Aid Access

{{short description|Abortion services provider}} {{Infobox organization | name = Aid Access | full_name = | native_name = | native_name_lang = | image_size = | image_alt = | caption = | logo = File:Aidaccesslogo.png | logo_size = | logo_alt = | logo_caption = | map = | map_size = | map_alt = | map_caption = | map2 = | map2_size = | map2_alt = | map2_caption = | abbreviation = | nickname = | pronunciation = | pronounce_ref = | pronounce_comment = | named_after = | predecessor = | merged_into = | successor = | formation = {{start date and age|2018|03|}} | founder = Rebecca Gomperts | founding_location = | extinction =  | merger = | type = Nonprofit organization{{ r | vox_2022-05-07 | p=1 | q=So Gomperts launched a new nonprofit organization based in Austria — Aid Access — with the goal of providing affordable and accessible abortion services to people in the US. }} | tax_id =  | registration_id =  | status = | purpose = | professional_title = | headquarters = Austria | location = | coordinates =  | origins = | region_served = | products = | services = Telemedicine prescription of medication abortion pills for delivery by mail | methods = | fields = | membership = | num_members_year = | language = | owner =  | secretary_general =  | leader_title = | leader_name = | leader_title2 = | leader_name2 = | leader_title3 = | leader_name3 = | leader_title4 = | leader_name4 = | board_of_directors = | key_people = | main_organ = | parent_organization = | subsidiaries = | secessions = | affiliations = | budget = | budget_year = | revenue = | revenue_year = | disbursements = | expenses = | expenses_year = | endowment = | endowment_year = | num_staff = | num_staff_year = | num_volunteers = | num_volunteers_year = | num_students = | num_students_year = | website = {{URL|https://www.aidaccess.org/}} | remarks = | former_name = | footnotes = | bodystyle = }} '''Aid Access''' is a nonprofit organization that provides access to medication abortion by mail to the United States and worldwide. It was founded in 2018 by Dutch physician Rebecca Gomperts who describes its work as a harm reduction strategy designed to provide safe access to mifepristone and misoprostol for people who may not otherwise have access to abortion or miscarriage management services. Their online abortion pill service mails pills to people in all 50 U.S. states so they can manage their own abortion with remote access to a physician and a help-desk for any questions. <ref name=":0">{{Cite web|title=Aid Access |url=http://aidaccess.org/en/|access-date=2025-08-09|language=en}}</ref><ref name=Atlantic_2018-10-18>{{Cite web|last=Khazan|first=Olga|date=2018-10-18|title=Women in the U.S. Can Now Get Safe Abortions by Mail|url=https://www.theatlantic.com/health/archive/2018/10/women-on-web-safe-abortion-mail/573322/|access-date=2020-08-04|website=The Atlantic|language=en-US}}</ref>

From its launch in 2018 until mid-2023, Aid Access prescriptions were filled by a pharmacy in India and mailed to U.S. patients. Since 2023, Aid Access has utilized Shield laws to partner with U.S.-licensed clinicians and pharmacies to provide domestic shipping within 1–5 days. Their online abortion pill service costs $150, but they also offer a sliding scale payment option for those who cannot afford the full price.<ref name=":0" /><ref name=Atlantic_2018-10-18 /><ref name="PlanC">{{Cite web|title=Where people get an abortion pill online in every state|url=https://www.plancpills.org/abortion-pills/where-people-get-abortion-pill#:~:text=1.,to%20obtaining%20abortion%20pills%20later.|access-date=2025-08-11|language=en}}</ref>

