In countries around the world where abortion is illegal, it isn't necessarily rare. What's happened is that the vast majority of them have become medical instead of surgical. Women can take Misoprostol and Mifepristone, which together are 97% effective in causing an abortion in the first trimester. These drugs are already how about a third of abortions happen in the United States. That number may be about to go up. This is Healthcare Triage News.

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Olga Khazan at The Atlantic has been all over this story, and much of what I'm going to tell you is from her reporting. And, you should go read her stuff, especially her big piece in the potential future of abortions in America there. Links in the description, below. 

So, an organization know as Women on Web has for some time given women with few options a way to get an abortion. They perform online consultations, write and fill prescriptions, and then send the pills to women who live in countries where abortion is otherwise illegal.

The service was studied in a BMJ paper published last year, focusing on women in Ireland (where abortion was illegal). Researchers followed up on 1,000 women who had used the service, and found that about 95% of them had ended their pregnancy without surgical intervention. Less than 1% needed a blood transfusion, and 2.6% later received antibiotics.

The conclusion of the paper was that, and I'm quoting, "Self sourced medical abortion using online telemedicine can be highly effective, and outcomes compare favourably with in clinic protocols. Reported rates of adverse events are low. Women are able to self identify the symptoms of potentially serious complications, and most report seeking medical attention when advised."

The news here is that Women on Web's founder, Rebeccas Gomperts, has launched a new service called Aid Access. Unlike Women on Web, Aid Access will ship to the United States. Like Women on Web, the new service screens women for their eligibility online (they need to be nine weeks pregnant or less), and Gomperts fills every woman's prescription. They're filled by a pharmacy in India they trust, and then the pills are shipped. 

The organization has avoided the US in the past, because they feared getting shut down by the anti-abortion movement here. But, they evidently see a need, and think that setting up a separate organization protects Women on Web. They say this is legal, even under FDA rules. It costs about $95, and it's possible for women who can't afford that to get assistance. 

But, their capacity is untested. They may have sent out like 600 pills in the last six months. It's not clear how many women they can service. There are way more abortions than that in the United States every year.

It's possible others will join the service with their own. It's also possible that abortion opponents will go after it to shut it down. But, as women report more and more difficulty getting access to abortions in the United States, this is likely a route more and more will take.

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