Self-sourced online and self-directed at home: a new frontier for abortion in the United States.

In their paper “Exploring the Feasibility of Obtaining Mifepristone and Misoprostol from the Internet,” Murtagh and colleagues provide the first published examination of the availability of abortion medications shipped to United States addresses by unregulated online pharmacies [1]. Among 20 products received from 16 unique websites, all contained the labeled active ingredients, and 72% contained them in amounts consistent with World Health Organization (WHO) recommendations for early abortion. Previous research suggests that women in the United States have sought out alternative pathways to abortion, including botanicals and abortion medications from pharmacies and markets [2]. The results of this important study now make it possible for those seeking abortion medications online to shop with increased confidence that pills will actually arrive in their mailbox and contain the labeled active ingredients. But, given that this form of access is a radical departure from our current clinical care model, it necessarily raises questions about the experiences of people who might self-source abortion medications online and self-direct the use of these medications at home. While these questions are by no means limited to clinical concerns, this commentary focuses on the ability to obtain an effective abortion with a low risk of complications and desired level of support.