Website Aims To Help Women Self Induce Abortions At Home Using Medication

We do know from research that has been done in Texas that there are women showing up [at hospitals and clinics] who said they tried and failed [to use misoprostol to induce an abortion]. Given that if one uses misoprostol alone exactly according to the WHO protocols, it’s 80 to 85 percent effective, we can assume either those women didn’t use it correctly or they’re in that 15 to 20 percent. That means 80 percent [of women who are self-inducing using misoprostol alone] aren’t showing up at the clinics. The goal of this project is not to drive women away from the clinics, it’s to support women who have already made a decision not to go to a clinic.

Are you concerned at all, working in such a polarized political environment on an issue that is so controversial, that something could go wrong?

The something that could go wrong could be medical, it could be legal, it could be related to security. Let me start with the medical. One always worries about that tiny, tiny percentage of women who are going to have a complication. One worries if you’re a clinic, one worries about the women who are already doing this, and of course Women Help Women worries about the women who get information from Women Help Women. But it reduces that risk if the woman is more informed. Women Help Women conceives of this as a human rights project. But one could also look at it as a harm-reduction program. Take needle-exchange programs - even with a needle exchange, there could be a bad outcome, but it certainly reduces the risk of infection. Abortion pills are safer that Viagra and they’re safer than penicillin. Of course we know that with any medication and any medical procedure, there’s a small risk of a bad outcome. But since abortion pills have such a demonstrated record of safety, we hope this helps women get medical care if they need it.

What could go wrong legally, well, there could be more arrests, whether a woman accesses this project or does it on her own. Our hope is if a woman truly understands that an abortion with pills is like a miscarriage, she’s less likely to say something that puts her at legal risk.

For security, when it comes to hacking the website, this site is not hosted in the U.S. There is a security team that is very confident in the security protocols that have been taken. We know from what has happened to Planned Parenthood and the cyber security attacks, we know what abortion opponents are capable of, but we can’t let that knowledge of their capacity for sabotage stop this project from going forward.

How confident can women be that their identities will be protected?

Women will not be asked for identifying information except for a first name or nickname. They will be asked, “Have you confirmed the pregnancy and if so, how?” They will be asked, “How many weeks pregnant are you?” and linked to a pregnancy calculator that helps calculate the last menstrual period. They will be asked, “What state do you live in?” And that’s it. If a woman writes in a second time, we will have the information that has been shared with her, but even in the extremely unlikely event someone gets their hands on it, it would say something like, “Jill, confirmed pregnancy via pregnancy test, New York.” And people may not even give their accurate name. It’s just so we have a way to keep their thread and identify them for the purpose of giving them full information on a second response.

If a woman calls you and asks for help procuring abortion-inducing pills, what happens?

There will be information on the webpage that says how women have gotten the medicines in the past. And that information is gathered from news stories of women who have been arrested and from some of the research that’s been published. But women will not be directed to a specific site to buy misoprostol because, to be honest, there isn’t one that is trustworthy.

Do you see this as a stopgap measure in response to the past decade’s barrage of abortion restrictions? Or is this part of the future of abortion rights?

It is not a stopgap measure. All over the world, women are using these medicines. The recent WHO study on maternal mortality on unsafe abortion noted that there have been increases in maternal mortality from unsafe abortion due to population expansion all over the world except in one place, and that was Latin America. In Latin America, misoprostol is over the counter.

If we truly believe in women’s self-determination, they should also have a choice in how. I think of it like the birth movement. Women should have the choice in having a birth in a hospital or at home with a midwife. They should certainly have the choice of whether to have a vaginal or a cesarean delivery. So why shouldn’t they have a range of choices for how to end an unwanted pregnancy as long as they have the information and it’s safe? This is a response to a more hostile climate, but we hope it will be part of building a vision for what abortion care could be. It isn’t the wave of the future. It’s already here.

Who are the people answering women’s inquiries about self-managing their own abortions?

Women Help Women has 23 staff based on four continents outside of the U.S who currently answer emails in six languages. Some of them have psychology and social work degrees; the majority do not, but they have been doing this for between two and nine years. Most of the people who are the counselors previously worked for Women on Web [an organization that helps women obtain and use misoprostol]. There are two physicians who are available pretty much around the clock if there’s a situation the counselor is unsure of with medication. But the Women Help Women staff is extremely well trained on giving information, not advice, and having a very deep knowledge of abortion, both misoprostol alone and the misoprostol/mifepristone regimen. Many of them have started abortion hotlines and have trained others.

Anything else women should know about this new site?

The overarching value here is that this project was initiated because of a deeply held belief that when anyone decides to end a pregnancy, they should be able to do it safely, effectively, without stigma, and with dignity. So I just want to make sure that anyone reading this understands that this is not about desperate women and second-class care. It’s about supporting women wherever they choose and however they choose to end an unwanted pregnancy.

This interview has been edited for length.

Follow Jill on Twitter.

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