Welcome, everyone. It's really great to have
you with us today. We have, well, a really fascinating
deep dive lined up for you. Yeah, we do. Our
mission today is to explore a singular, highly
detailed compilation of research surrounding
an organization called Plan C. And this is a
nonprofit and public health campaign that's entirely
focused on providing information and educational
resources about accessing abortion pills by mail
in the United States. Right. And before we get
into the mechanics of how this organization operates,
we really need to pause and establish a very
important ground rule for today's deep dive.
Absolutely. We are looking at source material
that covers abortion access and reproductive
rights. And this is a highly politically charged,
deeply personal topic for many people. So we're
going to make something crystal clear to you,
the listener. Neither of us is taking a political
side here. No, not at all. We aren't here to
endorse any viewpoints, advocate for any policies
or... or condemn any practices. Right. Our job
is strictly to act as your guides through the
research, just bringing you the facts of the
case. Exactly. We are looking at this strictly
through the lens of organizational history, digital
networking, and healthcare logistics. We're going
to impartially convey the factual history, the
operational mechanics, and the stated objectives
of the Plan C organization exactly as they are
presented in our sources. Nothing more, nothing
less. I'm glad we laid that out because it lets
us focus entirely on the operational mechanics,
which are, I mean, honestly, they're mind -blowing.
They really are. Okay, let's unpack this. Because
if you are sitting there wondering why this specific
deep dive matters to you, consider this. Whether
you're studying the evolution of health care
technology, tracking modern legal history, or
if you're just insanely curious about how digital
information networks adapt in real time to physical
roadblocks. This is a masterclass. It is a masterclass.
It's an incredible look at how a single organization
utilized telehealth, digital directories, and
the U .S. postal system to navigate a constantly
shifting medical landscape. So let's start with
the blueprint. What exactly is Plan C? Well,
the foundation was laid in 2015 by three founders,
Francine Coetho, Elisa Wells, and Amy Merrill.
And structurally, it operates as a campaign that
is fiscally sponsored by a 501c3 nonprofit called
Possibility Labs. And just to clarify what that
means for anyone unfamiliar with the nonprofit
world, physical sponsorship basically means Possibility
Labs handles all the heavy lifting regarding
tax -exempt status. Right, the legal compliance,
the financial administration. Yeah, all that
back office stuff. This is a common strategy
because it frees up the Plan C founders to focus
entirely on executing their actual mission rather
than getting bogged down in administrative paperwork.
Which is crucial when you have a mission as complex
as theirs. And their mission is driven by four
main goals. Let's break those down. What are
they actually trying to achieve day to day? So
the first goal is all about data gathering and
sharing. They research and publicly share information
about how people are accessing the two medications
used for abortions, mifepristone and misoprostol
in the U .S. And to give a very quick baseline
here, these two medications are used in tandem
as a regimen to end an early pregnancy. Exactly.
So Plan C's goal is to gather domestic and global
evidence about the safety and efficacy of accessing
these pills, especially outside of traditional
clinic settings. So they aren't just an advocacy
group making noise. They are actually functioning
like a data gathering research hub. That's a
great way to put it. They're heavily data driven.
And building on that data, their second goal
is connection. They actively collaborate with
reproductive health organizations and technology
innovators. To build bridges, essentially. Right.
Connecting individuals directly to the telehealth
providers or services that actually facilitate
medication abortion. Then the third goal moves
into the cultural space, which is advocacy. They
actively push for the destigmatization of self
-managed abortion, and they advocate for over
-the -counter access. And the fourth goal? Disruption.
They want to dismantle what they view as unjust
barriers to medical abortion access with the
ultimate objective of putting agency back in
the hands of individuals. It's a highly structured
four -part strategy, but the fascinating part
is how they actually execute this. Because the
main tool they built to achieve these goals is
something called the Plan C Guide. Yes. Think
of this guide like a highly specialized geotargeted
search engine. Or maybe a super robust medical
directory, almost like a Yelp for telehealth.
