What do you do if you find yourself pregnant and you do not want to be? The question has renewed urgency in our brave new America—even in a blue, relatively abortion-friendly state like Washington. Who can you safely tell about your decision? Where can you go for care? What if you can’t afford the care you need?
So here’s a guide on how to get and abet an abortion—yours or someone else’s. If we wind up in Stephen Miller’s personal prison for writing this, please send treats.
Washington Is Good but Not Perfect
Washington law protects abortion access until the fetus can survive outside the womb—which is typically between 24 and 26 weeks into pregnancy. If you’re in Washington, you’re pregnant, and you don’t want to be, the state has a few measures that keep the federal government’s nose out of it. State law gives abortion patients an extra layer of privacy—all you have to do is complete a form. And Washington has a “shield” law that prevents cooperation with out-of-state investigations and prosecutions relating to abortions in Washington.
Washington’s Reproductive Parity Act also requires all state-regulated health plans that cover maternity services to also cover abortion services, including medication abortion. (Medication abortion involves taking a series of pills that terminate a pregnancy in its early stages, generally up to 11 weeks in Washington. Procedural abortion can take several forms—including dilation and curettage [D&C] and dilation and evacuation—and may be used in later stages of pregnancy.)
Washington Medicaid covers abortion care, too—at least in theory. In practice, Apple Health doesn’t cover the whole procedure. For example, for a D&C, Apple Health covers $146, but the procedure typically costs between $700 to $1,850. (In contrast, in New York, state Medicaid reimbursement for a D&C is $1,000.)
Still, we’re in better shape than a lot of states in the union. So what can we do to help?
Abet in Advance
Right now, medication abortion is accessible in all 50 states. That’s all thanks to shield laws in eight states that allow providers to practice according to their own state’s laws, even if their patients are elsewhere. So, for example, a doctor in Massachusetts—where abortion is legal, and they’ve passed this type of shield law—can provide telehealth service to a patient in Tennessee, where abortion is almost completely illegal. Providers can meet with patients online, and within just a couple days, send abortion pills—mifepristone and misoprostol—by mail.
That access depends on the US government not enforcing the Comstock Act—a currently unenforced law from 1873 that criminalizes mailing “vices,” including contraceptives and literally anything related to abortion. If the federal government were to start enforcing Comstock, that would do away with our shield law loophole.
That (and, of course, the looming risk of a national ban) is where abetting in advance comes into play. Elisa Wells is the co-founder of Plan C, a team of abortion advocates that researches creative—and effective—methods for accessing abortion pills. Right now, she says, it’s possible to prepare for an unwanted pregnancy years ahead of time—for yourself, or for a future friend in need. “The first thing people can do is get abortion pills now, in case they need them in the future,” she says. “Why not have it on hand as part of your medicine kit—like you have aspirin in case you have a headache, or bandaids if you have a scrape? In case your period’s late, then you have something right on hand, so you don’t have to travel to another state or scramble at the last minute to try and find care.”
There are two main ways to get pills in advance. The first is through the same type of telehealth provider that you’d go to if you were pregnant. Many of these clinics operate on a sliding scale, she says, so “this is a great way for people in any state to support these providers by investing in a full-price version of the pills to have on hand. It helps pay it forward.” The second is through what Plan C clunkily calls “Websites That Sell Pills.” “We used to call these online pharmacies, but they’re not pharmacies in the way that we know them in the United States,” Wells says. “We call them Websites That Sell Pills, because that’s exactly what they are: They are commercial enterprises that get generic abortion pills in India.”
It sounds sketchy, but it’s not. Abortion pills are “safer than many other medicines like penicillin, Tylenol, and Viagra,” according to Planned Parenthood. So it’s safe to self-administer, but if you need backup during a medication abortion, you can call the M+A Hotline for free medical, emotional, and legal support. Mifepristone has a shelf-life of about 5 years. Misoprostol around 2 years.
That’s all well and good if you have time to prepare, but what if you’re knocked up?
So You Think You’re Pregnant
Think your birth control failed? Is your period late? Feeling pukey? Here are a few guiding steps.
1. Confirm that you’re pregnant. (Maybe that nausea you’re feeling is just a reaction to seeing yet another picture of Pete Hegseth’s tattoos!) “Cheap pregnancy tests from the dollar store work just as well as the expensive ones at the pharmacy or grocery store, so grab whatever feels right for you and your budget,” write abortion activists Renee Bracey Sherman and Regina Mahone in their book Liberating Abortion. Know, though, that a pregnancy test may not deliver accurate results until a week after you’ve missed an expected period—and be wary of free pregnancy tests, which may be given out by pregnancy crisis centers intent on persuading you against abortion.
2. If you are pregnant, be careful—very careful—how you share the information. “Talk to people on the phone or in person rather than in writing,” Sherman and Mahone advise. “Delete your call log history. Clear the browser history of the search engine you use, or use a private browser that doesn’t save or track your history. Use a lock on your phone and computer.”
Be careful, too, about who you share your pregnancy news or abortion plans with. Texas’s largest antiabortion network recently spent millions to launch an advertising campaign on Facebook and X encouraging men to report their partners who’ve had abortions, and anyone who helped facilitate those abortions can be sued in state court.
3. Take a moment to think through your options, if you need it. The All-Options Talkline can help if you’d like unbiased, compassionate counseling about your decision. “You deserve the time to think through what you’d like to do with whomever you feel safest,” Sherman and Mahone say, but unfortunately, “the never-ending abortion restrictions and bans, and increasing costs of the procedure, can make it difficult, expensive, and logistically challenging to take an extended period of time to pause and think.”
4. Find a Provider. If you or your friend does want an abortion, you can find the closest clinic or telehealth provider by visiting INeedanA.com. In the first 10 weeks or so, medication abortion is your easiest option. Plan C provides guidance on safe and accessible medication options.
If you decide to visit a clinic in person, make your appointment as soon as you can. Many clinics provide care only on certain days of the week, and they may book up far in advance. Even here in Washington, look out for crisis pregnancy centers: groups that masquerade as abortion clinics, but serve only to deter and shame you. They “may provide patient care by staff or volunteers who are not licensed healthcare providers and who may provide incomplete, medically inaccurate information,” the Washington State Attorney General’s Office warns. “These clinics are not subject to HIPAA and may not keep your health information confidential.”
5. Plan your finances. If you have insurance, check if your policy covers abortion care. In addition to the cost of the abortion itself, make sure you’re planning for other things, such as transportation, meals, and childcare. If you need financial help, the National Network of Abortion Funds can connect you to local and national resources. And Plan C can connect you to community networks that operate on a mutual aid model, mailing thousands of pills a month to people who need them. If you need legal help, the Repro Legal Helpline and Abortion Defense Network may be able to provide counsel for free.
6. Take care of yourself or your friend getting an abortion! Wear comfy clothes; talk to people you trust; eat your favorite snacks; feel your feelings, whatever they are; generally pamper yourself or your loved one. “There are millions of people” who have had abortions, say Sherman and Mahone. “And when we show up for one another with love and dignity, we win.”