Floridians want,” the Windermere Democrat said in a phone interview. “The majority of Floridians, and the majority of Americans, think that these kinds of decisions should be left to a woman and her physician, her partner, her clergy, but not to have the government involved. I think we will see voters reject this just as we saw voters in Kansas reject an attempt there for an absolute ban.”

* A word about language: At VoxPopuli, we strive for inclusivity. In recognition that transgender men also get pregnant and often face more challenges when seeking abortion, we refer to “pregnant people” throughout the article, not just women.