Note: This originally published on ThinkProgress.
A website run by Netherlands-based group Women Help Women is stepping up to fill the void in U.S. abortion access by counseling women on how to self-manage medical abortions — and, in the process, shining a spotlight on the legal dangers facing pregnant people who choose to self-induce.
Although a cursory Google search yields millions of hits on how to use the abortion pill, Women Help Women’s site is distinct in that it connects users to a trained counselor who provides instructions and advice in real time. The advocacy group does not provide abortion pills to the United States for legal reasons, but walks women through the process if they have obtained the medication without a prescription.
“In the U.S., abortion is legal in every state, and every state has at least one clinic that provides abortion care,” the website reads. “However, in many states the law requires that abortion pills be given by licensed health care clinicians, and a woman may be arrested for using abortion pills that were not obtained through a clinician.”
Indeed, although mifepristone has been approved for early non-surgical abortions since 2000, a majority of states have enacted restrictions targeting its distribution, making it difficult for women to legally access medical abortion.
According to the Guttmacher Institute, 37 states require a licensed physician to provide medication-induced abortions (rather than mid-level providers like physicians assistants, which the World Health Organization recommends). Eighteen states require that a clinician be physically present during the procedure, thereby prohibiting the use of telemedicine, a particularly helpful resource for women in rural areas. And even after the Food and Drug Administration updated its labeling protocol for mifepristone in 2016, increasing its eligibility of use from 49 days’ gestation to 70 days’, three states — North Dakota, Ohio and Texas — refuse to comply, instead adhering to the outdated protocol.
“Regulation of medical abortion, like any medical regulation, should be based on sound science, and with the health and well being of women as the first priority,” said David Brown, Senior Staff Attorney at the Center for Reproductive Rights. “Unfortunately, that’s just not the case in much of the country, where politicians prefer to play games with women’s lives.”
The idea for Women Help Women’s service, called SASS (Self-Managed Abortion; Safe and Supported), emerged after Donald Trump was elected president. “In November, we were quite alarmed, as many people were, at the new administration and we quickly realized that it was a unique threat to the reproductive rights to the women in this country,” the group’s U.S. spokeswoman, Susan Yanow, told CBS News.
Yanow is right. While the Trump administration didn’t invent anti-choice ideology or policies, it is unapologetically laying the groundwork for an unprecedented attack on reproductive rights and the women who seek abortion care. And although anti-choice legislators have historically focused on restricting surgical abortion, medical abortion is very much in their crosshairs, too.
“While people in the U.S. have been self-inducing abortion with pills safely, effectively and privately, they do so under the looming threat of arrest and prosecution, or detention and deportation,” said Jill Adams, Chief Strategist at the Self-Induced Abortion (SIA) Legal Team at Berkeley Law. “Not because self-induced abortion is per se illegal, but because rogue prosecutors have been manipulating and misapplying laws in a modern day witch-hunt.”
According to the SIA Legal Team, there are 17 known arrests or convictions in connection with self-induced abortion. “This threat looms most heavily over communities of color, immigrants, and people living in poverty who already face some of the highest obstacles to reproductive healthcare access and over policing of their communities,” said Adams.
Women should never have to choose between accessing safe health care and their freedom. With Women Help Women’s SASS project, they don’t have to. The site prioritizes women’s privacy, enabling them to log into a portal and send secure messages without detection. It’s the ultimate form of clandestine activism.
That such information sharing must be kept secret is an indictment of the politicization and, in some cases, criminalization of women’s health care — and a critical area of concern for reproductive rights activists. Without the proper knowledge of state laws or even of how abortion works, women are less likely to take advantage of the options available to them.
“The flurry of headlines people see about attempts to restrict abortion at the state and federal levels create confusion. And sadly, sometimes people don’t even know if abortion is legal in their state,” said Kelly Baden, Director of State Advocacy at the Center for Reproductive Rights. “Expanding the availability of abortion is critical for us all, and that includes making sure people know about and understand how medication abortion works…We need more education and information about abortion options and sexual and reproductive health in this country, not less.”
Adams agrees. “There is a fundamental right to seek and relay information that supports health and safety.”
Just as there is a constitutionally protected right to seek abortion care — for now.