Will The U.S. See A Rise In Remote Abortion Treatment?

We recently wrote about the devastating effects of Texas’s extreme abortion law HB-2—and how things were about to get even bleaker for Texas’s 5.5 million reproductive-age women if more of the legislation were to go into effect September 1. Well, we’re happy to report that on Friday a federal judge found its most restrictive provision to be unconstitutional. Which means a dozen clinics have been spared from closing—yay! (But, of course, the anti-abortionists have pledged to battle back in court—boo.) 

This news came a day after the New York Times Magazine published a deep dive called "The Dawn of the Post-Clinic Abortion." The piece was a fascinating (in that rubber-necking-what-is-this-world-we-are-living-in-kinda way) exploration of the realm of abortion rights activists who are seeking new ways of providing safe abortion treatments remotely. 

The article centers on the work of Rebecca Gomperts, a physician and activist, who initially offered abortion treatments to women on boats offshore of countries where abortions are illegal. She has a new strategy now: providing women with mifepristone (previously known as RU-486) and misoprostol, the two drugs that work in tandem to induce miscarriage during the first trimester, via mail. Her service, which she founded eight years ago, is called Women on Web. Women (who are often terrified and desperate) can email the service and, provided they meet the necessary health and geographical requirements, are mailed the correct dosages of the medical abortion drugs, guided as to what they can expect when taking them, and offered a help line if they have questions.

Why Are Such Efforts Necessary? 

According to the World Health Organization, 21.6 million women experience an unsafe abortion worldwide each year, in part because nearly 40% of the world’s population live in countries where abortion is either banned or severely restricted. Of these, 47,000 women die annually from such procedures. 

The recent/ongoing attempts to legislate abortion access into extinction in the United States (reminder: There is but one abortion clinic in all of Mississippi) of course brings up questions surrounding the necessity and appeal of such services for those of us under Uncle Sam’s watch. And according to Women on Web, 40 to 60 of the thousands of emails they receive a month now come from the U.S.—double the number from just two years ago. 

These pleas are often desperate. Take this one from a woman in Florida: “I live in the United States and have no health insurance. I have two children and I am currently out of work, there’s no way I can afford another child. Please help. I’m desperate.” Yet such emails stemming from America are met with, “We’re sorry, the doctors of Women on Web cannot provide the service in any country with safe abortion services.”

So what are women doing in places like Texas where there are now 19 abortion providers for the entire giant-ass state?

Data back up that there have been drops in abortions obtained in light of HB-2. After the first wave of closures—when the number of clinics jumped down to 19 from 41—the number of the procedures performed had already fallen by 13% compared to the previous year. 

Self-induction could very well be a part of the picture. Many women in, say, Texas’s impoverished Rio Grande Valley, are already familiar with self-inducing miscarriage, some turning to Vitamin C and herbs, others crossing the border into Mexico to buy misoprostol, where it’s sold over the counter. 

Says Dan Grossman of the Texas Policy Evaluation Project: 

One important reason that women turn to self-induction is because of a lack of clinic-based care. It’s a hypothesis, but it seems likely that given the clinic closures, greater knowledge about self-induction methods, and the high rates of poverty in the area, that this is something more women are going to consider.

So this is where we are as one of the countries that provides “safe abortion services”—our women emailing web-based activists and crossing the Mexican border seeking a medical service that is both desperately needed and theoretically available to us. And though the New York Magazine article identifies how some states and clinics are experimenting with their own versions of providing medical abortions remotely, it’s overall a tragic crossroads to be at—with the specter of the hundreds of thousands of women who either died or sought medical treatment for botched abortions before the practice was legalized seeming to linger ever nigher.

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