Of those she's served, Hearn said, Gomperts is "not aware of a single death, hospitalization or serious complication attributed to the prescriptions she prescribed for her patients in the U.S."
There are other ways to get abortion pills by mail in the United States, for women who can't get to or afford clinic visits, but Aid Access is the most affordable option at $95, according to the grassroots group Plan C
, which aims to educate women about self-managed abortion. Aid Access also offers the possibility of financial help, according to its website.
Plus, it's the single source to offer physician oversight, according to a Plan C report card
Aid Access is the only one of eight suppliers to receive a grade of A.
What happens next
A 2015 study
showed abortions by medication to be about 97% effective. Interest in self-managing or self-inducing abortions is on the rise, according to reports.
In a one-month period in 2017, research published last year showed
, there were nearly 210,000 US Google searches for information about self-abortion. This indicates a demand for alternatives, perhaps driven by barriers to clinic access due to financial hardship, geographic distance, fear of being publicly shamed or other reasons.
Hearn outlined further points of comparison to illustrate the safety of these abortions.
"Medical abortions have the same mortality rate as natural miscarriages, (approximately 1 death per 234,000 prescriptions)," he wrote. "That means that medical abortions are significantly safer than natural childbirth, (1 death per 3,788 births), penicillin (1 death per 100,000 prescriptions) and Viagra (1 death per 20,000 prescriptions)."
US women "have a 60-fold higher risk of death from childbirth than from a medical abortion," he wrote.
The FDA, however, maintains its concern that drugs purchased online from foreign sources "are not the FDA-approved versions of the drugs" and, if unregulated, "may be contaminated, counterfeit, contain varying amounts of active ingredients, or contain different ingredients altogether," according to an email from the office of media affairs.
The federal agency would not comment on its next steps, in light of Hearn's insistence that his client would continue her work and not turn US women away. But its media relations department recounted its warning from the March letter, saying, "failure to correct the violations of the law may result in FDA regulatory action, including seizure or injunction, without further notice."
What that would look like in Gomperts' case is unclear, but Hearn is not concerned. He said that the FDA rarely enforces its warning letters, isn't in the business of regulating doctors and that it would be up to the Department of Justice to try to prosecute Gomperts.
Because Gomperts lives in Europe, he suspects that the Department of Justice wouldn't bother. But if it ever comes to that, he insists, he's prepared to stand and fight for her and her patients.