==History== Gomperts, a physician based in the Netherlands, started Aid Access in March 2018, to provide access to medication abortion in countries like the United States where abortion is legal but may be hard to access.{{ r | Atlantic_2018-10-18}} Aid Access was incorporated in Austria, where Gomperts is registered to practice medicine.<ref name="vox_2022-05-07">{{Cite web |last=Cohen |first=Rachel M. |date=2022-05-07 |title=The abortion provider that Republicans are struggling to stop |url=https://www.vox.com/23056530/aid-access-abortion-roe-wade-pills-mifepristone |access-date=2022-05-19 |website=Vox |language=en | quote=Aid Access has faced one regulatory challenge, in 2019, when the FDA sent the group a cease-and-desist letter, claiming that its generic mifepristone drug represented a “misbranded and unapproved” drug that posed risk to consumers. (The FDA approved one brand of mifepristone, Mifeprex, in 2000, and in 2019 approved a generic version.) Aid Access, in turn, sued the FDA, alleging the agency was impeding Americans’ constitutional right to an abortion and that its drugs were, in fact, approved. Aid Access also maintained that the FDA had no legal jurisdiction over Gomperts. The case was dismissed in part because the FDA never took action following its letter. }}</ref>

In 2019, Aid Access received a warning letter from the Food and Drug Administration (FDA) stating that they were not authorized to distribute generic mifepristone in the US. Aid Access in turn sued the FDA, stating that they were helping women exercise their constitutional right to abortion. The FDA pursued no further legal action, and the lawsuit ended. In 2021, the FDA made telemedicine abortion permanently legal.<ref name="vox_2022-05-07" /><ref name=":2" />

In 2021, Aid Access started offering "advanced provision" pills, whereby someone can order the pills ahead of time in case they might need them in the future.<ref>{{Cite web|title=Abortion Pills for Future use | website=Aid Access |url=https://aidaccess.org/en/page/2880027/advance-provision|access-date=2025-08-09|language=en}}</ref>

In October 2018, after six months of non-publicized operation, Gomperts stated that she had fulfilled about 600 requests for pills (an average of 3 per day).{{ r | Atlantic_2018-10-18}} By February 2022, she said that she had served over 30,000 people in the US.{{ r | Ms_2022-02-28 }} In January 2023, she said that they receive about 4,000 requests per month.<ref name=WSJ_2023-01-03 >{{ cite news | url=https://www.wsj.com/articles/abortion-pills-to-be-available-more-widely-under-new-fda-rules-11672789765 | title=Abortion Pills to Be Available More Widely Under New FDA Rules - Patients will be able to get the drug, called mifepristone, from bricks-and-mortar pharmacies | last=Whyte | first=Liz Essley | newspaper=Wall Street Journal | date=2023-01-03 | quote=Aid Access, a nonprofit based in Europe that mails pills worldwide, even to states with abortion bans, said it is receiving about 4,000 requests for abortion pills a month from the U.S. }}</ref> In 2024, she said that over 6,000 people each month receive pills from Aid Access in US states with abortion bans.<ref>{{Cite news |last=Kitchener |first=Caroline |date=April 11, 2024 |title=Alone in a bathroom: Fear and uncertainty of a post-Roe medication abortion |url=https://www.washingtonpost.com/politics/interactive/2024/abortion-pill-experience-stories/ |access-date=April 11, 2024 |newspaper=The Washington Post}}</ref>

===Shield laws=== {{see also|Abortion shield laws in the United States}} In 2022 a paper was published in the Columbia Law Review about ways in which US shield laws could protect medical practitioners providing abortion who treated patients in banned states.<ref>{{cite journal| last1 = Cohen | first1 = David S.| last2 = Donley | first2 = Greer| last3 = Rebouché | first3 = Rachel| title=THE NEW ABORTION BATTLEGROUND | journal=Columbia Law Review|volume=123|issue=1| date=January 2023 | url=https://columbialawreview.org/content/the-new-abortion-battleground/ }}</ref> Following publication of the paper, several states passed shield laws for medical practitioners. {{As of|2023|7}} fifteen states had shield laws, and five had telemedicine provisions, specifically protecting a provider who prescribed and mailed medication abortion pills to a patient in a state where abortion was banned. Aid Access began serving patients throughout the US in June 2023 with providers licensed in the five states with telemedicine provisions. With no further need to ship packages from other countries, their delivery times decreased from 3–4 weeks down to 2–5 days.<ref name=shield>{{cite news| last=Grant | first=Rebecca | title=Group using 'shield laws' to provide abortion care in states that ban it | newspaper=The Guardian | date=23 July 2023 | url=https://www.theguardian.com/world/2023/jul/23/shield-laws-provide-abortion-care-aid-access}}</ref>

