Restrictions on abortion incite international activists to provide care in the United States
Restrictions on abortion incite international activists to provide care in the United States
Dr. Rebecca Gomperts talks about abortion pills with a police inspector from Northern Ireland on May 31, 2018. Photo credit: David Young / PA Wire (Press Association through AP Images)
Across the country, women's access to reproductive care has been protested, closed, legislated and, at times, strictly limited. So much so that an international organization has intervened to provide consultations on abortion and drugs to women who face high barriers to receiving care.
AidAccess was recently founded by Dutch doctor Rebecca Gomperts to provide American women with access to abortion medications. The litigation program operates online and offers consultations to women and abortion medications delivered by mail.
The legality of AidAccess is not yet defined. The FDA has said it is investigating the program for possible legal violations. Currently, the administration requires that mifepristone, one of the two medications needed for a successful medical abortion, be sold through a tightly controlled distribution channel.
The risk assessment and mitigation strategy (REMS) used by the FDA in mifepristone prevents the sale of the drug online or in retail pharmacies. Defenders of access to abortion argue that REMS is generally used for drugs far more dangerous than abortion pills.
Studies on the abortion pill cocktail found it to be extremely effective and extremely safe. A 2017 study published in the medical journal Obstetrics and Gynecology found that of more than 8,700 patients who obtained abortion pills through telemedicine services, only 18% of them had any complications, none of which resulted in death or even surgery.
Women in the United States have had problems accessing telemedicine abortion services that competently meet their care needs. Abigail Aiken, an assistant professor at the School of Public Affairs at LBJ at the University of Texas at Austin, studied abortion options online.
"If you have money and resources, you can access these medications. If you are a poor woman, you can not. "
Aiken's work found that many online options, whether they can not sell the drug online or, if they do, are very scarce instructions and information. She said that women resort to online options for a variety of reasons. Some prefer their privacy, others do not have access to clinics and others face financial and logistical limitations to meet the requirements of their state for a legal abortion.
"From a public health perspective, there is a justification for harm reduction to help people avoid using ineffective or unsafe abortion methods," he wrote in the study.
Particularly at risk of self-managed insecure abortions are women economically and geographically marginalized. In this regard, he said he has noticed parallels between his research on access to abortion in Ireland and the United States.
"The real options available to people in the two countries are surprisingly similar," Aikens said. "That access problem continues."
He said that the country is effectively living in a world after Roe v. Wade, where access to abortion services is very limited for women in much of the country and varies greatly from one state to another.
Aiken sees parallels for women in rural Texas or Ireland. He said getting a safe abortion in both places often means traveling hours to a clinic and paying hundreds of dollars out of your pocket. Texas state law does not allow the use of Medicaid or other public funds to pay for an abortion. A 35-year ban on the procedure was recently overturned by a national referendum in Ireland, and before that, women had to leave the country to stop an unwanted pregnancy.
This gap in access and affordability is what Gomperts and its multiple abortion care services try to cover. In the United States, women can get consultations and, after a screening process, abortion medications for only $ 95.
Gomperts could not be reached for comment, but detailed his new efforts in a recent story at The Atlantic, which reported that AidAccess had already served some 600 American women.
Gomper's first foray into health care activism came almost two decades ago. In 1999, she founded Women on Waves, which sailed in international waters on a Greenpeace ship that provided women with access to reproductive care, abortion education and services, all while keeping local laws in check.
Advocates of abortion rights, Grace Fried, center, Claire Roden and David Tuke demonstrate before the Philadelphia City Hall on Friday, January 21, 2011, on the eve of the anniversary of the decision of the Supreme Court Roe v. Wade of 1973 that legalized abortion. (AP)
That company pushed Gomperts to found Women on Web, an online service for women seeking abortion drugs almost anywhere in the world, except in the United States. The Dutch doctor feared that serving American patients through Women on Web would jeopardize the entire operation. Instead of taking the risk, she started AidAccess.
Aiken said that Gomperts organizations provide women with the right doses, proper instructions, warnings and proper aftercare procedures so they can safely manage their abortions at home.
Of course, not everyone is satisfied with the efforts. Eric Scheidler, executive director of the Pro-Life Action League, said the program poses problems for women.
"Telemedicine abortions are a bit more sinister in some ways," said Scheidler. "They make every place in the world effectively an abortion scene."
His organization, which mainly focuses its efforts on the defense of the "public square", is firmly opposed to any type of abortion. He disagreed with the arguments that AidAccess helps with the problems of accessibility and affordability of reproductive care.
"I do not see that this falls under the banner of making medical care more affordable, because abortion is not medical care," he said.
Aiken's research shows that the reasons why women seek self-managed medical abortion are as innumerable as the women themselves. Beyond her options, she said that programs such as AidAccess provide an unequivocal benefit for marginalized women who have problems in overcoming access barriers.
"If you have money and resources, you can access these medications," Aiken said. "If you're a poor woman, you can not ... AidAccess is trying to provide a way for women to do this at home."
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