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How a Group of Women Sails Past Countries' Restrictions on Reproductive Rights

Thanks to Women on Waves, women in international waters are receiving instructions on how to have safe, drug-induced abortions.

There are five deaths from drug-related reactions for every 100,000 prescriptions written for Viagra, according to the Journal of American Medicine. The drug has won near universal acceptance—social and medical—and 1 billion prescriptions have been written for it so far.

Conversely, just one out of every 100,000 medical abortions results in death. This means that inducing one’s own abortion with the use of drugs such as Misoprostol and Mifepristone is actually safer than inducing an erection with Viagra. And yet, women in the United States and around the world are not afforded this autonomy, and instead must combat global politics to gain some modicum of control over their bodies.

Try to imagine doctors standing over the shoulders of Viagra users. Such a scenario is unfathomable because it would mean a medical professional interfering with one of life’s most private activities, and a reasonably safe one at that. So why aren’t women spared this indignity?

Dutch doctor Rebecca Gomperts began Women on Waves (WoW), an Amsterdam-based non-profit, in 1999. The group travels by boat to countries where abortion is restricted or illegal and offers medical abortions to women on board the vessel. International law dictates that territorial waters only extend for 12 miles. Beyond that, a boat and everyone on it can operate under the laws of the vessel’s country of origin—in this case the Netherlands.

In the Netherlands, medical abortions using the drug Misoprostol, alongside the “abortion pill” Mifepristone, are legal. The combination is safe and 99% effective in inducing a reaction that is very similar to a naturally occurring miscarriage. In fact, Gomperts said, natural and chemically induced miscarriages are indistinguishable by medical examination. According to Dutch law, however, a doctor must obtain a special license to perform abortions past six and a half weeks, which means many physically eligible women cannot receive abortions on board.

Medical abortions are recommended for the first trimester of pregnancy, and can be safely administered by a woman nine weeks pregnant or less without the help of a doctor. Misoprostol is 90% effective when used alone to induce abortion and can be purchased over the counter in many countries besides the U.S. as a treatment for gastric ulcers. Given that 90% of abortions occur during the first 12 weeks of pregnancy, according to the World Health Organization, at-home medical abortions are viable as a primary method for terminating pregnancy. This is especially the case for women living in countries where abortion is illegal, unsafe, or otherwise inaccessible.

“A woman does not need a doctor to put a pill under her tongue, or to put four pills under her tongue,” Gomperts said. “Women have miscarriages by themselves in rural areas without a doctor all the time. People have no agency in any way when it concerns health issues, and it makes [doing your own abortion] sound like a fairy tale in the U.S.”

WoW cannot operate in the U.S. due to strict FDA regulations, but it’s no surprise that the U.S. WoW helpdesk consistently receives calls from desperate women. According to the Guttmacher Institute, in the first half of 2011, 162 new provisions were set in motion regarding reproductive rights in the U.S. Nearly half aim to limit abortion access. As it stands, American women can get medical abortions with Mifepristone and Misoprostol through Planned Parenthood. But legality does not equal accessibility.

For women living outside the 15 states where Medicaid covers abortion services, a medical abortion costs about $500, varying slightly state to state. A surgical abortion costs around $460 with general anesthesia and slightly less with a local anesthetic. Because Medicaid does not transfer from state to state this fee would apply to the majority of American women on Medicaid.