The pills come with instructions, and if women have questions, Gomperts says they can Skype with her or call her help desk. Anti-abortion groups say these pills are not safe, but Daniel Grossman, a professor of obstetrics and gynecology at the University of California, San Francisco, told me that “it doesn’t appear that women are having serious complications” from self-inducing abortions using pills. However, if women using these regimens experience heavy bleeding or some other complication—as about 3 percent of women have—they are generally advised to go to a hospital and say they had a miscarriage.

Women on Web has never worked with American women because Gomperts worried that the American anti-abortion movement would try to close down the organization. In an interview, she told me she still has that fear, but she was being inundated with requests from women in countries such as the United States, where abortion is technically legal but growing more difficult to access. “I got an email from a woman who was living in a car with two kids,” she told me. “Something had to be done.”

Read: When abortion is illegal, women rarely die. But they still suffer.

She launched Aid Access as a separate service in order to mitigate the risk to Women on Web, and she claims that every step of the Aid Access process is legal. (According to Gomperts, the FDA allows people to import medicines for their personal use. However, the FDA told me, “Mifepristone, including Mifeprex, for termination of pregnancy is not legally available over the Internet. The agency takes the allegations related to the sale of mifepristone in the U.S. through online distribution channels very seriously and is evaluating the allegations to assess potential violations of U.S. law.”) Gomperts launched the service six months ago, but has kept it quiet until now. She estimates that she has already sent pills to 600 women.

A new Guttmacher Institute report on self-managed abortion notes that what Gomperts is providing is recognized as an acceptable option by the World Health Organization:

A person’s ability to self-administer mifepristone and misoprostol after receiving instructions from a provider is well established, and there is evidence that it is safe and effective for someone to do so without the direct supervision of a provider. WHO recommends this option if the individual has “a source of accurate information and access to a health-care provider should they need or want it at any stage of the process.”

In an email, Kristan Hawkins, the president of Students for Life of America, criticized this service as unsafe for women. “Handing out deadly drugs through the mail is a disaster waiting to happen,” she said. “Women later in pregnancy or women experiencing an ectopic pregnancy in particular are in great risk—two things that must be determined by examination and not by some online questionnaire.”