At the end of August, KT Volkova got an abortion in central Texas, where she lives. She was nearly six weeks pregnant.
“Time was of the essence,” she says. Just a few days later, on September 1, SB8 became law in Texas. SB8 effectively bans abortion in the state by making the procedure illegal when a heartbeat is detected, usually around six weeks after someone’s last period (unpredictable cycles mean that many people don’t know they are pregnant at that point). SB8 also offers a $10,000 bounty on those who help someone have an abortion within the state after the six-week mark.
Volkova was one of the lucky ones. An untold number of pregnant people in Texas are now stranded, unable to access a safe abortion within the state’s borders. Now activists are fighting back. Money-raising efforts for people trying to fund out-of-state abortions have taken off within Texas. Citizen activists are spamming bounty sites with fake reports.
And for pregnant Texans needing an abortion now, nonprofits are stepping in to help. Aid Access, which helps provide access to abortion pills online, has seen a spike in requests since the bill passed. The pills are mifepristone—which blocks progesterone, a hormone needed to maintain a pregnancy—and misoprostol, which induces a miscarriage.
“We definitely saw an increase after September 1 from Texas,” says Christie Pitney, a midwife who volunteers with Aid Access. Some people are even stockpiling abortion pills in Texas in case they need them in the future. She says Aid Access is now looking to add more volunteers to take calls in the state.
The process only requires an internet connection: patients go online and answer some HIPAA-compliant questions about their pregnancy, such as when the first day of their last period was. If it’s a straightforward case, it’s approved by the doctor—there are seven American doctors covering 15 states—and the medication arrives in a few days. In places like Texas, where Aid Access doesn’t have doctors in state, Aid Access founder Rebecca Gomperts prescribes the medication from Europe, where she is based. That can take around three weeks, Pitney says.
The ability to get a safe, discreet abortion at home with just an internet connection could be life-changing for Texans and others in need. “It’s really changed the face of abortion access,” says Elisa Wells, the cofounder of Plan C, which provides information and education about how to access the pills.
In Texas, the need is especially acute because cultural stigma and an existing history of restrictive laws means there are very few in-person clinics available. Before the recent law change, Texans were three times more likely than the national average to use abortion pills, because abortion clinics were so far away.
“In a situation like Texas, where mainstream avenues of access have been almost entirely cut off, it is a solution,” says Wells, who describes much of Texas as an “abortion desert.” Black and Hispanic people often have less access to medical care, and so the ability to access abortion pills online is vital for these communities.
They’re also much cheaper than medical abortions, with most pills costing $105 to $150 plus a required online consultation, depending on which state you live in. (Aid Access forgives some or all of the payment if necessary.)
But while they’re commonly prescribed in other countries (they’re used in around 90% of abortions in France and Scotland, for example), only 40% of American abortions use pills. In fact, using the pills in the US to “self-manage an abortion” can lead to charges in at least 20 states, including Texas, and has been the basis for the arrest of 21 people since 2000. Aid Access’s use of Gomperts to write prescriptions as a foreign doctor has come under federal investigation by the FDA, which the group challenged. The situation remains unresolved.
Reaching people in need is another challenge, so activists often target Instagram and TikTok to pass on information about the pills. They use Instagram slideshows to show how they work and hashtags that make searching for information easier.
But not everyone is happy about the work that these groups do. In just the past week, Wells says, Plan C’s Instagram page has been shut down multiple times after someone reported it. “We appealed it,” she says. “The language was general—something about violating the terms and conditions. Do they think we are selling medication? Because we’re not. Are we doing something illegal? It’s freedom of speech, so no.” An Instagram spokesperson confirmed that Plan C was taken offline but said the page was “mistakenly disabled.”
Another problem on Instagram has been unsearchable hashtags, particularly for #mifepristone and #misoprostol. Instagram refused to answer questions about this on the record.
The Instagram shutdowns has led abortion organizations to reverti to pre-internet tactics that are harder to censor and reach those without internet access. These include using a giant billboard on a truck to drive through Texan towns, operating 24-hour hotlines, distributing stickers and zines to locals to plaster around public spaces, and other “guerrilla marketing techniques.”
Volkova, who also had a previous abortion, has refocused her energy on activism, working with Buckle Bunnies, a grassroots group collecting funds for abortions in Texas.
“For a long time, I felt ashamed to speak about my abortion,” she says. “But I realized there is so much love and support in organizations that do this work, and this love has empowered me to share my story and continue working in expanding abortion access.”