It provides detailed state -specific information
so a user can understand their exact logistical
options based on the specific state they live
in. And the level of categorization within this
guide really highlights how complex the current
medical landscape is. They've had to map out
an incredibly fragmented system. Let's run through
the categories they've built into this directory
because it really paints a picture. First, you
have U .S.-based telehealth clinics that mail
pills. That's your standard domestic virtual
doctor's office. Right. Next, they list international
online clinics. These are international providers
that ship medications directly into the United
States operating across borders. Then there's
a category called websites that sell pills. And
those are sites offering the pills by mail without
a prescription. They often market themselves
as online pharmacies, and Plan C's guide actively
tracks their pricing and their shipping reliability.
What's fascinating here is how this guide takes
highly decentralized and honestly very confusing
medical and legal information and wrestles it
into a centralized, usable hub. What's fascinating
here is that they don't stop at just listing
where to buy pills. The guide also tracks community
networks that mail pills. Wow. So like grassroots
operations. Exactly. These are peer -to -peer
community -based support networks where everyday
people help discreetly route medication to those
who need it. They also include in -person clinics
for local care. And crucially, they have an entire
section dedicated to legal and safety guidance.
Which has to be incredibly important for the
user, given the shifting laws. understand potential
legal risks and digital privacy considerations
when searching for this kind of care online.
Right. Because the logistics of getting a package
in the mail is only half the battle. Understanding
the legal landscape of your specific zip code
is the other half. And they also integrate direct
support resources right into the directory. Like
hotlines. Yeah. They provide contact information
for a live phone and tech support hotlines, specifically
the M plus A hotline and IAC Contigo, which offer
confidential medical and emotional assistance.
So it's a living, breathing document of access.
But to really understand how a digital directory
of this magnitude came to be, we have to look
at the timeline. And the roots of this project
actually go all the way back to the 1990s. The
background context is vital here. Two of the
founders, Elisa Wells and Francine Coetho, didn't
just wake up in 2015 and decide to map out internet
pharmacies. No. Back in the 90s, they were heavily
involved in the massive effort to get Plan B,
the morning after pill, approved by the FDA for
over -the -counter sale. Which means they already
had decades of experience navigating the intersection
of medication logistics, FDA regulations, and
public access campaigns before the idea. for
Plan C even existed. They knew exactly how regulatory
frameworks operate. So when they officially launched
the Plan C website in 2016, they approached it
with a very rigorous, almost academic mindset.
They didn't just throw up a list of hyperlinks
and call it a day. They began with strict quality
control. This might be one of the wildest details
in the research. Imagine being these founders
in 2016. You're basically acting as rogue quality
control agents. They started identifying these
random websites that called themselves online
pharmacies and claimed to sell abortion pills.
Right. And instead of just trusting the marketing,
the founders actually ordered the pills through
the mail themselves. They used their own credit
cards, waited for the packages to arrive from
these unverified sites, and then evaluated what
actually showed up in their mailboxes. They were
testing it firsthand. Yes. Were the pills real?
Did they arrive on time? Was there any hidden
tracking? It was essentially a consumer protection
initiative for a very specific high stakes type
of medication. They took all that data and published
their findings in something they called the Plan
C report card. It was a way to verify the digital
supply chain for the public. Which is brilliant
because anyone looking for this kind of care
online is incredibly vulnerable to scams. And
that intense focus on verification leads perfectly
into what happened in 2018. They took that same
rigorous approach and applied it to formal academia.
In 2018, Plan C played a significant role in
the launch of a major academic study called the
CHAT study, which stands for California Home
Abortion by Telehealth. This was a rigorous study
conducted by researchers at the University of
California, San Francisco. Why was an academic
study so critical for a directory website? Because
up until that point, telehealth for this specific
procedure was largely viewed as an edge case
or a theoretical alternative. The UCSF researchers
wanted to gain a deep, documented understanding
of the experiences of individuals utilizing virtual
clinics across the United States. To see if it
actually works safely at scale. Exactly. Plan
C's involvement was crucial because it wasn't
just about normalizing telehealth. It was about
generating hard data on its effectiveness and
safety. It was about validating telehealth as
a genuinely viable, medically sound option through
rigorous, peer -reviewed academic study. They
were building a fortress of tested data and academic
validation. And you can see the results of that
foundation by 2019. The scale of what they were
building was starting to become undeniable. By
2019, the Plan C website was receiving over 50
,000 visitors every single month. That's huge.
