With the Supreme Court reportedly poised to overturn Roe v. Wade, a liberal foundation that works to curb population growth is fighting to maintain abortion pill access—even when acquiring that pill is illegal.
In the last five months alone, the multibillion-dollar Packard Foundation has sent more than $3.5 million to groups that advocate for the abortion pill, its grant disclosures show. Some of those groups, such as Planned Parenthood of Northern New England, distribute the pill in traditional, legal settings. But another grantee, nonprofit DKT International, manages websites that encourage users to obtain abortion pills through an international provider. That provider, Austrian-based nonprofit Aid Access, uses "telemedicine abortion" to mail the pills to all 50 states, even those that have banned the practice. Packard gave DKT $500,000 in 2022.
The controversial scheme provides a window into how deep-pocketed liberal groups are fighting to maintain abortion access should the Supreme Court overturn Roe. In addition to DKT's overseas abortion pill promotion, the group exclusively distributes a line of manual vacuum aspirators that are used to perform abortions. One Minnesota-based nonprofit, Abortion Delivered, plans to use such aspirators to perform abortions in mobile vans dispatched just outside red states if the Court strikes down Roe.
The Packard Foundation, which did not return a request for comment, has not been shy about its desire to use abortion to curb population growth. Roughly a decade before his death in 1996, tech billionaire David Packard penned a letter to his children that condemned skyrocketing birth rates, which he said would cause "utter chaos for humanity." The foundation's "highest priority," Packard wrote, "must be to reduce worldwide population growth" through abortion and other avenues.
DKT promotes international abortion pills through a sister organization, Women First Digital. One of the group's websites, HowToUseAbortionPill.org, features a chat function that helps women obtain abortion pills. Users who indicate they are in the United States and would like to purchase pills online are automatically referred to two "highly trusted online partners" that help send women abortion pills from overseas. Both of those "partners," Women on Web and Women Help Women, encourage Americans in all 50 states to obtain abortion pills through Aid Access.
DKT's HowToUseAbortionPill.org also directs visitors to Plan C. The nonprofit assures women in states "that restrict access to telehealth abortion" that abortion pill access is "still possible" thanks to Aid Access and other online pharmacies. Plan C acknowledges that the practice is legally questionable—its FAQ page says that while "no one should ever be punished for providing their own medical care," at least "60 people who have self-managed an abortion or have helped someone else are known to have been arrested or prosecuted."
"People who live in very conservative states also face a higher risk of prosecution," Plan C's site notes.
The websites help Aid Access spread awareness about their service to women in the U.S., a difficulty for the overseas abortion pill provider after Google updated its algorithm in 2020. Because of the change, Aid Access is no longer listed as a top result when users search terms such as "abortion by mail" and "abortion pills." Sites such as HowToUseAbortionPill.org, therefore, serve as important intermediaries through which Aid Access can recruit customers.
Nineteen states ban the use of telemedicine for abortion, and others may move to prohibit telemedicine abortion consultations in their states if the Supreme Court strikes down Roe. But Aid Access has already evaded regulatory challenges in the United States. After the Food and Drug Administration in 2019 sent the nonprofit a cease-and-desist letter, Aid Access sued the federal agency. The FDA did not follow through on its threat, and the lawsuit was subsequently dismissed.
Still, experts expect international abortion pill providers such as Aid Access to face additional legal threats if Roe is overturned. According to the nonprofit's founder, Dutch doctor Rebecca Gomperts, Aid Access saw an "incredible increase" in abortion pill requests after Texas passed its "Heartbeat Act," which bans abortion when there is a detectable heartbeat. Gomperts expects a similar surge if the Court overturns Roe.
Aid Access mails abortion pills to women prior to or during pregnancy and covers costs for those who claim to be financially vulnerable. The organization's website directs women to complete an online form so that they can be prescribed the pills by a European doctor who approves them to be mailed from a manufacturer in India.
Abortion by pill consists of two drugs. The first, mifepristone, is taken to cut off the hormone supply to the fetus, which stops development. Users then take misoprostol, which contracts the uterus and delivers the remains. Complications from these chemical pill abortions, which often include excessive hemorrhages and bleeding, are four times higher than surgical abortions.
Mifepristone can only be prescribed in the United States by certified, FDA-approved health care providers. The federal agency first approved mifepristone in 2000 under the brand name Mifeprex and has since cut back on regulations targeting the drug. Before the coronavirus pandemic, the FDA required mifepristone users to visit a doctor in person prior to taking the drug. The Biden administration in April 2021 temporarily lifted that requirement, a decision the FDA made permanent in December.
Lawmakers in eight states this year proposed outright bans of chemical abortion pills, but none was enacted. Other restrictions that prolong the process to obtain mifepristone were blocked in court thanks to lawsuits filed by Planned Parenthood and other liberal organizations.
The Supreme Court is set to overturn Roe this summer, according to a draft leaked to Politico. The move would allow states to restrict abortion prior to the current standard of fetal viability at roughly 24 weeks.