Throughout history, abortions at home have been a byword for horror, danger, even a grisly death. Many countries that legalised abortion did so partly to eradicate them.
But now we have the abortion pill. Women who are up to nine weeks pregnant can safely have an abortion at home by taking two medicines over two days, according to the World Health Organization.
The second dose of pills triggers bleeding and painful stomach cramps while the embryo is passed; this typically takes a few hours but can last several days. A requiring a hospital visit to complete the process. But it鈥檚 more or less like an early miscarriage 鈥� which women are usually told to cope with at home 鈥� and statistically is still safer for the woman than continuing with the pregnancy and giving birth.
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It鈥檚 also that 聽we are allowed to buy from pharmacies without a prescription, such as Viagra in the UK. So why can鈥檛 women get abortion pills from pharmacies and manage the process themselves at home if they choose?
It might sound radical but it鈥檚 already widespread in countries where abortion is illegal, with women buying the pills from online pharmacies. While some countries, such as Poland, are trying to tighten their already strict abortion laws, the advent of mail-order abortion pills means the law is becoming almost irrelevant.
Rising requests
Not all pharmacy websites can be trusted, but one reputable site, called 聽provides online medical advice along with the pills, and waives the 鈧�70 fee if someone can鈥檛 afford it. Requests for help from women in Ireland and Northern Ireland, where abortion is illegal in almost all circumstances, nearly tripled between 2010 and 2015, to 1438 a year, .
Using this method isn鈥檛 risk free, though. In April a woman in Northern Ireland was prosecuted for buying the pills online, after her .
In Northern Ireland women can have the drugs sent to their home but for Irish women there鈥檚 an extra hurdle: sending medicines through the post is illegal. The envelopes get stopped at Irish customs if online pharmacies mark their packages as containing medicines. So Irish women have to get their pills sent to Northern Ireland, either to a friend or to a post office for collection.
Despite the stress, most users say they are happy with how it went. In a who used Women on Web, 97 per cent said terminating their pregnancy at home was the right choice for them. Over 99 per cent said they could cope with their feelings about it. This gives the lie to claims by anti-abortionists that the procedure leaves women destroyed by guilt.
But even in countries such as the UK and the US, where abortion is legal, we could emulate Women on Web鈥檚 approach to make terminations easier, simpler and quicker.
Over the counter?
In the UK, for instance, although abortion on demand is effectively allowed up to 24 weeks, women must have two doctors sign it off and visit a clinic two or three times. That鈥檚 not always easy for those who can鈥檛 take time off work because they are in low-paid or insecure jobs, or have young children and no one to mind them. Then there are illegal immigrants, and those who want to keep their abortion secret, such as teenagers or women in abusive relationships.
Of course some women want counselling to help weigh up their options and this should always be on offer. But many do not and just want to get it over with.
Eighty per cent of UK abortions happen , with about two thirds of this group opting for the medicines, not a surgical procedure. So for those who want it, the abortion pills should be available in pharmacies after discussion with a pharmacist to explain what to expect and what complications to watch out for. Failing that, we should let women get it with just a GP鈥檚 prescription.
At the very least we should allow abortion clinics to give women the second dose to take home with them. This is starting to happen in many countries, including in parts of the US, but UK law says they must take it in a doctor鈥檚 presence. So those who want their abortion to take place at home with the support of family or friends have to risk the bleeding and pain starting on their journey home.
UK abortion law is so archaic and bureaucratic it almost suggests we are making the process as difficult as possible to punish women for ending up in this situation. Instead we should treat abortion just like any other medical intervention. 鈥淚t鈥檚 such a safe treatment and it鈥檚 still so regulated,鈥� says of Women on Web. 鈥淚t鈥檚 nothing to do with medical science, it鈥檚 about controlling women鈥檚 lives.鈥�
