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The website helping U.S women perform their own abortions

In times when body autonomy is at risk, Women Help Women offers guidance and advice for those who choose the DIY route

Women have long been performing their own abortions: before the historic Roe V Wade, and after. Reports from last year show that 4 per cent of women in Texas alone have attempted to self-induce. And as the Trump administration continues its assault of women’s reproductive rights in the U.S, a new project is providing help to women who wish to induce their own abortions with safe drugs, outside of clinics or hospitals.

Women Help Women has created Self-managed Abortion, Safe and Supported (SASS), a portal dedicated to providing advice and guidance for women who have independently procured their own pills (like misoprostol, a drug proven to be safe by the World Health Org). While they can't help with actually obtaining them because of the law, a team of counselors with full training gives advice on using the pills and available funding for access, and the service is private and confidential.

In the states, it’s illegal to administer or take the pills outside of certified clinics. In 2014, a woman received up to 18 months for buying her teenage daughter pills for an abortion. And in contemporary times, women have been desperate enough to attempt unsafe DIY methods.

There are the spotlighted cases in the U.S such as that of Anna Yocca, charged with attempted murder when she was accused of trying to abort using a coat hanger. After global outrage, her sentence decreased to one year, pleading guilty to attempted procurement of a miscarriage. There’s the still active case of Michelle Frances Roberts – claims centre around fetal remains found at her home. Purvi Patel was sentenced to 20 years in prison for feticide after self-inducing in 2013. In the U.S, around 18 women at least have been charged with crimes relating to self-terminations.

The coat hanger is one of the most evocative, disturbing and real images that features in many protests for abortion access. There are horror stories of hot baths, herbs, knitting needles and spoons. SASS is part of the framework that makes DIY abortions with pills safe, informed and dignified.

Laws surrounding reproductive rights vary state by state, and counselors tailor advice for women using their helpline. For example (and it’s pretty outrageous), in some states, doctors can actually lie about totally false claims surrounding abortion, like fetuses experiencing pain, and links to breast cancer and infertility. Below, we speak to Susan Yanow, the U.S spokesperson for Women Help Women, about de-medicalising abortion and the future for women’s full body autonomy.

Why is the project so necessary now?

Susan Yanow: As was shown by the outpouring of support around the world at the inauguration, there are new threats to abortion rights in the United States, and women around the world recognise that threat.
We know women have been self-managing their abortions for years all around the world. It isn’t a new phenomenon, but what’s new is the effort to make sure that these women have all the information they need so they can do it safely, effectively and with dignity.

And what are your biggest hopes that the project will be able to achieve?

Susan Yanow: To break the myth around the abortion pill, to work with others working to de-medicalise it, and make it more accessible. There are colleagues in the U.S working to make it over the counter and this project is part of what we see as a collaborative effort to show that women can be trusted, and to use these pills safely and effectively. Projects like Women Help Women and Women On Web have been helping women do this on their own for years. So it’s not a revolutionary concept – what’s revolutionary is supporting women in the U.S.

Do you have a particular demographic of women in mind when creating this project – those who have trouble accessing abortion for economic reasons, or controlling and abusive partners for example.

Susan Yanow: There’s been research on women self-managing their own abortions since the year 2000, and what we know is that we don’t know all the reasons why. A study was done in 2000 in New York, where abortion is covered by Medicaid. Low income women don’t have to pay, it’s got great subways, and there are lots of clinics. But yet, research showed that some women were self-managing rather than going to a clinic.

We can guess that some women say they just prefer having control over when they take their first pill and doing it all at home themselves; they like the privacy, and not going to the clinic and having protesters yell at them. It’s less expensive too. But, this doesn’t mean they couldn’t go. For example you, sitting in London right now – if you had £500 in your pocket, enough to go to the clinic, but you had another option that was only £50 and you could get it in the mail and do it at home, with good information. Some women prefer to go to the clinic and get checked by a doctor, and some women would not.

It’s all individual and relative. It’s interesting what you say about ‘de-medicalising’, we usually hear ‘de-politicising’ in discourse.

Susan Yanow: Well I think it’s over medicalised because it’s politicised, right? People manage their diabetes at home and that’s more complicated medically than taking these pills, yet there’s nobody in the street saying ‘Oh protect people, make sure they know what they’re doing – these poor, poor people with diabetes who can’t possibly figure it out’. We know that the rhetoric is because it’s abortion. I think it’s over-medicalised, and I can only speak on behalf of the U.S, but I think it’s true around the world, is because it’s abortion and it’s a way to control.

What are the core values of the project?

Susan Yanow: I think the values should hopefully be conveyed in every single email and everything that Women Help Women says. We trust women. We believe that women have the right to make decisions about their bodily autonomy, and they can be trusted to do so, and whatever choice they make; whether it’s to become pregnant, not become pregnant, to have a baby, to not have a baby – is a very fundamental right to decide.

What are the biggest challenges of keeping this project safe and lawful?

Susan Yanow: There are huge challenges, one being that in the last few years over 10 percent of our clinics have closed due to restrictive legislation in the states and the added costs. We have a very hostile administration now where the elected president has vowed to overturn the law that made abortion legal in 1973. Our Supreme Court had nine people and we had a very important victory last summer, but the new president has just given a Supreme Court seat to someone who is hostile to abortion and if another vacancy is filled by this president, they could overturn the law and make abortion illegal. While self-managed abortion is a good option for some women, it shouldn’t be the only option – there should be access and clinics. It’s critically important.

How are you working to protect the identities of women who use you service?

Susan Yanow: So when she goes to our website, she goes to a portal and puts in her question, there’s nothing in her device to save her question. When her question is answered, what comes back is a unique, secure link with her answer which will then disappear within seven days. The only information a woman is asked is if she confirmed the pregnancy and how. A counsellor needs to know if she had an ultrasound or a urine test. She’ll be asked how many days pregnant she is and there’s a calculator to help her. She’s asked for a first name or nickname and what state she’s in. In terms of counselling people about clinics and financial support, it varies state by state, and where there are abortion funds to help women.

“People manage their diabetes at home and that’s more complicated medically than taking these pills” – Susan Yanow

It must be difficult to work across such a broad scope given the size of the states.

Susan Yanow: Well to give you an idea, there are many parts of our country where it is 500km to a clinic, and they require a waiting period of 24, 48 or 72 hours, so the woman has to make that trip twice or stay overnight. That’s extra time away from work or arranging childcare. It can be like driving from Denmark to Portugal.

Is this the future of abortion rights?

Susan Yanow: I think it’s a piece – we will always need clinics. The pills should only be used up to 10 weeks, and many women need abortions after 10 weeks. Sometimes an aspiration abortion is a better option, and some women feel safer and more secure when a clinician involved. This is a choice: it’s not the way of the future, because it’s already here. Women all over Latin America use these pills, women all over Ireland, frankly, have been using these pills – and women in the states, even though we can’t measure it. It’s not new, what’s new is making sure these women are supported.