Every year there are an estimated 22 million unsafe abortions resulting in some 47,000 women dying and another 5 million women suffering from disabilities, according to the World Health Organization (WHO). One of the factors that could help prevent these deaths and disabilities is “legal induced abortion and care for complications of abortion,” says the WHO. But in many countries restrictive laws force women to turn to unsafe methods to end their pregnancies.
Launched 10 years ago by Dutch physician and activist Rebecca Gomperts, the Women on Web project based in the Netherlands tries to help women around the world access safe abortion services by sharing information, giving counseling and – in places where it’s needed and possible – sending the medical abortion drugs misoprostol and mifepristone through the mail for women to use at home.
Before they can use the telemedical service, women have to fill in an online consultation form, and anyone with an unwanted pregnancy of up to nine weeks is referred to a doctor who checks to see they meet a set of clinical criteria. (The WHO recognizes the safety of medical abortion up to 12 weeks of gestation.) For a donation of 70–90 euros ($78–100), a doctor provides a prescription and the abortion medication is dispatched by a partner organization. If a woman can’t afford the donation, the pills are sent to her for free. Then real-time instruction and follow-up are conducted through email by a multilingual, specially trained helpdesk team.
Women on Web reports that more than 200,000 women have done the online consultation, with approximately 50,000 women receiving a medical abortion at home. Since its launch, Women on Web’s helpdesk has answered more than 600,000 emails from women looking for advice and information on their reproductive health.
Anti-abortion campaigners have condemned the organization, calling it neocolonial. But Gomperts says it’s meeting a demand from women around the world for information and safe abortion who cannot find help anywhere else.
Women & Girls Hub: Where did the inspiration for Women on Web come from?
Rebecca Gomperts: Women on Web was really created in response to requests. Fifteen years ago, we started another organization called Women on Waves, which outfitted a ship to go to countries where abortion is illegal to take women aboard and provide abortions in international waters. Those trips got so much attention and so much media coverage that we started receiving many emails from women all around the world asking us when the ship was going to be near their country. We decided that we have to find a way to help these women. At that time, we were only providing abortion pills or medical abortions aboard the ship. We thought, well, it’s a pill; it should be possible to mail it. That is how we started researching the possibility for Women on Web as a general medical service.
Women & Girls Hub: What challenges do you face in getting medical abortion pills to women?
Gomperts: We work with a pharmacy that is making the medicines. Women on Web acts more like the connection. We have the doctors that provide prescriptions and help women in 14 different languages now.
Actually, mailing medicines is only a small part of the work. Many women around the world are emailing us with all kinds of questions. Sometimes women have been able to locally find misoprostol, which is the medicine that can be used to induce an abortion by itself. Sometimes the questions are about anything that has to do with sex or fear of pregnancy. Sometimes women email us who are actually living in countries where abortions should be legal and accessible but they don’t know how to get the information.
What we try to do is to make sure that all women get the information that is most appropriate to their situation and respond best to their needs, their questions. Sometimes there are women who cannot access the medicine that is needed, and we ask our partner pharmacy to send it to them by mail. In the 10 years since we’ve existed, we have faced a lot of hurdles and obstacles. One of the most distressing for everybody is when customs in some of the countries are stopping the packages with the medicines, which is currently happening, especially in Brazil, Ireland and the Philippines [all countries where abortion is banned].
What we see is that even in a country like the Netherlands, they are still putting obstacles in the way of women to access the medicine – which is not based on any scientific evidence, just politics and religion.
Women & Girls Hub: Some critics argue that Women on Web is encouraging women to break the law. How do you respond to that?
Gomperts: We are encouraging women to claim their human right among others to healthcare and access to essential medicines. Human rights agreements always overrule outdated local criminal codes.
Women & Girls Hub: You mentioned Brazil as one of the countries where you face difficulties, but the Zika virus epidemic appears to have raised concerns about women being pregnant. How does Zika affect the situation?
Gomperts: There are many women who are extremely anxious about Zika in that region. We see that in the health requests that we get.
What it did for the women’s organizations in the region is to show again that the responses of the governments to such a crisis are not adequate. By restricting access to abortions, it is women who are suffering, especially poor women, because in every country where abortion is restricted, women who have the financial means or come from families with good connections, they will always be able to afford a doctor who will help them or they travel abroad.
Women & Girls Hub: Does Zika present an opportunity for Brazil to change its position on abortion?
Gomperts: In Brazil, women’s groups have launched a court case against the Brazilian government arguing that it’s really a violation of women’s right to health that even in cases where they have Zika they cannot access abortion services. If that case is heard, and if the court recognizes the human rights violations that are taking place with the current policy of restricting access to abortion, it could be a turning point. It will depend on the decision of the courts, but I’m not hopeful that politicians by themselves in that region are going to implement any policy change that might benefit women.