By mid-2025, the list of U.S.-based telehealth abortion pills providers that utilize shield law protections to offer 1-5 day domestic shipping and prices of $150 or less had expanded to include The MAP, We Take Care of Us, Choices Rising, and A Safe Choice, and Abuzz, each of which also offer 1-5 day shipping times and prices of $150 or less.<ref name="PlanC" /><ref name="PlanC2">{{Cite web|title=Where People Get Abortion Pills Online in Florida|url=https://www.plancpills.org/abortion-pill/florida|access-date=2025-08-11|language=en}}</ref>

=== FDA warning letter and lawsuit === In March 2019, the United States Food and Drug Administration (FDA) sent AidAccess.org a letter warning it to cease selling the generic drug mifepristone, which they said was a "misbranded and unapproved new drug" in the United States.<ref>{{Cite web|last=Research|first=Center for Drug Evaluation and|date=2019-12-20|title=Aidaccess.org - 575658 - 03/08/2019|url=https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/aidaccessorg-575658-03082019|access-date=2020-08-11|website=Center for Drug Evaluation and Research|language=en}}</ref>{{ r | NBC_2019-06-01 }} In a statement three days later, the National Women's Health Network stated that this was a politicized attack against medical abortion, rather than a broader attempt to curb online drug sales.<ref>{{Cite web|date=2019-03-12|title=NWHN statement in response to the FDA's action against Aid Access|url=https://www.nwhn.org/nwhn-statement-in-response-to-the-fdas-action-against-aidaccess/|access-date=2020-08-11|website=NWHN|language=en-US}}</ref> In May 2019, over 100 anti-abortion members of Congress sent a letter thanking the Trump administration and the FDA for this action, even though major medical organizations stated that medication abortion is safe for use at home and should be more readily available.<ref>{{Cite web|title=Anti-Choice Lawmakers Cheer FDA Crackdown on Medication Abortion Imports (Updated)|url=https://rewire.news/article/2019/05/15/anti-choice-lawmakers-cheer-fda-crackdown-on-medication-abortion-imports/|access-date=2020-08-11|website=Rewire.News|language=en | quote=Over 100 anti-choice members of the U.S. House of Representatives thanked the Trump administration in a letter last week for addressing the sale of overseas medication abortion pills and encouraged Food and Drug Administration (FDA) officials to continue limiting the import of the drugs. ... But major medical associations have argued that medication abortion is safe for home use and should be more widely available, and researchers wrote in the Journal of the American Pharmacists Association in 2018 that the FDA limitations on medication abortion drugs are unnecessary.}}</ref> Gomperts did not comply with the warning and stated that she was not selling medications in the United States, since she sent the prescriptions to an independent pharmacy, which then dispensed the medications.<ref name=NBC_2019-06-01>{{Cite web|title=A European doctor prescribes abortion pills to U.S. women over the internet — but the FDA is watching|url=https://www.nbcnews.com/news/us-news/european-doctor-prescribes-abortion-pills-u-s-women-over-internet-n1012676|access-date=2020-08-11|website=NBC News|language=en}}</ref>

In September 2019, on behalf of Aid Access, Gomperts sued the FDA, Alex Azar (then secretary for the Department of Health and Human Services) as well as other federal officials for seizing several packages containing medications and blocking transfer of some payments to Aid Access.<ref name=NPR_2019-09-09>{{Cite web|title=European Doctor Who Prescribes Abortion Pills To U.S. Women Online Sues FDA|url=https://www.npr.org/2019/09/09/758871490/european-doctor-who-prescribes-abortion-pills-to-u-s-women-online-sues-fda|access-date=2020-08-11|website=NPR.org|date=9 September 2019 |language=en|last1=McCammon |first1=Sarah | quote=In the lawsuit, Dr. Rebecca Gomperts says she believes federal officials have seized between three and 10 doses of abortion drugs she has prescribed through her organization, Aid Access, since March. It also says Gomperts believes the government has blocked Aid Access from receiving payments from some patients. Gomperts' attorney, Richard Hearn, said the goal of the lawsuit is to force the FDA to stop those actions and to prevent Gomperts or her patients from being prosecuted under federal law. }}</ref> The goals of the suit were to stop these actions as well as to stop FDA prosecution of Gomperts and Aid Access in providing constitutionally protected abortion access.{{ r | NPR_2019-09-09}}

In November 2019, the FDA filed a motion to dismiss the suit that was followed in December 2019 by a response letter from Aid Access to the FDA. The presiding judge accepted the FDA's position that this case was about a person's right to any unapproved drug and not about a woman's right to an abortion, and, because the FDA had not taken any subsequent action following its letter, dismissed the lawsuit.{{ r | vox_2022-05-07 }}<ref>{{Cite web|title=Legal complaint against the FDA|url=http://aidaccess.org/en/page/302089/legal-complaint-against-the-fda|access-date=2020-08-11|website=AidAccess|language=en}}</ref>

=== FDA permanent legal approval === In 2020, the FDA temporarily suspended its ban on online consultations in response to the COVID-19 pandemic. In 2021, the FDA made it permanently legal for abortion pills to be sold following an online consultation.<ref name=":2">{{Cite news |last=Belluck |first=Pam |date=2021-12-16 |title=F.D.A. Will Permanently Allow Abortion Pills by Mail |language=en-US |work=The New York Times |url=https://www.nytimes.com/2021/12/16/health/abortion-pills-fda.html|access-date=2023-03-19 |issn=0362-4331}}</ref>

=== 2025 Texas lawsuit ===

A Texas woman who claims her ex-lover spiked her drink with 10 misoprostol pills (causing her to have an abortion) is suing him in federal court. She named Aid Access (where she claims her ex-lover obtained the pills), and its founder Rebecca Gomperts as additional defendants. The local district attorney's office investigated the criminal allegations and stated that: "elements of a crime could not be established, and the investigation was subsequently closed as unfounded."<ref>{{cite news|url=https://www.nytimes.com/2025/08/14/us/marine-abortion-pills-lawsuit-texas.html |newspaper=New York Times|date=August 18, 2025|first=Alexandra E.|last=Petri|title=Woman Claims Marine Laced Her Drink With Abortion Pills |access-date=August 24, 2025 | quote=Ms. Davis brought the pill bottles with her to the emergency room and gave them to the Corpus Christi Police Department, according to the lawsuit. The Police Department said a detective investigated the allegations and shared the results with the Nueces County District Attorney’s Office. “After careful review, both agencies concluded that the elements of a crime could not be established, and the investigation was subsequently closed as unfounded,” Madeline Vaughn, a spokeswoman with the department, said in a statement.}}</ref><ref>{{cite news|url=https://www.nbcnews.com/news/us-news/texas-woman-sues-marine-claiming-spiked-drink-abortion-pills-rcna224297 |title=Texas woman sues Marine, claiming he spiked her drink with abortion pills: In a lawsuit filed Monday, Liana Davis says the hot chocolate, allegedly tainted with nearly a dozen abortion pills, killed her unborn baby April 5.|work=NBC News|access-date=August 24, 2025}}</ref><ref>{{cite news|url=https://cbs4indy.com/news/texas-woman-sues-man-she-says-spiked-her-drink-with-abortion-pills/amp/ |work=CBS Channel 4 Indianapolis |title=Texas woman sues man she says spiked her drink with abortion pills|first=Steph |last=Whiteside|access-date=August 24, 2025}}</ref>

==Studies== Data from Aid Access has been used in several studies because they had been the sole online abortion telemedicine service in the United States until April 2021, when the FDA (due to COVID-19) temporarily legalized delivery of medication abortion by telemedicine and mail (the FDA in December 2021 made it permanently legal).<ref name=NBC_2022-02-25 >{{ cite news | url=https://www.nbcnews.com/health/health-news/-home-abortion-medication-requests-soared-texas-restrictions-rcna17634 | title=At-home abortion medication requests soared after Texas restrictions | last=Sullivan | first=Kaitlin | newspaper=NBC News | date=2022-02-25 | quote=In December, the FDA said it would permanently allow patients to receive the abortion pills by mail. ... A 2021 study on requests to Aid Access found that the distance from an abortion clinic and whether the person lived below the federal poverty level were the two main factors that drove pregnant women to seek abortion medication by mail, which is often much cheaper than in-office care. }}</ref>{{ r | ObGyn_2020-10 }}

