For years, an organization called Women on Web has given women a way to perform their own medication-induced abortions at home. The organization would, remotely, do online consultations, fill prescriptions, and ship the pills that trigger miscarriages to women who live in countries where abortion is illegal. Several studies have shown that the service is safe.
For American women who’ve wanted pills, though, there’s been one major problem: Women on Web wouldn’t ship to the United States. American women could (and have) instead searched online for abortion pills, but some of the medicines and pharmacies they found were less than reliable. But now, the Women on Web’s founder, a doctor named Rebecca Gomperts, has launched a new service that she says is just as safe as Women on Web, and it does ship to the United States. The cost is $95, but the website says it will try to help women who can’t pay.
Just like Women on Web, the new service, Aid Access, will screen women’s eligibility to take the pills—they should not be more than nine weeks pregnant—through an online process. (If the pills are taken later, they are less likely to work.) Gomperts will herself fill each woman’s prescription for misoprostol and mifepristone, which together are about 97 percent effective in causing an abortion within the first trimester and already account for a third of all abortions in the U.S. She then sends the prescriptions to an Indian pharmacy that she trusts, which ships the pills to women at her homes in the U.S.
The pills come with instructions, and if women have questions, Gomperts says they can Skype with her or call her help desk. Pro-life groups say these pills are not safe, but Daniel Grossman, a professor of obstetrics and gynecology at the University of California, San Francisco, has told me that “it doesn’t appear that women are having serious complications” from self-inducing their own abortions using pills. However, if women using these regimens do experience heavy bleeding or some other complication—as about 3 percent of women have–they are generally advised to go to a hospital and say they had a miscarriage.
Women on Web has never worked with American women because Gomperts worried that the American pro-life movement would try to close the organization down. (I’ve reached out to Americans United for Life for comment and will update this piece if they respond.) In an interview, she told me she still has the same fears, but she was being inundated with requests from women in countries like the U.S., where abortion is technically legal, but growing more difficult to access. “I got an email from a woman who was living in a car with two kids,” she told me. “Something had to be done.”
She launched Aid Access as a separate service in order to mitigate the risk to Women on Web, and she claims that every step of the Aid Access process is legal. (According to Gomperts, the FDA allows people to import medicines for their personal use.) Gomperts launched the service six months ago but has kept it quiet until now. She estimates she has already sent the pills to 600 women.
A new Guttmacher Institute report on self-managed abortion notes that what Gomperts is providing is recognized as an acceptable option by the World Health Organization:
A person’s ability to self-administer mifepristone and misoprostol after receiving instructions from a provider is well established, and there is evidence that it is safe and effective for someone to do so without the direct supervision of a provider. WHO recommends this option if the individual has “a source of accurate information and access to a health-care provider should they need or want it at any stage of the process.”
I asked Gomperts if she worries that, in becoming the only abortion doctor for large swathes of America by providing abortion pills, she might become overwhelmed with requests. “I have no idea,” she stammered. “I really don’t know. That’s probably something that, in principle … I don’t know. I wish I had a better answer to that.”
Finally, she said, “I hope I will be the first of many others, so I won’t be in a situation where I can’t deal with the amount of requests.”
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