Nebraska abortions, uncounted by state, likely happening by pill, mail

More than 7,000 Nebraskans visited Plan C, a website with abortion resources and links to abortion pills by mail, last year. 

Many of them clicked on links to virtual clinics that mail abortion pills, according to Plan C. Others went to an online pharmacy that offers abortion pills as low as $35 and delivers them in two days without a consultation.  

The number of online vendors providing abortion medications in the U.S. has shot up since the 2022 Supreme Court decision undoing the constitutional right to abortion. Plan C, a national group that provides information on how to access at-home abortion pills, currently lists 25 online vendors on its site.

The cost of abortion medication has also dropped dramatically, from as high as $400 several years ago to as low as $30 now, according to Plan C. 

Bans like Nebraska’s don’t stop abortions, said David Cohen, Drexel University law professor. Instead, they drive many patients to travel or turn to abortion pills obtained online or through telemedicine, he said. 

It’s unclear if the state’s 12-week ban will drive more people to online providers, since medication abortion is generally only considered safe for patients up to 12 weeks pregnant. 

Nebraska law prohibits physicians from prescribing abortion medication without an in-person visit. The penalty doesn’t extend to patients. 

Out-of-state providers prescribing these pills to Nebraska patients are technically violating Nebraska’s law, but they’re outside of the state’s jurisdiction, Cohen said.

And six states have passed laws protecting physicians for prescribing pills from being prosecuted, known as shield laws for abortion providers, according to Plan C. 

Marion Miner, a lobbyist for the Nebraska Catholic Conference, called these mail-in pill services “illegal and dangerous,” and “cynically demeaning to women.”

Anti-abortion groups focus on providing support for women, he said in a statement Friday. “Abortion pill distributors would rather focus on the profits they can rake in from taking advantage of vulnerable people.”

Julie Kay helped write New York’s shield law and founded the Abortion Coalition for Telemedicine Access, which assists telemedicine abortion providers. Some virtual clinics have served patients from all 50 states. Patients go through a virtual consultation first, and receive abortion medication — mifepristone and misoprostol — in the mail with instructions.

Kay said providers in her network mail mifepristone and misoprostol to about 10,000 patients each month living in Southern states where abortion is totally or nearly banned.

Compared to abortions offered at a brick-and-mortar location, which typically costs about $800 in Nebraska, telemedicine medication abortions range between $150 and $250, sometimes offered at a nominal price for patients with financial difficulties, Kay said.

There are also online vendors that ship pills without a consultation for under $50, or community networks that can offer abortion medication for free.

Abortion through telemedicine has become more available and “taken off like a rocket ship,” Kay said. But it’s not going to fit everyone’s needs, especially for those later in the pregnancy, which involves more complicated and specialized abortion care.

Kay worked with Dr. LeRoy Carhart, who once provided late-term abortions before the U.S. Supreme Court overturned Roe. Before passing its 12-week ban, Nebraska allowed abortion up to about 22 weeks of pregnancy.

“Concessions have been made of getting rid of access to later abortion in order to preserve earlier abortion…  in Nebraska and elsewhere,” Kay said. “But it really stigmatizes people who are having later abortions and who are having them for unusual and very worthwhile reasons…”