Currently, a woman who wants to take the abortion pill — actually a combination of two drugs — must go to a medical facility where she takes the first medicine, mifepristone, in front of a clinician, and the second, misoprostol, at home some hours or days later.
But in the new survey of more than 7,000 reproductive-age women, 49 percent said they supported at least one of three models for obtaining the abortion pill. Forty-five percent said they supported getting the drugs in advance from a doctor for potential use down the road, 37 percent said they believed the drugs should be available over the counter and 30 percent said they supported making the pills available to women online.
And when asked whether they’d consider using any of those methods personally, nearly a quarter of the women said they’d consider getting the pills in advance from a doctor or obtaining them over the counter, while 16 percent said they’d be interested in buying the pills online.
“If we consider that this is a representative sample of adult, reproductive-age women across the US — many of whom may not support abortion at all, may never have considered having an abortion themselves, or may never need an abortion — the proportion in favor of these models is extremely high,” study author Antonia Biggs, a social psychologist researcher, said in an email to HuffPost. “When we exclude the women who are morally and legally opposed to abortion rights, levels of support increase to 62 percent.”
Since Brett Kavanaugh’s appointment to the Supreme Court put reproductive rights advocates on high alert about the future of Roe v. Wade, there has been a frenzy of activity around making self-induced abortion safer for women — particularly through increased access to the abortion pill.
“When we exclude the women who are morally and legally opposed to abortion rights, levels of support increase to 62 percent.”
Before Roe v. Wade legalized abortion in all 50 states in 1973, more than 1 million illegal abortions may have been performed in the United States each year — many of them deadly. American women went to Mexico to have surgical procedures, traveling alone in cars with strangers to see providers they knew nothing about. They used coat hangers and even drank bleach. The abortion pill has fundamentally changed the nature of so-called “back alley” abortions, but many reproductive rights advocates believe access is still far too limited.
Earlier this fall, the founder of Women on Web — an organization that has long helped women outside of the United States perform their abortions at home — told The Atlantic she had been quietly shipping abortion pills to women in this country for more than six months through her new organization, Aid Access. Like Women on Web, it not only sells women the medications but also provides them with online consultations to walk them through the process.
Right around that time, the Sia Legal Team — which works with women who have induced their own abortions — announced the launch of a free helpline for women who have been questioned by the police about ending their pregnancies (or who fear they might be), as well as a website with information about the legal landscape surrounding self-managed abortions. In some states, women have been prosecuted and jailed for attempting to terminate their pregnancies.
“Before abortion was declared legal by the Supreme Court more than 40 years ago, finding a safe abortion was really difficult,” Jill Adams, SIA’s strategy director, told HuffPost. “But now people who can get abortion pills have a safe option to end a pregnancy on their own. In this scenario, and in this age, the risk is legal; it’s not physical. The image of the coat hanger has been supplanted by the image of handcuffs.”
There is research backing the safety of largely self-managed abortions, although these studies have not necessarily examined the safety of women going it entirely alone. A 2017 investigation found, for example, that abortions are just as safe when managed remotely via telemedicine as they are when a clinician actually watches a woman take the first pill.
What this all means for the future of self-managed abortions in the United States is uncertain.
In an email to HuffPost, the Food and Drug Administration said it “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.” The FDA said it was unable to discuss potential or pending investigations, if any exist.
A spokesperson for the American College of Obstetricians and Gynecologists said the organization does not have an official stance on Aid Access, though it has urged the FDA to remove certain restrictions on where a woman is able to access mifepristone, given the medication’s track record of safety and efficacy. The group has also come out strongly against the criminalization of women who end their pregnancies.
But the new survey suggests that interest from women is there.
“We really knew little about the demand for and interest in alternative models (advance provision, online access, and over-the-counter access) of medication abortion provision,” said Biggs, a researcher at Advancing New Standards in Reproductive Health, at the University of California, San Francisco.
“We would not expect these alternative models to meet the needs of all women,” she added, “but do feel that by offering women more options, we are more likely to meet the needs of most women.”
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