Brent Monseur, MD, ScM Explores the Dark Web for Illegal Family Planning Marketplaces

Most people browse the internet every day without ever encountering the dark web, a.k.a. the digital underground. But as push comes to shove, more may be using it to buy and sell family planning medications due to increasing legal restrictions.

If you haven’t heard of the dark web, here’s a primer: Over 5 billion people around the world access the internet to complete work functions, email, stream videos, and more. In order to do that, web browsers, such as Safari and Google Chrome, connect to a network of computers that relay information housed on servers, physical data storage units, to the user. The dark web like the internet also uses a network of computers but in order to access its content, the user must have a specific encryption key or a specific browser. Users of the dark web are more likely to be conducting business or services that are illegal.

Brent Monseur, MD, ScM
REI Fellow

With new and ever-increasing restrictions on abortion, Dr. Brent Monseur, a third-year Reproductive Endocrinology and Infertility Fellow, was curious to know if these illicit businesses are selling medications such as mifepristone and misoprostol as well as birth control pills through the dark web. It’s a project that received the 2022 Ted Adams Scholarship Award at the annual Pacific Coast Obstetrical and Gynecological Society Annual Meeting. Well-deserved as Monseur’s study is the first of its kind to examine family planning medications on the dark web.

Using a historic database from 2011-2015, the team found that there were several marketplaces — 25 listings in total — that offered birth control pills as well as mifepristone and misoprostol.

Monseur hypothesizes that as a result of stigma, limited access, and increasingly restrictive legislation, patients will increasingly use illegal means of obtaining family planning medications despite significant risks of using drugs without a prescription (e.g., counterfeit, contamination, and presence of untested substances). The study team is working on collecting updated data given the new post-Roe legal landscape we currently find ourselves in.


Patients should refrain from purchasing medications on the dark web due to significant public health issues.

Knowing that there is the potential for patients to seek these medications on the dark web, doctors should counsel patients on the dangers of this practice and be prepared to provide referrals when they are not able or unwilling to provide comprehensive family planning services due to conscientious objection or local legal restrictions.

Monseur shares, “Patients should refrain from purchasing medications on the dark web due to significant public health issues (e.g., drug misuse and abuse) as well as serious health consequences including death due to substandard or falsified medical products.” His team has replicated the study using a database of fertility medications — the results of which will be shared as an oral presentation this fall at the American Society for Reproductive Medicine’s annual meeting.