With reproductive rights under threat, Women Help Women gives legal and medical advice to women who may be taking matters into their own hands

New website offers US women help to perform their own abortions

Fearful that Donald Trump’s presidency poses a once-in-a-generation threat to US reproductive rights, an international advocacy group this week is unveiling what is sure to be a controversial response: a web portal dedicated to helping US women terminate their own pregnancies with abortion-inducing drugs they have obtained outside of a medical setting.

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The project, launched by Women Help Women, is a nod to the fact that many US women may already be taking matters into their own hands as abortion options in this country contract.

“Women in the US have been and are using the pills without good guidance,” said Susan Yanow, the US spokeswoman for the group, Women Help Women. “If a woman is anxious and has the pills in her hand, and doesn’t know what to do … we can help her understand what to do. We can help her understand what signs to look for, and what’s going on.”

Research suggests that there is a small but significant number of US women who attempt to induce their own abortions without any medical supervision.

Several studies have shown that many of these women, particularly those living along the US-Mexico border, are using misoprostol, a miscarriage-causing drug that can be legally purchased over the counter in many Central American pharmacies. In the US, it is illegal to administer the drug outside of certain medical clinics.

Rules for taking misoprostol are easy to find online. What Women Help Women has done differently is connect US women with counselors who can provide step-by-step instructions, and answer questions, in real time.

Their counselors are trained by medical professionals to walk women through the process of using misoprostol for a DIY abortion. Counselors will also strive to connect women with abortion funds if payment is the main obstacle for getting an abortion in a clinic.

But the main goal is to support the unknown numbers of women who are performing their abortions themselves.

Part of the inspiration, Yanow said, came from an article the Guardian US published in November. The story followed a young Texas woman who, unable to afford an abortion in the US, traveled to Mexico to purchase an abortion-inducing drug over the counter.

“There’s just so many questions,” the woman told the Guardian. “I would so much rather have a health professional help me in this and kind of guide me through it versus DIY.”

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Those words stuck in Yanow’s mind. And as she grappled for a way to respond to November’s election, it occurred to her that Women Help Women could tailor its services to the needs of women in the US.

The project will be titled Self-managed Abortion, Safe and Supported, or SASS, and use the website abortionpillinfo.org.

Women Help Women is already a longstanding provider of abortion pills and instructions in other countries. Every month, its staff members answer 5,000 emails from women around the globe seeking to end their own pregnancies.

The group will not provide abortion-inducing drugs to women in the US. And it has made other changes to its methods because of the United States’ uniquely hostile, anti-abortion atmosphere.

In the US, at least 18 women have been charged with a crime based on allegations that they attempted to induce their own abortion. A handful of states have made it explicitly illegal for anyone but certain medical professionals to administer abortion-inducing drugs.

Enterprising prosecutors have found other, creative ways to levy charges, through the use of laws against child endangerment, practicing medicine without a license, or drug possession.

Women Help Women counselors will inform clients of some of the legal risks that come with self-administering misoprostol, as well as some of the limitations.

But the legal implications of the project are far from certain.

“This area of the law is nothing if not complicated,” said Jill Adams, the chief strategist of the the Self-Induced Abortion Legal Team, a project associated with Berkeley Law. Her group has shared legal information about self-induced abortion with Women Help Women, but stopped short of legally vetting the information that counselors will provide to US women.

In general, the act of looking for or giving out information about self-inducing an abortion is protected by law, Adams said. And she knows of no one who has been prosecuted merely for seeking information.

Still, it could compound the risk of prosecution. Purvi Patel, the first US woman to receive a significant prison sentence for inducing her own abortion, was convicted after prosecutors obtained emails that showed her purchasing an abortion-inducing drug from a Chinese pharmacy.

With those facts in mind, Women Help Women designed its portal to delete conversations between clients and counselors after seven days.Its servers are located abroad – out of easy reach for US prosecutors, the thinking goes – as are all 23 of its counselors.

The legal risks are thought to loom larger than the medical risks.

“In general, I would say there’s kind of a growing recognition that from a safety or a medical perspective, we have very few concerns about” women using abortion drugs on their own, said Daniel Grossman, a clinical professor of obstetrics and gynecology at the University of California–San Francisco who researches self-induced abortion.

“Especially if we’re talking about women using misoprostol on their own. It’s a very safe and effective medication,” he continued. “If women have information about how to use it, then women can safely use it on their own.”

When women go to an abortion clinic, they are typically given two drugs: mifepristone, a drug that blocks hormones necessary to sustain a pregnancy administered in person, and misoprostol, which is taken many hours later and causes the uterus to contract and expel its contents. The Food and Drug administration permits women to leave the clinic and take misoprostol at home.





Researchers believe that women who self-administer abortion drugs are most likely taking misoprostol by itself, because it is easy to obtain from foreign pharmacies. Misoprostol used without mifepristone is less likely to cause an abortion but still has a high success rate.

There are certain medical risks in self-administering an abortion drug without the involvement of medical professionals. An ultrasound is often necessary to confirm a pregnancy and assess how many weeks a woman has been pregnant. Misoprostol is less effective and requires a different drug regimen later in the first trimester.

Medical professionals will also inform women about how to recognize complications, like excessive bleeding, that could occur after they leave the clinic and require medical attention. And using the drug improperly – say, at a high dose in the second trimester – can lead to serious medical complications.

Grossman argued that a project like Women Help Women’s could minimize those risks. “I think that it’s worse to just remain silent while we know women are doing this,” he said.

But abortion rights opponents cite these safety concerns as reasons to oppose any project that makes abortion drugs available outside a clinical setting.

In response to a study, first reported by the Guardian, that tests the efficacy of sending women abortion drugs by mail, a spokeswoman for Americans United for Life said, “We have grave concerns about handing out dangerous, life-ending drugs without medical supervision because women face great risks for chemical abortions.”

Carol Tobias, president of the National Right to Life Committee, asked, “Who are they supposed to call if they have a problem?”

Yanow says that’s exactly the point of Women Help Women’s new portal.

“People are not being advised to use the pills,” she said. “They’re being advised if they’ve already decided to use the pills. What drives this project is the knowledge that women have been managing this on their own.”