Abortion by Internet

// 11 July 2008

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

Comments From You

Torygirl // Posted 11 July 2008 at 4:54 pm

I don’t have medical knowledge but when I heard the statistics relating to complications arising from the use of such drugs this morning I was surprised that they surely must be roughly equal to medically supervised terminations.

The sad thing is that even though this is the best of a bad bunch of options for some women it depends on a) knowing about it, b) access to the internet, c)having the funds d) having the right kind of account to pay online. I would hazard a guess that this would prevent many in poorer and developing countries.

Whilst we take the web practically for granted here, there are still lots of places where it’s not available.

BareNakedLady // Posted 11 July 2008 at 5:17 pm

From what I saw on the site earlier (and I can access it from work, but I’m a bit wary of doing so too much as it’s not very subtle!) there is not an obligation to pay for the drugs; a minimum donation is suggested but not insisted upon. The Guardian points out that every seven minutes, someone somewhere dies from a botched abortion. That’s a statistic I’d never heard before, which made me tremble to my bones. How horrible – and how good that an organisation like this has been instigated. Even if it can’t reach many people at this stage, it’s still an improvement.

Natalie Bennett // Posted 11 July 2008 at 9:45 pm

I heard a speaker from this group at at the Global Safe Abortion conference last year, and she said that provided you wait until the pills are fully absorbed, in case of any complication that requires medical treatment, the abortion is medically indistinguishable from a spontaneous abortion, so even women in countries where abortion is illegal should be able to seek help if they need it.

Christian Fiala, MD, PhD // Posted 12 July 2008 at 9:44 am


when discussing delivery of the abortion pill, mifepristone over the web, we have to consider the baseline, what are the other options for women with an unwanted pregnancy who are living in a country where the medieval abortion laws are still in force?

I have been working in many of these countries as specialist in obstetrics and gynaecology. I have experienced the ‘clinical routine’ of 3-5 women being admitted every day to the emergency ward half dead or dead after a botched abortion.

Women still use all kinds of objects or instruments to induce an abortion if it is illegal: Knitting needles, coat-hangers, all kinds of plastic sticks or branches etc. Online you can find a collection of foreign bodies which colleagues and myself have retrieved from the uterine cavity of women:


The initiative of women on web to deliver safe medical abortion to women in countries where abortion is illegal will save thousands of women’s lives. The few side effects are regrettable and could easily be avoided if the societies would respect women, including the need to end an unwanted pregnancy. But these side effects are nothing compared to the consequences of unsafe abortion which are ‘daily routine’ in these countries.

best regards

Christian Fiala

Steph Jones // Posted 12 July 2008 at 5:14 pm


Sir???! An example of the male-default!! (/blog/2008/06/the_male_defaul)

Anyway, back to the article!

The nature of the internet, where it over-rides physical country and continent boundaries, will make it increasingly difficult for the law-makers of countries to prevent people from being able to access treatments, pharmaceuticals and services which would otherwise not be freely available.

“Women on Web” echoes the similar rise in on-line suppliers of drugs to the transgender community – which would historically only be available under controlled conditions and prescribed by a psychiatrist with the supervision of an endocrinologist. The ability of people to be able to effectively ‘self-medicate’ hormones via the internet is starting to force the NHS here in the UK, for example, to re-evaluate how such drugs are provisioned.

E-Visible Woman // Posted 15 July 2008 at 2:43 pm

Women on Web is the sister of the wonderful group of doctors, Women on Waves, who sail the high seas and set up abortion clinics on their boat in international waters next to countries where abortion is illegal.

Lynne Miles // Posted 15 July 2008 at 2:54 pm

That’s really interesting – I didn’t know that, but I have nothing but respect for Women on Waves. They do a really amazing job.

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