For many women, the answer to this question is the bottom line and may be the determining factor as to where they get an abortion, or if they get one at all. You may find websites offering free abortion pills and others with estimated costs of up to $1100 or more. Why the disparity? What gives? What questions should I be asking?

Should I go with the cheapest option?

In short, no. Any here’s why: 1). The FDA approved dosage of pills is NOT being followed by many of these sites. An overdose of pills can result in uterine rupture. Uterine rupture is when your uterus tears open, and is a medical emergency. Some clients have shared they were given four times the FDA approved dosage, placing them at higher risk for complications, including uterine rupture. 2). Online pharmacies are not regulated by the FDA and alarmingly up to 96% of them operate illegally. They often sell counterfeit or harmful products which may be expired, tampered with or incorrectly dosed. The risk in this is that the pills may be ineffective or only partially effective which could lead to heavy bleeding requiring surgery or infection which if bad enough could necessitate removal of the uterus. If you are wondering if an online pharmacy is operating legally you should look for the VIPPS seal (Verified Internet Pharmacy Practice Sites). 3). Lack of Medical oversight/screening:

a. No screening for ectopic pregnancy, which is the leading cause of maternal death in the first trimester. When pills are ordered online and you do not have an ultrasound to ensure the pregnancy is in the uterus, you could delay a diagnosis of ectopic pregnancy leading to heavy bleeding or even death.

b. No confirmation of gestational age – women do not always know exactly how far along they are and mifepristone has only been approved for pregnancies under 10 weeks. If you are not within that window it could be ineffective or you could experience complications including bleeding, or infection.

c. No one will review with you if these medications are safe for you. There are contraindications (reasons the pills should NOT be used) some of these are:

i. Confirmed or suspected ectopic pregnancy (a pregnancy not located in the uterus) ii. Pregnancy greater than 10 weeks gestation iii. IUD (intrauterine device) in place iv. Allergy to mifepristone or misoprostol v. Chronic adrenal failure – also called Addison’s disease – where your adrenal glands don’t make enough of certain types of hormones namely cortisol (regulates stress and blood sugar) and aldosterone – regulates body water. vi. Long term steroid therapy – for conditions such as asthma, autoimmune disease, eczema etc. vii. Blood disorders where your does not clot properly viii. Anemia depending on how low the levels are ix. Inherited Porphyria – a rare disease where the body does not properly make heme, a protein important for carrying oxygen in blood cells x. If you have had prior cesarean sections the drug misoprostol may not be safe for you especially if you are further along than 10 weeks and its use could lead to uterine rupture which is where the wall of the uterus breaks open causing catastrophic bleeding and possibly death.

d. You will not have anyone to call if something does go wrong or if you experience complications.

Certainly, avoid any pharmacy or abortion provider who tells you to lie about your medical history. If you have taken abortion pills and are having a complication you should go immediately to the emergency room and be honest about what has happened to make sure that you get the best possible care. 4). Legal risks: Most online pharmacies are operating illegally. Many states, including North Carolina, have healthcare laws to protect women. North Carolina abortion law makes it illegal to obtain abortion pills without a prescription or to get it online without an in-person consultation.

So what am I supposed to do?

That’s why we’re here. We believe you deserve safe, confidential support as you navigate your options. You deserve excellence in your health care without worrying about billing. Our team of licensed medical professionals, including a board certified OB/GYN, are committed to supporting women just like you free of charge. We believe in caring for every woman as a whole person, not just another body, so we also have a team of Care Managers who will be advocating for you throughout the process and will be a sounding board for you if you need to talk. Call or text us today for free healthcare and support as you make one of the biggest decisions of your life. Take a breath. We’re right here with you. Call Raleigh 919-833-0096 Call Durham/Chapel Hill 919-251-9444 Confidential text: 919-901-0096