This Dutch doctor will continue to prescribe abortion pills to American women

Rebecca Gomperts, a 55-year-old Dutch doctor, has been working for years for access to abortion everywhere in the world. Made famous by her “abortion boat”, whose journey is traced in a documentary released in 2014 (“Vessel”), she offered women the possibility of medical abortions off the coast of Poland, the Spain, or Mexico, from international waters.

But it is today in the United States that his other organization, Aid Access, which has been offering the sending of abortion pills via the Internet since 2018, is experiencing a sharp increase in requests. In question: the threat of cancellation of the right to abortion at the federal level by the American Supreme Court. If this decision is confirmed, twenty American states should prohibit voluntary terminations of pregnancy (abortion).

“An avalanche of requests” in the United States

“There has been an avalanche of requests in recent days,” Rebecca Gomperts told AFP, evoking a feeling of “panic”. “It’s not just when it comes into effect. People are already realizing how vulnerable they are. »

Aid Access, which is based in Austria, works with doctors in the United States on requests from the 20 US states where prescribing the pills via telemedicine is now possible. For the others, it is Rebecca Gomperts who takes care of it, from abroad, exploiting a legal vagueness. In just over a year (October 2020-December 2021), Aid Access has received more than 45,000 requests in the United States.

The reasons commonly given: the cost of other services, being too far from a clinic performing abortions, or the impossibility of getting around (employment, childcare, etc.). After completing a questionnaire, women are instructed on how to take the pills alone at home. The price is adapted to their financial situation, and the drugs are posted by a pharmacy in India. They can ask for a follow-up.

The poorest women without a solution

Elsewhere on the internet, the pills are easy to find, for a few hundred dollars. But these purely commercial sites also operating from abroad do not offer any medical support. For Rebecca Gomperts, who was named one of the magazine’s 100 Most Influential People of 2020 Timefighting for this cause is a matter of “social justice”.

“The biggest problem” if the Supreme Court upholds her choice, she said, “is that illiterate women, or those who do not have access to the Internet – the poorest group – will not be able to find these solutions” alternatives. Nor will they likely be able to travel to a state where abortion will remain legal. “They are the ones who will be forced to give birth, or to take drastic measures to end their pregnancy,” laments the doctor.

According to her, the maternal mortality rate, already very high in the United States, especially among minorities, will automatically increase. “Access to information, to services that are not just around the corner, is a privilege,” she says.

A safe method

According to a study of several thousand adult women in the United States in 2017, 20% of those who had already attempted an abortion alone had used these pills, compared to 29% of other drugs, 38% of plants, and 20% of physical methods. In protests this month outside the Supreme Court, women once again brandished a chilling object, as if from another time: metal coat hangers, symbols of dangerous clandestine abortions.

But up to 10 weeks of pregnancy, abortion pills are very safe, insist the experts. They now represent half of abortions in the United States (70% in France). And using it alone is also recognized as a “highly acceptable” option by the World Health Organization.

Two drugs are used: a first tablet, mifepristone, is first ingested to block the development of pregnancy. Then, between 24 and 48 hours later, misoprostol tablets trigger the contractions. Possible complications requiring consultation (excessive blood flow, infection, allergic reaction) are rare.

These measures “instill fear in people”

Beyond the medical aspect, the real risk in practicing one’s own abortion is therefore legal today. Some 60 cases of arrests, prosecutions or convictions were recorded in the United States between 2000 and 2020 by the If/When/How association, which puts women having abortions alone in contact with lawyers. And the NGO fears that this trend of criminalization will worsen if the Supreme Court reverses its protection of abortion.

“The problem with these measures is that they instill fear in people, especially in health professionals, regrets Rebecca Gomperts. This is their biggest impact. That’s not to say there isn’t a way around them. »

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