Is there any scenario in which AidAccess, an abortion pill provider accessed through the Plan C website, would decline chemical abortion drugs to an individual?
How about a 13-year-old girl on blood thinners, with an IUD (intrauterine device) in place, who reported three previous cesarean sections, an ectopic pregnancy, and who suffers from anemia?
Apparently, the conditions listed above were not enough to stop such a transaction.
With no ID requirements, in an undercover investigative report, the online abortion provider AidAccess delivered abortion pills through the mail in just four days.
Dr. Christina Francis, CEO of the American Association of Pro-Life OB/GYNs (AAPLOG) who is a board-certified OB/GYN and hospitalist, personally conducted this investigation. It was her intention to assess the level of medical screening of this online abortion provider and the result was disturbing.
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The video of Francis navigating the online searches and website as a typical user demonstrated how the system responds to various answers which included conflicting medical histories, high-risk health conditions, and additional medical contraindications to the drugs.
Once the screening process is completed it is suggested that medical staff would review her answers and she would receive an email on the next steps. Within a minute she received an email directing her toward payment and completion.
Francis noted in speaking with Pregnancy Help News that her office has reached out to the Department of Justice to make them aware of her report.
Additionally, AAPLOG contacted Members of Congress, with the investigative report and an accompanying letter to the appropriate committee chairs in the U.S. Senate and House of Representatives.
At press time, no response had been received from the Congressional Committees or individual Members of Congress contacted.
“Our purpose in releasing this was two-fold,” Francis said. “One was to encourage the administration to take action. Our hope is that at the very least they would reinstate the in-person dispensing requirements for situations like this.”
“Theoretically a 13-year-old with multiple medical contraindications to a drug-induced abortion in a state where its illegal was able to obtain these pills very, very easily,” Francis stated.
It is Francis’s intent to encourage the Trump administration, specifically through the U.S. Food and Drug Administration (FDA) to restore the safeguards that previously were in place on the distribution of abortion drug mifepristone.
The FDA loosened standards between 2016 and 2023 under the Obama and Biden administrations, the latter calling it a reduction in “barriers to care,” opening the door wide for women to be at risk and abortion pill vendors unaccountable.
The FDA regulation which sets conditions for prescribing and dispensing drugs with high risk of adverse events is called Risk Evaluation and Mitigation Strategy (REMS).
With the REMS for mifepristone all but dismantled women and girls are left vulnerable to the drug’s potential adverse effects and potential abuse seen in the rising case of forced or coerced abortions with the alleged perpetrators purchasing abortion pills online.
“The second big reason for putting this out is because this truly is a public health crisis,” Francis explained. “It’s really important for the public to be aware.”
She specifically expressed concern for abortion-vulnerable women, who need to understand the information offered on these websites is not medically accurate.
“Many people don’t realize exactly how bad this situation is,” said Francis. “Young girls can easily get this as we discuss in the video and as we’ve seen multiple reports in the news that abusers can get their hands on this to force abortions on women who don’t want them.”
It is her hope there would be a larger public awareness campaign to educate the general population about what is happening to women through the dangerous practice of distributing chemical abortions without proper informed consent, medical evaluation, and oversight.
The system Francis investigated even advised customers to conceal abortion pill use in the event they have complications and need to go to an emergency room. The pill sellers suggest individuals having complications can just say they are having a miscarriage rather than disclose that they have taken abortion pills.
Even while noting what may occur with potential complications, the advice offered can cause further risk for women in getting appropriate medical help by having them conceal information necessary to an appropriate diagnosis and treatment from medical staff.
“Early pregnancy needs to be evaluated in person in particular if a woman is contemplating abortion,” Francis stated. “She either needs a physical exam or an ultrasound to rule out ectopic pregnancy—ultrasound really being the gold standard.”
Francis noted women are often wrong about how far along they are in pregnancy and confirming gestational age is critical. An in-person exam also offers safeguards against forced abortion.
While telehealth does not provide the safeguards an in-person visit to a medical clinic offers, at the very least it could offer some degree of interaction with a medical provider. In the end, even the medication that arrived in the mail in Francis’ investigation lacked any information on a prescriber.
Abortion medication carries with it a Black Box warning which is the strongest safety alert required by the FDA for prescription drugs. Francis pointed this out to emphasize the uniquely haphazard way mifepristone is being distributed.
Francis noted that an ectopic pregnancy is a life-threatening condition. An in-person exam is necessary to diagnosis it, so for a pregnant woman to not be evaluated first is reckless.
The medication Francis was able to order as she conducted her investigation was distributed out of California, one of the states protecting such practices via shield laws.
With shield laws, while women are exposed to risk from no meaningful medical oversight and a grievous lack of communication concerning medical risks, as well as potential abuse by forced abortion, those who stand to profit from selling chemical abortion drugs online are protected.
“Typically, the prescribers are located in a state that has a shield law and so I think actually the federal government needs to look at what actions they could potentially take to allow state sovereignty, not just in pro-life laws but in prosecuting criminals that are performing crimes in that state from another state,” she said.
With there being no prescriber noted on the medication Francis received, the authorities would need to pursue the pill distributer or drug manufacturer. Abortion medication is unique in being distributed with no prescriber noted which begs the question of how this is being allowed.
“If there’s a complication or you were intentionally harmed, who do you go to for medical malpractice?” Francis asked.
“I have no way of knowing if it was a certified prescriber,” she said. “They’re supposed to be REMS certified. How do I even know if that was the case?”
Additionally, a prescribing physician would need to be licensed in the state where the pills are sold.
“The FDA should act to restore common sense and basic safeguards by reinstating the in-person visit requirement for abortion pill distribution as a first step to protect the maternal and fetal patients,” Francis said. “Ensuring direct involvement of medical professionals is a critical step toward protecting patient safety, informed consent, and continuity of care.”
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Editor's note: Heartbeat International has established a national tracker documenting reported abortion pill poisonings and forced abortions and added a page to the Abortion Pill Reversal website addressing coerced and forced abortion through the chemical abortion pill. Heartbeat International manages the Abortion Pill Rescue® Network (APRN) and Pregnancy Help News. Heartbeat is currently the subject of two lawsuits brought by state AGs concerning sharing information about Abortion Pill Reversal.
