By Joelle Boxer
Tracy Droz Tragos’ new documentary, “Plan C,” follows the work of a grassroots organization dedicated to improving access to the abortion pill by mail in the U.S., while navigating an increasingly restrictive legal landscape.
There is no better time to hear the perspectives of these patients, providers, and activists. Just last month, the U.S. Supreme Court took on a case to determine the legal status of the pill, also called mifepristone. With a decision expected in June 2024, Tragos’ film shows us what’s at stake.
As a law student and aspiring lawyer, I take the law seriously. I write about cases, legislation, and policies related to reproductive health care — a lens that, on its own, can be self-defeating, neglecting actual access to care. “Plan C” took me in the opposite direction, with access as the only goal. Describing its information-sharing mission, co-founder Elisa Wells shares that “people said you can’t do that, that’s illegal, right?” Its other co-founder, Francine Coeytaux, declares that “the law hasn’t been helpful already. I’m not going to be stopped or hindered by the law one way or the other.” We learn that Plan C “operate[s] in six states legally and in all fifty states illegally.”
“Plan C” begins during the COVID-19 pandemic in the U.S., when access to abortion pills by mail, typically shipped from India, came to a halt, and in-person visits were shut down in most states. The organization reaches out to reproductive health care providers in the U.S., asking for help prescribing pills through telehealth and shipping them through the mail. At this time, “pills by mail” existed in a legal grey area. Coeytaux explains: “It wasn’t clear that it was legal… My role is to push and say we need you to do your part so we can get closer to this vision.”
In July 2020, a federal judge confirmed that “pills by mail,” were, in fact, legal, at least during the pandemic. The judge did so by suspending an FDA rule that required in-person ordering, prescribing, and dispensing of the pill by a provider. The film outlines how this decision led to the creation of “pill by mail” start-ups in some states. As one counselor tells a patient: “the law requires the patient to be within either Minnesota or Montana… so you can be anywhere, a lot of patients just drive over the state line and they just pull over, park, have the conversation with the doctor, and then go back home.”
“Plan C” also gives us insight into the personal motivations of those impacted. We hear one patient describe the shame she feels to her provider, who quickly reassures her that she is not alone; abortion is something that one in four people choose in their lifetime. We hear another patient describe the immense stress of unwanted pregnancy, rendering her unable to leave her house for weeks before a counselor tells her that a fund can cover the cost of the pill. We hear patient after patient describe their preference for an at-home, by mail option: the comfort of “having my own way through the process” and doing so “at my own pace, on my own time”; the fear of having a protestor “scream in my face that I’m a sinner”; and the difficulty of driving to a clinic from a remote area, during a snow storm, or after starting a new job.
Despite these benefits, the film documents a quickly shifting legal landscape: the death of Justice Ruth Bader Ginsburg, the appointment of Justice Amy Coney Barrett, the insurrection of January 6, 2021, and the Supreme Court’s reinstatement of the FDA’s in-person pill requirements on January 12, 2021. We hear providers struggle with new legal risks: “I can’t keep providing services if I get [my license] taken away.”
This concern only worsens with the passage of SB 8 in Texas, which outlaws abortion after six weeks gestation. Loretta J. Ross, a founder of the reproductive justice movement, contextualizes these restrictions in the film, through America’s long history of racial oppression. Plan C continues to run information campaigns in Texas, from sign-carrying trucks to stickers in school bathrooms. It protests for Lizelle Herrera, a woman prosecuted for self-managed abortion. It highlights an anonymous distributor that ships pills to Texas by cutting out parts of the packaging that identify the prescriber and stuffing the bottle with cotton swabs (to avoid a rattling sound in the mail).
At one strategy meeting, a prescriber worries about how they could possibly expand fast enough if “the states around Texas shut down.” Unfortunately, that’s exactly what happens—the Dobbs draft leaks on May 2, 2022; Oklahoma bans abortion on May 20, 2022; and Roe is finally overturned on June 24, 2022. Still, the film reassures us that Plan C and other networks continue to work to make the pill by mail option available. We hear counseling to patients on how to take the pill to avoid detection in an emergency room and we hear about the need for shield laws for providers continuing to prescribe in banned states.
“Plan C” makes a strong case that the law has failed people with the capacity to become pregnant. When the law fails, patients, providers, and activists will push legal limits to access health care. While many of their faces are blurred and their voices are distorted, this documentary is a rare chance to hear directly from them on their own terms.
The post Plan to See ‘Plan C’ This Year first appeared on Bill of Health.
