Pills of Misoprostol, used to terminate early pregnancies, are pictured in this illustration taken June 20, 2022.
Pills of Misoprostol, used to terminate early pregnancies, are pictured in this illustration taken June 20, 2022. Reuters / EDGARD GARRIDO

Abril, a 22-year-old college student, has a plan if Roe v. Wade is overturned: use encrypted messages, burner phones and international numbers to ensure women still have the choice to terminate a pregnancy.

And maybe save for a bail fund, she joked.

Abril, who declined to give her full name, is originally from Reynosa, a city on Mexico's northern border. She now lives in Texas, where she co-founded a group to help women in the United States access abortions, including through pills, which are easier to obtain south of the border.

In the past two years the group has received requests from over 2,000 women, many from Texas, seeking help with abortions, she said.

They plan to keep helping even if restrictions are tightened or abortion outright banned after the U.S. Supreme Court decides if it will overturn the landmark 1973 opinion that guarantees abortion access.

Texas already enforces significant restrictions. The state only allows abortions past six weeks of pregnancy if a mother's life is in danger or her health severely compromised, and it has banned the use of medication abortions entirely after seven weeks.

Mifepristone, which blocks the pregnancy-sustaining hormone progesterone, and misoprostol are the two drugs commonly used for abortions. Mifepristone is available by prescription in Mexico, while misoprostol, typically used for ulcers, can be bought cheaply over the counter. The most effective method is for the two to be taken together, but misoprostol alone is also often used.

So activists from Mexico meet Abril and her group at the border to hand them over - in one case, disguised in vitamin bottles. Abril has also stocked up on the pills in Reynosa and walked across the border back into the United States. She said she had 'nothing to declare' and hoped for the best.

She is preparing for things to get tougher if Roe v. Wade is overturned - but she won't give up on the women she helps.

"I'm already offering them help and support under the table and I'll keep offering them that help and support," Abril said.

"It might just become harder to reach out to them."

With a Texas 'trigger' law slated to take effect in 30 days if Roe v. Wade is overturned that would make it a felony to provide an abortion, Abril's group is aware they will need to be careful. They are setting up some Mexican phone numbers and plan to get Canadian lines, too, along with short-term 'burner phones' that are harder to trace. They are also using encrypted messages to organize and share abortion advice.

Access to doctor-prescribed abortion medications expanded during the COVID-19 pandemic after U.S. regulators allowed women to get the pills by mail following online appointments.

Telemedicine now accounts for more than half of abortions in the country, according to abortion rights advocacy group Guttmacher Institute.

The growing use of pills has worried anti-abortion advocates, and at least 16 state legislatures this year have introduced bills that would restrict administration of abortion pills or ban their use altogether, according to the institute.

Activists like Abril are looking for more ways to obtain pills abroad and deliver them through clandestine networks. U.S. authorities have acknowledged they have no effective way of policing orders from foreign doctors and pharmacies.

Abril thinks it is becoming riskier to repeatedly smuggle the pills into the United States herself, but said other activists may take turns going back and forth across the border.

The medicines can also be mailed from Mexico or the U.S. border area at low risk. Recently, an anonymous donor in Mexico reached out to Abril, saying she wanted to send mifepristone. The package arrived with no return address; the pills wrapped in small boxes as if pieces of jewelry.

Veronica Cruz, who runs abortion rights organization Las Libres in the central Mexican state of Guanajuato, which offers step-by-step assistance to women taking the pills, said her group receives donated medication and sends it to women in the United States.

From February to April this year, Las Libres sent 1,000 packets to the United States. Getting hold of more would be easy in Mexico, Cruz said.

"We're getting ready if more women need it," she said, adding that an increasing number of U.S. residents were keen to help. "People say I want to be the one who distributes the medication in the United States," Cruz said.