How one unmarked van is quietly delivering abortion pills on Colorado’s border
As abortion becomes more restricted across the country, a non-descript mobile clinic is operating on Colorado’s border, where women from out-of-state can go to pick up medications themselves.
“It doesn't have any signage on it,” Dr. Julie Amaon, the medical director of Just The Pill, said. “We're not trying to tell people what we're doing to keep patients safe because we know that even in more protected states like Colorado, there are still lots of people that don't agree with what we're doing.”
Just The Pill provides medication abortion, which is a dose of two pills that can be taken at home. Patients who live in states with restrictions can travel to Colorado to pick up the medications from the organization’s sole mobile clinic, which parks at various spots near state lines.
“We try to get to as close to the patients as possible, depending on what method they're coming in,” Dr. Amaon said. “Are they coming in by bus, by car, by plane? And so that gives us some more flexibility to move around and meet patients where they are.”
Just The Pill works with patients across the West and Midwest. Everyone starts with a telehealth consultation, some joining the appointment from a hotel or car if this process is prohibited in their home state. Then medications are mailed or picked up by hand in Colorado, a state seen as a safe haven for abortion access in the region.
Just the Pill has worked with thousands of women via telehealth so far this year. The mobile clinic, which goes out on the road approximately every two weeks, has served around 100 women since it launched in August— the organization is hiring and plans to expand its hours. The small operation is one of many piecemeal efforts to increase access to care as states move to shut it down.
Planned Parenthood plans to launch a similar mobile operation later this year in Illinois. Other mail order and telehealth options do already exist; Just The Pill goes one step further in driving abortion medications to pick up spots in Colorado.
“Obviously, we are trying to push the envelope as far as you know; how can we stay within the law but push the envelope and try to get patients care where they need it? But we also need to be able to continue to offer services to continue to help patients,” Dr. Amaon said.
During the pandemic, the Food and Drug Administration temporarily lifted the requirement that women obtain abortion pills from a provider in person, allowing them to be mailed instead. In December, the FDA made the change permanent. Still, many states prohibit these telemedicine visits.
“What do those conservative states do about their citizens that are accessing abortion in other ways? And the two big questions that come out here,” Josh Wilson, a professor of politics at the University of Denver, said. “One is physically leaving, right? Like going to another state and returning. The other is mail. And that’s actually a federal concern, that’s interstate commerce.”
In 2019 nearly half of all abortions were medication abortions, according to data from the federal government. It’s too soon to know how access has changed since the Supreme Court eliminated the constitutional right to abortion in June, but research indicates demand for medication abortion increased during the pandemic.
Abortion pills are only approved for use for up to ten weeks of pregnancy. Kate Coleman-Minahan, an assistant professor at the University of Colorado College of Nursing, points out that this method of terminating a pregnancy won’t always be applicable.
“There are people who don't have private and safe spaces to manage medication abortion who don't feel like they have the social support to do that,” Coleman-Minahan said. “And so while the increased access to medication abortion is incredibly important, it does not substitute the full range of evidence-based options for people to end their pregnancy.”
Just The Pill hopes to launch a procedural mobile clinic offering surgical abortions next year. To do so, they will need to find somewhere to park for hours at a time and are considering buying land. For now, the staff is working with a handful of brick-and-mortar clinics in Colorado, referring patients out for blood work and ultrasounds and taking on some of those clinic’s medication abortion patients.
“So the hoops that people have to jump through are pretty ridiculous for general medical care. But this is the state we are in currently,” Dr. Amaon said.
Just The Pill is fundraising for another mobile clinic, just like the one parked in Colorado. That unit will operate in Illinois, another state that has protected access to abortion, surrounded by states restricting it.