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safe abortionThe Indpendent are reporting on an internet site, Women on Web, who are selling abortion pills online to women in countries with heavily restricted access to abortion. The drugs cost £55.

This originates from a British Journal of Obstetrics and Gynaecology (BJOG) article in the current issue. I can’t access the full text of this study, but the abstract concludes that outcomes “are in the same range as TOP [Termination Of Pregnancy] provided in outpatient settings“, although the BBC and the Independent are reporting that 11% need subsequent surgical intervention in a tone which suggests this is abnormally high. Without checking the article I can’t really tell whether this is the case.

Women on Web describe themselves as

“a digital community of women who have had abortions and individuals and organisations that support abortion rights”,

whilst the Family Planning Association in Northern Ireland (where abortion rights are severely restricted) call them “helpful and reputable“.

The combination of the drugs mifepristone and misoprostol (commonly termed a ‘medical’ as opposed to a ‘surgical’ abortion) can be used until 9 weeks gestation and (in the UK at least) women can take them at home as an outpatient, under supervision by a medical practitioner. This report from last year finds no significant increase in post-abortion complications from medical abortions when compared with surgical abortion.

Women on Web apparently (I say apparently as I can’t actually access the site from work, where I currently am) ask a list of 25 questions, and encourage women to see medical professionals and get an ultrasound before dispatching the drugs.

Unsafe abortion is a leading killer amongst women. The WHO estimates that 48% of all abortions worldwide are unsafe, and that 68,000 women die every year because of it. Earlier this year, Laura reviewed a programme showing the devastating effects of the outlawing of abortion in Nigeria.

I’m no medical practitioner, so it’s hard for me to comment with any authority, but I will say that it sounds as though this website are doing a pretty valuable service. If the study is correct that buying pills online and administering them yourself is no less safe than inpatient care, then this has the potential to save an awful lot of lives. I would imagine the danger would be greater in those countries where medical facilities are insufficient to help women experiencing complications, or where women are too scared of recriminations to present for emergency help. Not to mention that £55 is a lot of money in some parts of the world. Do any of our readers with more medical knowledge than me have anything to add on this?

Audrey Simpson of the Northern Ireland FPA does also point out that, whilst Women on Web may be ethical and responsible, others may not be:

“There are potentially serious medical complications for women from sites which aren’t well managed and this could be the new era of backstreet abortions.”

The ideal, of course, would be that all women would be able to access safe, legal, free abortion whenever they need it. Backstreet unsafe abortions are totally unacceptable to anyone who cares about women’s – human – rights. This is undoubtedly a pretty uneasy middle ground, but for an awful lot of women it could be the best option they have.

Hat tip to commenter Sian for pointing this out

Pic by Peace Chicken, shared under a Creative Commons license