With traffic coming from all 50 states. That
is a massive number for a highly specialized
medical directory. And it's an incredibly important
data point when we look at the timeline. It proves
that a massive nationwide demand for this specific
digital resource already existed before the huge
global and national disruptions that we're about
to hit. People across the entire country were
actively searching for ways to bypass traditional...
clinics and get these pills by mail. And speaking
of those disruptions, here's where it gets really
interesting, because you have this steady, organized
buildup, and then April 2020 hits, the onset
of the COVID -19 pandemic. Everything changed
overnight. The pandemic was the ultimate stress
test for the entire global health care system,
but especially for telehealth. It forced an immediate,
dramatic shift in how medicine was delivered
across the board. Almost immediately. The medical
community had to expedite the adoption of no
-test protocols. To put that simply, it meant
doctors could prescribe certain medications virtually
without requiring patients to come into a physical
clinic for prior ultrasounds or blood work. It
removed the physical barrier to entry. Completely.
This spurred the creation of new telehealth startups
and allowed existing clinics to suddenly serve
patients entirely online. And remember the context
of early 2020. You had the majority of the country
living under safer -at -home orders, severely
restricting access to basic medical care. In
some states, abortions were deemed non -essential
medicine during the lockdowns. Right. So in response
to that unprecedented public health crisis, the
FDA temporarily lifted its longstanding restrictions
on shipping Mifepristone through the mail. That
temporary lifting of the shipping restriction
was like opening a floodgate. And Plan C didn't
just sit back and watch. During this specific
window, they actively issued a call to providers.
They broadcasted to the medical community that
there was a massive, growing need, a new legal
window, and an opportunity to serve patients
through telehealth. They leveraged their position
as a central hub to essentially recruit doctors
and entrepreneurs into the space. And it worked.
This call to action led directly to several new
providers launching startups. If we connect this
to the bigger picture, the pandemic accelerated
the infrastructure of telehealth by a decade
in the span of a few months. But that rapid expansion
was really just a warm -up. The ultimate test
of that new infrastructure, the crisis they had
unwittingly been preparing for, came a couple
of years later, moving into 2022 and 2023. The
2022 Dobbs v. Jackson decision, which officially
overturned Roe v. Wade. With that Supreme Court
ruling, the legal landscape in the United States
fractured entirely. Access to abortion was no
longer federally protected, and individual states
immediately began implementing widely different
laws, bans, and restrictions. Plan C suddenly
had to adapt its directory to a reality where
the map was constantly changing. And they responded
by expanding their directory to heavily feature
a concept called advanced provision. This is
such a fascinating logistical workaround. Advanced
provision basically means ordering the pills
before you even need them, just in case. It's
a risk mitigation strategy. It creates the option
for someone to consult with a provider and order
the medication in advance so it is already sitting
safely in their medicine cabinet if a need arises
in the future. Completely bypassing the panic
of navigating a sudden legal or logistical hurdle.
Exactly. The Plan C website immediately began
listing specific organizations that had the capacity
to offer this advanced service. They highlighted
providers like Aid Access, Carafum, Women on
Web, and the Massachusetts Medication Abortion
Access Project. And as we moved into 2023, they
vastly increased the resources available on their
site to help people understand the safety and
mechanics of managing this process at home. They
evolved from mapping the landscape to actively
helping users preemptively navigate it. But while
the legal and logistical adaptations are incredible,
there is another impact they had that is almost
entirely unexpected. As we look at the data from
2024, we see a completely different kind of consequence,
an economic consequence. This part blew my mind.
Because the Plan C guide became the premier go
-to resource for anyone searching for this information,
it inadvertently created a hyper -competitive
free market. Providers naturally wanted to be
listed at the very top of Plan C's directory.
It's the basic principle of market competition
and digital visibility. But it's playing out
within the framework of a nonprofit health directory.
Because providers were competing to rank in those
first few results, they had to incentivize users.
