Dangerous double talk on safety
By Randall K. O’Bannon, Ph.D. NRL Director of Education & Research
Specialty online pharmacies and virtual abortion clinics are popping up everywhere offering to sell and ship abortion pills by mail in the wake of a recent Biden administration decision to drop enforcement of a government requirement that the abortifacient mifepristone be delivered only in person on site by certified prescribers.
Hey Jane, or Hey Jane Health, is just one of the latest, offering “fast, safe and affordable abortion care from home” for just $199.
Currently, the website says that the service is only available to women in New York and Washington state, though articles linked on the website say Hey Jane has plans for distribution in California
How we got here
Rebecca Gomperts and Aid Access have been defying regulations of the U.S. Food & Drug Administration (FDA) for years, making foreign-made abortion pills available by mail to women in all fifty states while fending off government regulators in court. Beverly Winikoff helped bring mifepristone [“RU-486”] to the U.S. when she worked at the Population Council in the 1990s. The last five years, she’s been offering abortion by mail to women in several states as part of her TelAbortion “study” with her new group, Gynuity.
But once lower courts temporarily lifted FDA restrictions on distribution of abortion pills in the summer of 2020 for the pandemic, on-line pharmacies Honeybee Health and American Mail Order Pharmacy began shipping pills to patients directly (Ms Magazine, 11/16/20). Virtual abortion clinics such as “Choix” and “Just The Pill” began offering “medication [chemical] abortions” via telemedicine. Choix focused on California while Just the Pill was set up for women in Minnesota. Hey Jane joined the fray around the same time.
These new on-line “providers” appear to have suspended operations once the Supreme Court reinstated FDA restrictions on distribution in January of 2021. Sales resumed in a matter of weeks, however, when the new Biden administration took charge and the FDA declared it would not enforce those regulations during the pandemic.
Though the original limits on distribution were supposed to be reinstated once the pandemic lifted, the Biden administration has given clear indications that it will review and consider dropping these regulations permanently (Endpoints, 5/10/21)
Clearly, Hey Jane, Choix, and Just The Pill expect to be around for the long term.
Who is “Hey Jane”?
The group’s name, origin, leadership, the names or credentials of their prescribers, the location of their offices, etc., are never really offered or explained on its website. The Hey Jane website links to a 10/2/20 online article by Fast Company which says the name is one “that evokes the Jane Collective, an underground abortion group that operated during the early 1970s in Chicago” [before the Supreme Court declared abortion legal].
Without specifying the credentials or the training of the prescribers, the website assures women that they can will consult with a “licensed provider” by “secure text chat.” That “provider” is available around the clock, 24 hours a day, but only on Monday through Friday. The number offered for “Text Us” lists an Oklahoma City area code.
They tell women that a video visit is available if they’d like, but it is not required.
Hey Jane tells women that they can receive their “FDA-approved abortion pills delivered to your door in 1-3 business days,” and assures them that “They’ll arrive in an unmarked box to protect your privacy.”
They promise that their service “Costs 60% less than average abortion care,” that there is “No need to travel to appointments, treatment or follow up,” that there is “Free 1-3 day shipping” on the pills and “Support during and after your treatment.”
If the $199 fee (about $300 less than what clinics normally charge for chemical abortions initiated on site) is still too high a cost, they helpfully note that “Financial assistance is available for those who need it.”
Double Talk on Safety
Hey Jane assures women that “Relief starts here,” that they can “Get the care you need from home – safe, fast and effective.”
“Abortion, regardless of the type you have,” Hey Jane tells women, “is very safe.” Repeating unwarranted denials pushed by the abortion industry against studies that actually demonstrate the contrary, Hey Jane wants to make clear that “abortion does not cause breast cancer or mental health issues” and “does not make it harder to have children in the future.”
As for the safety of chemical or “medication” abortions, Hey Jane says that “Complications from this treatment are very uncommon – they occur in less than 1% of patients.” This may be what standard industry propaganda states. However, actual studies found complication rates for chemical abortion in California to be much higher – 5.19% – more than four times higher than they were for standard first trimester suction abortions!
The group mentions, almost casually, that a woman’s self-dating of her pregnancy “could be inaccurate.” But this is very important.
The FDA originally approved mifepristone for pregnancies no more than 7 weeks after a woman’s last menstrual period (LMP) because the drug’s “effectiveness” dropped off after that. While the FDA extended that to ten weeks LMP in March of 2016, the reality of the drug’s reduced effectiveness as the pregnancy progressed did not change.
A woman visiting a doctor or clinic might have her pregnancy properly dated by an ultrasound. However, the possibility of mistakes in self-dating—or deliberate misreporting of dates to the “licensed provider”—obviously not only increases the likelihood that the abortion will “fail,” but also that a subsequent surgical procedure will be required to address complications or complete the abortion.
Hey Jane tells women that the risk for an undiagnosed ectopic pregnancy may be increased, but assures women that ectopic pregnancies are rare. But their advice in this regard seems at odds with their marketing model.
They say that by “very rare” they mean that these occur in 1-2% of pregnancies. While that might spare most women, it seems self serving to readily dismiss something that is likely to occur to perhaps every 50th patient of yours.
Their advice–“You can make sure that your pregnancy is inside the uterus by having an ultrasound”–seems to undercut their claim that women can get “fast, safe, affordable abortion care from home” (emphasis added).
Mifepristone does not work in circumstances of ectopic pregnancy. However, mifepristone and its companion drug misoprostol does prompt pain and bleeding that look very similar to the normal side effects of a ectopic pregnancy that is growing in and rupturing a mother’s fallopian tube. Even an attending physician may not be able to tell the difference until it is too late to repair the damage and save the mother’s life.
Not our problem
Despite promises that “Throughout your treatment, we’re here to support you” and the provision of telephone numbers or website where women can text or call if they have “urgent concerns,” Hey Jane’s “Terms of Service” makes the following disclaimer (emphasis ours):
Possible Health does not provide medical services or medical advice. Possible Health does not make any representations or warranties about the training or skill of any Providers who provide services via the Services. You are ultimately responsible for choosing your particular Provider, if any. All Providers are independent of Possible Health. Any information or advice received from a Provider comes from the Provider alone, and not from Possible Health. Possible Health is not responsible or liable for any advice obtained from a Provider or any other user of the Services. You acknowledge that your reliance on any information provided by any Provider or any other user via the Services is solely at your own risk. No doctor-patient relationship is created by use of the Services. Information you receive via the Services is not a substitute for a formal diagnosis or physical examination, and should not be used to treat a medical condition. Do not ignore or delay obtaining professional medical advice because of information you obtain through the Services. (
Whether “Possible Health” is the legal name of Hey Jane or just the entity hosting its website the message is clear to women relying on Hey Jane for their health and safety – “you’re on your own here.”
At least two dozen women who have taken mifepristone have died and thousands more women have suffered serious, potentially life threatening complications. And this was with nearly all of those patients coming into the clinic, meeting and being screened, counseled and physically examined by a trained medical professional – that is,a trained medical professional who could confirm their pregnancy, verify their gestational age, eliminate the possibility of ectopic pregnancy, and ensure that they had no disqualifying medical conditions that could make these drugs deadly for them.
Women are not only putting the lives of their unborn children at risk, but their own as well every time they get these pills from unnamed, unaccountable strangers with perhaps only minimal medical qualifications, exploited by activists ready to write off the loss of a few patients for the sake of the “cause,” bought from a website built by slick entrepreneurs who see the chance to make a quick buck.