A study of the reasons given for requesting a self-managed abortion by the 57,506 individuals who requested this service between March 20, 2018, and March 20, 2020, found the reasons for requests to be: lower cost compared to a clinic (74%), privacy (49%), distance to a clinic (40%), and difficulty getting time off work or school (38%). Some also stated a preference for an at home, self managed abortion with 28% saying they would be more comfortable, and 27% saying it would be more convenient.{{ r | NBC_2022-02-25 }}<ref>{{ cite journal | last1=Aiken | first1=Abigail | last2=Starling | first2=Jennifer | last3=Gomperts | first3=Rebecca | date=2021-05-21 | title=Factors Associated With Use of an Online Telemedicine Service to Access Self-managed Medical Abortion in the US | url=https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2780272 | journal= JAMA Network Open| volume= 4| issue= 5| pages= e2111852| doi=10.1001/jamanetworkopen.2021.11852 | pmid=34019085 | pmc=8140373 }}</ref>

Another study that included the 49,935 requests made through the online consultation form between January 1, 2019, and April 11, 2020, found that during the 2020 COVID-19 lockdowns and restrictions (March 20, 2020, to April 11, 2020), average daily requests increased 27% compared to the preceding 14 months.<ref name=ObGyn_2020-10>{{Cite journal|last1=Aiken|first1=Abigail R. A.|last2=Starling|first2=Jennifer E.|last3=Gomperts|first3=Rebecca|last4=Tec|first4=Mauricio|last5=Scott|first5=James G.|last6=Aiken|first6=Catherine E.|date=2020-07-21|title=Demand for Self-Managed Online Telemedicine Abortion in the United States During the Coronavirus Disease 2019 (COVID-19) Pandemic|journal=Obstetrics and Gynecology|volume=136 |issue=4 |pages=835–837 |doi=10.1097/AOG.0000000000004081|issn=1873-233X|pmid=32701762|pmc=7505141 |doi-access=free}}</ref>

In a third study covering the period between October 1, 2020, and December 31, 2021, Aid Access received 45,908 requests from across all 50 USA states. In the first week of September 2021, after Texas Senate Bill 8 went into effect, the mean daily requests from Texas spiked by 1200%, (from 11 to 140) gradually decreasing over the next three months to 30 per day (175% higher than the pre-Senate Bill 8 level).<ref name=Ms_2022-02-28 >{{ cite news | url=https://msmagazine.com/2022/02/28/online-abortion-pill-orders-telemedicine-texas-ban-sb8-researchers/ | title=Online Abortion Pill Orders Surged After Texas Ban. Researchers Say This Is Only the Beginning. | last=Baker | first=Carrie | newspaper=Ms. | quote=New research published in the Journal of the American Medical Association shows that in the first week after SB 8 went into effect, average daily requests from Texas increased by almost twelve-fold, or 1,180 percent—from 10.8 to 137.7 per day. In the following three months, requests remained higher than before, at 29.5 per month or 174 percent higher than before SB 8 went into effect. ... She [Gomperts] has served over 30,000 people in the U.S. since she began Aid Access four years ago. }}</ref><ref name="texas">{{Cite journal |last1=Aiken |first1=Abigail R. A. |last2=Starling |first2=Jennifer E. |last3=Scott |first3=James G. |last4=Gomperts |first4=Rebecca |date=2022-02-25 |title=Association of Texas Senate Bill 8 With Requests for Self-managed Medication Abortion |url=https://doi.org/10.1001/jamanetworkopen.2022.1122 |journal=JAMA Network Open |volume=5 |issue=2 |pages=e221122 |doi=10.1001/jamanetworkopen.2022.1122 |pmid=35212751 |pmc=8881771 |s2cid=247106637 |issn=2574-3805}}</ref>