And the primary way to do that was by lowering
their prices. Digital visibility single -handedly
forced free market price corrections in a healthcare
sector. Let me give you the exact numbers because
they are staggering. By 2024, because of this
intense competition on the directory, The cost
for abortion pills by mail without a clinician
consultation dropped between $25 and $28. Wow.
And if you wanted the pills by mail with a telehealth
consultation from a U .S.-based clinician, the
average cost fell to $150. Which is already a
significant reduction compared to traditional
in -clinic costs. But wait, it gets crazier.
The lowest -cost telehealth provider on the directory
began offering their service across all 50 states
for a minimum payment of just $5. $5. That is
a profound shift in healthcare economics. It
completely redefines accessibility. It highlights
how a centralized digital ecosystem, simply having
a trusted website that aggregates and ranks options,
can directly and drastically slash the out -of
-pocket costs for a patient in the physical world.
It's a wild example of how digital structures
can manipulate physical markets. And clearly,
this level of rapid adaptation, the sheer scale
of the operation, and the dramatic impact on
the healthcare market caught the attention of
the wider culture. It did. The efforts of the
organization actually became the subject of a
feature -length documentary film, appropriately
titled Plan C. It was directed by Tracy Drozd
-Tragos and premiered at the 2023 Sundance Film
Festival. The documentary really focuses on the
human element. The grassroots efforts to expand
this access via the Internet and the mail, while
the legal ground was shifting beneath their feet.
But the cultural footprint didn't stop at film
festivals. In 2024, the film and the campaign
actually won a Webby Award. And a Webby Award
specifically honors excellence on the Internet.
Exactly. They won it for their creative use of
social media for advocacy. Which is so fitting
when you think about it. It proves they aren't
just a static medical directory sitting on a
server somewhere. It synthesizes everything we've
been discussing. Plan C operates on multiple
overlapping levels. Yes, it's a medical directory.
Yes, it's a research hub that partners with academic
institutions. But it's also a highly active cultural
and media campaign. Utilizing every channel.
They use every digital tool available to them,
from SEO rankings that drive down market prices,
to documentary filmmaking, to social media algorithms,
all to... further their stated goals and reach
the public. So what does this all mean? When
we look back at the journey of this organization,
we see the incredible evolution of a single website.
It started with founders who took their 1990s
experience with Plan B and applied it to the
internet age. They launched a site to literally
act as secret shoppers, testing and grading sketchy
online pharmacies. Then they partnered with major
universities to academically validate telehealth.
Right. They took the terrifying stress test of
the 2020 pandemic and used the regulatory shifts
to encourage a whole new ways of medical startups.
They adapted to the massive earthquake of the
post -Roe legal landscape by promoting advanced
provision and through sheer organized market
competition on their platform. It is a remarkable
trajectory. They transformed from a simple information
portal into a major central node in a highly
complex international network. They managed to
connect international supply chains, peer -to
-peer community networks, and domestic telehealth
into one streamlined user experience. All while
navigating some of the most profound legal and
global health shifts of the 21st century. And
for you, the listener, the value of understanding
this story is immense. Whether you are studying
supply chain logistics, legal frameworks, or
internet culture, this is a real -world, highly
documented example of how digital networks adapt
in real time to physical and systemic changes.
It shows that when physical avenues close, Digital
information finds a way to reroute and rebuild
the infrastructure. It certainly does. And it
leaves us with a lot to think about regarding
the future of medicine, technology, and governance.
This raises an important question, one that builds
on everything we've explored today. Let's hear
it. We've seen how a decentralized network of
telehealth platforms, international mail services,
and community peer -to -peer support can successfully
create an alternative infrastructure for abortion
access. So how might these exact same digital
and postal workarounds be applied to other restricted
or highly regulated areas of medicine in the
future? When physical geographic borders clash
with the completely borderless nature of digital
information, which one ultimately dictates the
future of human health care? That is a brilliant
and heavy question to end on. Definitely something
for you to mull over as you go about your day.
Thank you so much for joining us on this deep
dive. We hope it gave you some valuable insights
and new perspectives on how information networks
operate. Keep questioning, keep exploring, and
most importantly, stay curious.