The story of the Dutch doctor who sends abortion pills to women around the world

Rebecca Gomperts, a 55-year-old doctor from the Netherlands, has spent years fighting for women’s access to abortion around the world.

Famous for her “abortion boat,” as recounted in the 2014 documentary, vesselshe and her group -Women on Waves- have anchored their ship in international waters off the coasts of Poland, Spain, Mexico and other countries, offering the abortion procedure to women who otherwise could not obtain it.

But it is in the United States that interest has increased in his other organization Aid Access, which since 2018 has been providing abortion pills online.

Behind the rapid rise in demand is what appears — based on a rare leak of a Supreme Court document — to be the imminent end of federal protection of abortion rights. Once the Court officially rules, perhaps next month, some 20 states in the United States are prepared to ban or severely restrict this procedure.

“We are already seeing a sharp increase in applications,” Gomperts told AFP, adding that some people are “in a panic”. “It’s not just about when this happens, it’s already made people realize how vulnerable they are,” he said.

Austria-based Aid Access has been working with doctors to fill requests from some 20 US states where abortion pills can be legally prescribed via telemedicine.

For other states, Gomperts’ group is using a loophole in the law to ship the pills from abroad. Demand was already high, even before the Supreme Court’s intent was leaked. In just over a year (from October 2020 to December 2021), Aid Access claims to have received more than 45,000 orders from the United States.

Among the reasons for this volume of requests are the high costs for these services, the cost and difficulty of traveling long distances to abortion clinics, or the impossibility of doing so due to work or child care.

After completing a questionnaire, the women receive instructions on how to take the pills. The price is adjusted according to your ability to pay and the pills are shipped to you from a pharmacy in India. Aid Access then contacts the women.

the most vulnerable

The pills are easy to find on the Internet elsewhere, usually for a few hundred dollars. But these sites, also based outside the United States, do not provide medical advice.

For Gomperts, who in 2020 was included in the list of the 100 most influential people in the world by the magazine Timethe fight for abortion rights is a matter of “social justice”.

“The biggest problem is that women who are not literate … and who do not have access to the internet – the most impoverished group – will not be able to find these solutions,” says Gomperts. Many of them may not have the resources to travel to a state where abortion is still legal.

“These are the women who may be forced to give birth or who may take drastic measures to end their pregnancy”, he added. The most certain result, says Gomperts, will be an increase in the mortality and vulnerability of women.

A method rated as safe

According to a 2017 survey of several thousand women in the United States, 20% of those who attempted an abortion at home used pills, 29% used other drugs, 38% used herbal teas, and 20% tried physical methods (some used more than one method, so the total exceeds 100%).

During the recent protests in front of the Supreme Court, several women showed a disturbing object, something similar to an artifact from another era: a metal clothes hanger – a symbol of highly risky abortions carried out clandestinely.

According to experts, until the tenth week of gestation, the pills would be safe. Today, this method accounts for half of all abortions in the United States (for comparison, in France, the figure is 70%). And its use outside any medical setting is a “highly acceptable” option, according to the World Health Organization (WHO).

The pills use active components that first block the female hormones that support the gestation process and, 24 to 48 hours later, a second component induces contractions.

However, there can be some rare complications such as excessive blood flow, infections or allergic reactions, and beyond the medical aspect the additional risk of home abortions is legal complications.

The NGO If/When/How has counted 60 cases in the United States in which women who allegedly performed self-abortions, or people who assisted them, were arrested, charged or sentenced between 2000 and 2020.

The group, which claims to envision “a future where all people can determine their reproductive lives free from discrimination, coercion or violence,” helps these women seek legal representation.

It is feared that the trend towards the criminalization of abortion will worsen if the Supreme Court rules as expected. Such a ruling, says Gomperts, “instills fear in people, and especially in health service providers, and that is the biggest impact.”

*With information from AFP.