== Services provided == Aid Access offers mifepristone in combination with misoprostol for medical abortion. Their abortion pill service is available to people in all 50 U.S. states. U.S.-based doctors work with Aid Access to provide pills from a licensed pharmacy in the U.S. in 1–5 days. An online consultation process is required, which includes questions to assess for the medical eligibility and safety of providing medical abortion by mail.<ref name=":0" /><ref name=Politico_2022-06-03>Conaboy, Chelsea, ''[https://www.politico.com/news/magazine/2022/06/03/rebecca-gomperts-interview-abortion-00036742 The Doctor Prescribing Abortions from Overseas]'', Politico, June 3, 2022</ref><ref name=":1">{{Cite web|title=Aid Access Abortion Pills Are Getting Stuck in US Customs|url=https://www.vice.com/en/article/aid-access-abortion-pills-stuck-in-customs/|access-date=2020-08-11|website=Vice.com|language=en}}</ref>

Following the passage of Senate Bill 8 by the state of Texas, Aid Access began providing "advanced provision" pills to individuals seeking access to abortion.{{ r | Politico_2022-06-03 }} The practice of advanced provision involves providing abortion pills to individuals before they are pregnant, so that they may have them readily available for use should they need them in the future.<ref>{{Cite web|title=Advance Provision of Abortion Pills|url=https://aidaccess.org/en/page/2880027/advance-provision|access-date=2023-02-21|website=AidAccess|language=en}}</ref>

Gomperts has expressed her hope that this approach will become more widely adopted by U.S. doctors. She believes that a way around the restrictive abortion laws is for all doctors to prescribe a set of abortion pills for a woman on her first menstruation, so that she will always have them if needed.{{ r | Politico_2022-06-03 }}

== Safety == Self-induced abortion with mifepristone and misoprostol can be performed safely, according to the World Health Organization (WHO).{{ r | Atlantic_2018-10-18}}<ref>{{Cite book|last=Organization, World Health.|url=http://worldcat.org/oclc/1122450460|title=Medical Management of Abortion|date=2019|publisher=World Health Organization|isbn=978-92-4-069900-7|oclc=1122450460}}</ref> The WHO recommends that determination of eligibility for medical abortion is made by a health provider, but self-administering the medications at home and self-assessing the completion of the abortion are recommended in specific circumstances.<ref>{{Cite book|last=World Health Organization. Reproductive Health and Research, issuing body.|url=http://worldcat.org/oclc/948838959|title=Health worker roles in providing safe abortion care and post-abortion contraception|date=17 December 2015 |publisher=World Health Organization |isbn=978-92-4-154926-4|oclc=948838959}}</ref> This aligns with the care provided by Aid Access.{{ r | Atlantic_2018-10-18}}

If someone needs care after a self-administered medication abortion, Aid Access advises that they should say they had a miscarriage since the symptoms and treatment are exactly the same, and that no traces of the abortion pills remain if taken orally; though traces of the pills can last as long as 4 days if administered vaginally.<ref name=NYT_2022-08-07 >{{ cite news | url=https://www.nytimes.com/2022/08/07/health/abortion-self-managed-medication.html | title=Some Women 'Self-Manage' Abortions as Access Recedes - Information and medications needed to end a pregnancy are increasingly available outside the health care system. | last=Caryn Rabin | first=Roni | newspaper=The New York Times | date=2022-08-07 | quote=A medication abortion cannot be distinguished from a miscarriage, and traces of the pills cannot be discovered if they are taken orally, said Dr. Rebecca Gomperts, a Dutch physician who founded Aid Access. If a woman needs care after taking the pills, “we always tell people to say they had a miscarriage,” she said. “It’s exactly the same symptoms, and the treatment is exactly the same.” A study of thousands of women in the United States who received abortion pills from a provider without an in-person visit during the pandemic found that the practice was safe. }}</ref>

== References == <references />

Category:Abortion providers Category:Organizations established in 2018 Category:Abortion-rights organizations in the United States Category:Medication abortion