For International Safe Abortion Day, Laura Hurley, Programme Advisor at the Safe Abortion Action Fund writes on why abortion regulations should be based on health needs rather than stigma and explains why abortion services should be more widely available by telemedicine.
The majority (73%) of all abortions which take place in England and Wales are medical abortions. That is, when someone has made a decision not to continue with a pregnancy, they are given two sets of medication. The first, mifepristone, stops the pregnancy developing, and the second, misoprostol, causes contractions that empty the uterus. Hundreds of people take these pills every day, with very few complications.
Medical abortions are so safe and simple to administer early in pregnancy that the World Health Organisation has recommended that in some circumstances individuals can self-manage their own medical abortion without the need for clinical supervision. The two medications are also on their “essential medicines” list.
For some context on just how safe these pills are, there is more risk from taking aspirin, penicillin, or getting a wisdom tooth taken out than having an early medical abortion.
However, the way these medications are policed and regulated around the world might make you think otherwise. Many countries have laws that restrict legal access to abortion, and even threaten long prison sentences for those who seek or provide treatment. Only last year, a woman in Northern Ireland was acquitted of ‘unlawfully procuring and supplying abortion pills’ for her teenage daughter. The Offences Against the Person Act, which she was prosecuted under, was written in 1861 and states the punishment of a life sentence for anyone who “administer(s) to herself any poison or other noxious thing…with intent to procure the miscarriage of any woman”. Unfortunately, this idea of abortion pills as a “noxious thing” rather than a safe and reliable, indeed life-saving medication is still around in the public imagination.
Abortions around the world
In my role at the Safe Abortion Action Fund, I meet people from all around the world who are advocating for restrictions to be removed on safe abortion. Some have seen relatives die from unsafe methods of ending pregnancies, or helped women travel long distances to reach the care they need and couldn’t find at home. Thankfully, in many countries where abortion is severely restricted by the law, people who need to end pregnancies can still do so safely, if they can find a way to get hold of safe medications.
The story goes that misoprostol, (which can still be used safely without mifepristone if it’s not available) was first “discovered” as an abortion medication by Brazilian women in the 1980s. They noticed that the instructions for this drug, originally used to treat stomach ulcers, warned that it could lead to miscarriage, and started using it deliberately for this purpose where no legal alternative was available. As knowledge of the drug and its use spread around the world, we can see a reduction in deaths from unsafe abortions, as those in restrictive settings are able to get hold of this medication rather than resorting to more dangerous means of ending pregnancies, like inserting coat hangers and sticks into the uterus or drinking bleach and washing detergent, as many still do in desperate situations.
Incredible organisations like Socorristas en Red in Argentina are thankfully willing to stand up for those seeking a safe and dignified abortion, especially during the COVID-19 pandemic when accessing a clinic or getting hold of medication is so much more difficult. Mama Network is a group of community activists and feminists working to ensure those across sub-Saharan Africa have the information and support they need on safe medical abortion. Many of the network members run confidential helplines to provide life-saving information and referrals, which are even busier now during lockdowns.
COVID-19 and abortions
Here in the UK, the government has now allowed for abortion services to be provided via “telemedicine”, recognising that unplanned pregnancies and the need for abortion do not go away during a pandemic. This means that you can speak to a medical professional online or over the phone, and when they are confident you can understand and consent to the treatment they can send the pills in the post.
Of course, those who oppose abortion 24/7 were not happy with this move, claiming what they term ‘DIY abortions’ are dangerous. In fact, recent statistics showed that the abortions which have taken place since the scheme started have been perfectly safe, but have also actually happened earlier in pregnancy. This is great news as the earlier an abortion takes place the smaller the chance of any complications, and it also means quicker treatment for someone facing an unwanted pregnancy in a tough time. Research into abortion telemedicine in other places like the US has also shown it to be safe, effective and well-liked by patients.
So what’s stopping every other country stepping up and allowing for easier access to abortion medications at a time when travelling to healthcare facilities is restricted? Quite simply, abortion stigma.
The idea that somehow, people seeking abortions shouldn’t be trusted with this form of medical self-care, in the way that we might for something like testing for STIs at home or administering our own insulin when diabetic.
This International Safe Abortion Day, I hope governments around the world hear the demands we are making for the removal of restrictions and abortion access based purely on health needs rather than ideology and stigma. Follow #IManageMyAbortion for more on the global campaign.