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DIY Abortion: Coathangers of the Digital Age?

Lauren

Women in areas where abortion is illegal or near-illegal are resorting to the internet to buy medication that allows them to terminate their pregnancies at home. Most of the women indicated in the article report they were “grateful” or found it “stressful but acceptable” that they were able to get medical abortions by this route, although about 11% needed surgical procedures after taking the medication because of incomplete abortion or excessive bleeding. Anti-abortion activists express regret that these women no longer need to walk through picket lines or die in cheap motel rooms to suffer properly for their sins, but methinks the ethics of the issue may be easily resolved by removing arbitrary restrictions against the procedure that force women to break the law in order to control the rate and frequency at which their bodies spawn. As long as pregnancy exists, so abortion shall exist.

Much of this article reads like moralistic hand-wringing, but I’m concerned that the cycle of drugs that takes several days to complete is handed out to self-reporting individuals, most of whom have little to no medical experience.

I can’t attest to the risk-levels of this kind of DIY reproductive health, but I imagine that it’s as harmful as being able to order vanity drugs or painkillers online. Thoughts?

20 thoughts on DIY Abortion: Coathangers of the Digital Age?

  1. I have to say I’m honestly not concerned with the number of women who needed surgery post-medical abortion. I don’t know the statistics off hand, but it is not at all uncommon for a miscarrying woman to need a D&C to finish the job, whether from excessive bleeding or an incomplete miscarriage. I’m sure that a sizeable percentage of people who have a medical abortion under doctor supervision still need a D&C, probably about as many as those who’ve miscarried naturally.

  2. I have to say that, sadly/disturbingly, my first reaction to the possibility of being able to by illegal, somewhat shady abortifacients online is “Whee! Another avenue of options outside of coathangers and ‘herbal remedies*’!”.

    And I’m a relatively-not-poor grad student in NY. Sweet jeebus.

    Is this what we’ve come to? Are we to the point where buying buying such things from random websites is actually a reasonable alternative?

    Please, please tell me that this reaction of mine is not reasonable, and that this is just my somewhat-desperate, under-employed, semi-supported by Medicaid side showing.

  3. Please, please tell me that this reaction of mine is not reasonable, and that this is just my somewhat-desperate, under-employed, semi-supported by Medicaid side showing.

    Can’t. I’m right there with you.

    On the general subject of medication, if it weren’t for online pharmacies I’d have more medical bills than I already do. That’s life without health insurance. At least this way I can keep some amoxicillin around for when I stop coughing up yellow stuff and start coughing up green stuff instead.

    It’s not a good situation and I’d be the first to admit it. On the other hand, if some well-meaning ass even hints that the solution here is to crack down on those evul online pharmacies and not, say, to push all the harder for universal health care, I’m going to get ugly.

  4. This is exactly the type of business I vowed to get into if abortion ever become outright illegal in the U.S. It is a pain in the ass to find, but you can make a donation to this group at http://www.womenonweb.org/article-240-en.html#bank. Sorry, without the nifty tools, I am incapable of hyperlinking. The minimum credit card donation is 70 euros (pretty damn steep if you ask me–credit card options for lesser amounts should be available) but I’m sure they will deposit your check in whatever amount you send them.

    It is appalling that such an organization is needed, but thank god (whichever one(s) you worship) for it.

  5. I think this website is making a good faith effort to provide women with all the info they need to have a safe medical abortion and in countries where abortion is illegal or heavily restricted, it is a good thing. This whole thread reminds me of the DIY abortion guides distributed by Jane and similar U.S. abortion rights groups in the days before Roe. While these methods, which included some “herbal remedies” that are not medically-approved, helped many women, they certainly weren’t as good as safe, legal abortion with the care of a licensed medical professional.

    That is exactly how I feel a out this website and service. I’m happy to see that Women on Web does promote the full legalization of abortion and tries, though I’m sure it’s imperfect, to regulate who can purchase RU-486 from their website to women in countries where abortion access is restricted that are in the first trimester. It is sad to me that this is the best we can do for women when safe, legal options are available.

  6. In many places, it’s common for this medication to be available for ‘at home’ abortions anyway, so as long as it’s being prescribed and distributed by a reputable medical organisation, I don’t really see the difference. Presumably the women are informed of the risks and side-effects involved, and of any warning signs that indicate they need to seek medical help.

    Of course it would be better to have the option of going to a doctor in person to discuss and ask questions, but for many women that’s unfortunately not possible. But as far as I can tell, this is not a ‘random website’ or anything ‘shady’, it’s a professional service where the drugs are prescribed by qualified doctors who are doing their best to help women in a very difficult situation. For those women it is absolutely a reasonable alternative.

  7. My understanding is that the primary advantage of drug-induced medical abortions is that it’s impossible for doctors (and thereby law enforcement) to distinguish a medical abortion from a spontaneous one. So if you do have complications, you can seek medical help without worrying that you’ll be arrested.

  8. I wrote about this last week over here . . . the short version is that I think it’s the best of bad options, the safest illegal abortion has ever been, and most likely the safest it’s going to get for some time.

  10. I’m really happy to read that this alternative exists and is available (or partly, as, e.g. how many women in Zimbabwe would be able to purchase something costing 70 euros via credit card on the internet? The exchange rate as well makes this rather unfeasible for MOST.) to women worldwide. At least the rich and not-so-rich can have access to it. It’s a start, I suppose. A fantastic start, if it’s helping any women at all. But perhaps costs should be lowered when providing the medication to women in the poorest countries — perhaps a line ought to be drawn somewhere. I really see this as problematic, charging 70 euros to every single woman who needs this drug, when women are the poorest class worldwide. I wonder if anyone from Yemen, Panama, Congo, etc. has ever been able to take advantage of Women on Web’s resource. If larger women’s rights organization’s are helping out, they really should be thinking of the added plight of poor women (who, for whatever reason, let’s say, managed to find access to the Internet and find this web site…). Otherwise, it’s only a privilege women in primarily first-world countries can “enjoy,” women who are mostly white and middle- or upper-class. This is a problem.

  11. @ April: well, sadly this is exactly the kind of thing that can cost “Larger women’s organizations” any access to funding that’s in any way linked to US funds, as far as I understand it.

    And I don’t think the net can provide any meaningful help to impoverished women. I think that’s something for local organizatons who can contact those women in teh real world.

    I agree with the other posters, if it’s the best we can do, we should by any means do it. But of course there’s no *real* solution outside safe, legal abortion for whoever needs it.

    I’m out of work at the moment and working to start my own business – I hereby vow to use my first 70€ of actual profit to pay someone her aborton. Link book marked and all 🙂

  12. Yes, most miscarriages, whether spontaneous or induced, should have a D&C to make sure everything is cleared out. While this isn’t the most ideal situation, I think this is a much safer alternative when abortion is illegal than coathangers. My main worry would be a generalized movement to criminalize any indication of miscarriage as evidence of such an attempt… *headdesk*

  13. I’m not sure how I feel about it, to be honest. A former friend of mine wasted time arguing with the guy she’d been having sex with, trying to get him to accept the pregnancy as real and his (she’s somewhat a chronic liar), thus missing the window for an abortion. So she resorted to buying an injection off the internet – which she told me was some sort of horse poison, in a dose enough to miscarry, but not enough to kill her. She asked about five different friends to inject her with it who refused, so she had to do it herself. She survived, but that definitely wasn’t the best line of action.

    On the one hand, I’d like to know how safe these drugs being available are, so I can agree with them being a viable alternative. On the other hand, I think it’s just sad that women have to go through their abortions without the support they could get from a good provider.

    Oh, and did anybody see the last line of the article?

    Josephine Quintavalle, from the group Comment on Reproductive Ethics, said: “This is very worrying indeed. It represents further trivialisation of the value of the unborn child.

    “It’s like taking abortion into the shadows. These drugs have side-effects and tragedies will increase.”

    ARGH!!!!!!!!

  14. Jha, there is nothing new or controversial about the drug itself, or its use at home – the difference is that the consultation (with a licensed doctor) and prescription take place over the Internet rather than at a doctor’s office or clinic. Nothing is entirely ‘safe’ or risk-free – including remaining pregnant – but mifepristone and misoprostol are considered to be a safe and appropriate method of terminating an early pregnancy.

    I agree it’s not ideal and would be better in many ways if the woman could go to her doctor in person, but this is hardly comparable with injecting yourself with horse drugs!

  15. There’s a short comment about it in the BBC article, but I’d like to reiterate that this is a really great, and important organization. Women on Web is part of the larger organization “Women on Waves,” and the overall mission of the organization is to make medical abortions accessible to women in countries where abortion rights are severely limited.

    The way Women on Web works is that you go to the website and tell them that you need an abortion. They then put you in contact with medical personnel in another country (but that speak your language) to do an over-the-phone (ideally) or over-email exam. (I’m pretty sure you only speak to doctors, but I don’t want to say that without knowing for sure, but it’s definitely doctors or nurses. Trained medical personnel.) If you are in the window to receive a medical abortion (ie abortion by orally ingested pills – a common abortion practice during the early periods of pregnancy even in countries where surgical abortions are legal, I don’t know the exact timetable), you are prescribed the medication and given instructions on how to take it and follow-up care, including the potential need to go to a hospital if there are complications.

    These aren’t some sort of top-secret, hush hush abortifacients that haven’t been medically tested. Depending on a woman’s specific circumstances, the prescribe some combination of Mifepristone (RU-486) and Misoprostol. These are the standard drugs given by doctors all over the world. The risks from the drugs are no different than if I were to walk into the Planned Parenthood I work at in Massachusetts and receive a medical abortion, the only increased risk is that you aren’t IN a hospital or doctor’s office, in case of complication. This, however, isn’t the fault of the women requesting the drugs or Women on Web, but rather a result of anti-abortion legislation worldwide.

    Women on Waves, the partner/mother organization is also REALLY cool, and I’d definitely recommend checking them out. They are based in Amsterdam, and I had the opportunity to sit down with the director this past fall. WoW owns a mobile abortion clinic (which was also designed as a piece of community artwork) encapsulated inside a shipping container. WoW rents a boat, puts the clinic/shipping box on the boat, and then they sail to a country that significantly limits or outlaws access to abortions. They come into port, and women who need abortions can board the ship. They then head back out into international waters to perform the abortions (only medical abortions, although the facility is equipped to perform surgical abortions), and return to port when they are done. The abortions are performed outside of the jurisdiction of the countries in question, but make abortions available to the women in said country.

    Their stop in Portugal a few years ago had overwhelming support from the citizens of Portugal, and was very influential in passing significantly more permissive abortion laws in 2006 or 2007 (I don’t recall off the top of my head when the law was passed, but I do believe it involved a referendum).

    It’s a legit, and important organization. I’d definitely encourage everyone to check out their website (http://www.womenonwaves.org). They also have a page where people can share their abortion stories and their photo (if they want). I think it’s a particularly good resource for people who have had abortions and are looking to hear about other women’s experiences – whatever they may have been.

  17. That Josephine Quintavalle misses the point completely, doesn’t she? The existence of the website doesn’t cause women to not want their pregnancies. The only women who have to use the service are those with an unwanted pregnancy and nowhere to turn. But of course she can’t demonize the women, because that would be insensitive. Instead of examining her position on reproductive rights, she concludes that the website is evidence of the “trivialisation of the value of the unborn child,” when it’s really indicative of the trivialization of what women need — safe and legal abortion on demand.

    As for the site itself, I don’t see anything wrong with it because it looks legit. But it makes me think about those sites that are secretly run by anti-choicers who try to pass off deadly concotions as herbal abortions. I just hope some crazy anti-choicers don’t create a similar looking website with a similar name and URL and send these women pills that will kill them.

  18. the short version is that I think it’s the best of bad options, the safest illegal abortion has ever been, and most likely the safest it’s going to get for some time.

    I agree with Cara, it is the best of the not so great options. And I’ll do everything in my power to support this kind of operation if it comes to that.

    I just hope some crazy anti-choicers don’t create a similar looking website with a similar name and URL and send these women pills that will kill them.

    That’s a scary thought.

  19. @ 17 & 18
    “I just hope some crazy anti-choicers don’t create a similar looking website with a similar name and URL and send these women pills that will kill them.”

    Oh, sweet jeebus, I hope there aren’t some kind of psycho-fundie lurkers reading this to cull ideas. Though, given how whack some amongst the anti-choice set can be, it wouldn’t surprise me.

    Talking about this makes me feel like we all live in some alternative crazyland reality. And it makes me kinda paranoid.

    Oh, and Ilyka, where do you order your amoxicillin from?

  20. Pingback: Anna Quindlen on RU-486 and Re-Privatizing Choice « ButtercupPunch - “La clique, c’est chic!”

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