Washington (AFP)

"They arrived in a small kraft paper envelope. There were only five pills. No instructions." Although illegal in the United States, Sally * decided to buy her abortion drugs herself on the internet.

An often stressful choice which can be the subject of legal proceedings, but which more women have to make in times of pandemic.

"A week after finding out I was pregnant, Texas has banned abortions" because of the coronavirus, Sally says from her home in Dallas. For several weeks, they were considered as non-emergency interventions there, and therefore suspended.

In full separation, this thirties sees no other choice but to order abortion pills on the internet. The first two sites are out of stock. After long days of waiting and a payment of $ 250 to a third, she finally receives the tablets.

It is then 10 weeks since the end of her last period, the limit for prescribing them in the United States (9 in France). "I was terrified," she says.

It was also on the internet that she learned how to carry out a induced abortion. She ingests a first tablet (mifepristone, which blocks the development of pregnancy), then the other four the next day (misoprostol, which triggers abortion). And painkillers.

After a night of "very painful" cramps and a quantity of blood that "impresses", everything goes as expected, and she returns to work the next day, "relieved". Despite everything, she is categorical: "I would have preferred to be followed medically, that's clear."

Which website to favor? Do the pills arrive quickly? Like Sally, dozens of women share tips and experiences every day on the "abortion" page of the Reddit forum, which is very popular in the United States.

- + 150% -

The right to abortion in the United States is protected by a Supreme Court decision. But it is already, under normal circumstances, attacked by certain conservative American states. And many have taken advantage of the pandemic to further restrict access to it in the name of the priority given to Covid-19.

There are many obstacles added by the virus: fear of infection in a health center; the impossibility of leaving their place of confinement, so as not to arouse the suspicions of parents; or financial problems caused by job loss.

To help women choose their abortion pills on the internet on their own, a platform, "Plan C", lists eight sales sites and ranks them according to the prices charged and the speed of dispatch. The products they sell were tested and declared reliable in 2018 as part of a study.

Contacted by AFP, one of them confirmed "an increase in sales in the United States in particular", of the order of "150% between April and March". Visits to the "Plan C" platform doubled in one month at the end of April.

According to its co-founder, Elisa Wells, if some 900,000 abortions are performed each year in the United States (40% of which are medicated), "at least 10,000" are performed outside any medical framework, via pills purchased on the internet or in Mexico.

- What risks? -

Abortions using mifepristone and misoprostol are safe, experts say. Complications requiring consultation are rare. "In 2020, in the United States, the real worry in practicing your own abortion is not medical, but legal," explains Jill E. Adams, president of the association If / When / How, which puts in touch women wanting to abort alone with lawyers.

Between mid-March and the end of March, the association's dedicated telephone line recorded twice as many calls.

Five states criminalize self-performed abortions. But women are not more protected elsewhere: certain prosecutors "divert" other laws to condemn them (foeticide, ill-treatment of children, illegal practice of medicine, failure to declare a death ...). Some have gone to prison.

At the end of March, 21 states asked for the lifting of federal restrictions on the mailing of mifepristone, which prevent telemedicine and "force" women who choose to comply with the law "to unnecessary travel" during the pandemic.

To circumvent these legal prohibitions, the sites operate from abroad.

Aid Access, the cheapest ($ 90), is the only one supervised by a doctor. Dutch activist Rebecca Gomperts has been engaged for a year in a showdown with the American Medicines Agency (FDA), which asked her to stop its activities. She was finally defeated by the virus: medicines can no longer be sent from India, which has closed its airports.

Another site, which sources in Russia, confirmed to AFP to expect a stock shortage for several weeks.

The only service currently authorized, in 13 American states, to post these pills, is an experiment in which some 700 women have participated since 2016, Telabortion. In March and April, the number of women who used it doubled compared to the previous two months.

* name changed

© 2020 AFP