WASHINGTON, D.C., June 28 (C-Fam) The idea of self-induced abortion has a long history as a scare tactic in legal debates over abortion both in the United States and around the world. Abortion advocates wielding coat hangers have argued that abortion should be a decision left to women and their doctors.
Yet the World Health Organization (WHO) is moving toward a standard that frames doctors—and even women themselves—as non-essential to the discussion.
According to a new guidance from WHO, self-induced first-trimester abortion using pills “without the supervision of a health-care provider” is “recommended in certain circumstances.” Specifically, they refer to “contexts where pregnant individuals have access to appropriate information and to health services should they need or want them at any stage of the process.”
The phrase “pregnant individuals” is used to stipulate that the individual might identify as a man.
The guidance is the first in a series of forthcoming examinations of “self-care” interventions for health, and focuses on “sexual and reproductive health and rights” with an emphasis on increasing access in the context of provider shortages and other constraints.
WHO asserts that “to the full extent of the law, safe abortion services should be readily available and affordable to all women,” and insists that it does not support “clandestine self-use” of abortion drugs by women without access to information or assistance. Nevertheless, elsewhere in the guidance, the authors say that the work’s “greatest potential” is to address contexts of “limited access to health care,” such as “self-managed medical abortion in countries where abortion is illegal or restricted.”
Nonetheless, those groups will likely welcome the WHO guidance. Abortion groups providing illegal abortion pills by mail, including “Plan C” and “Action Aid,” have targeted the U.S. in response to state-level abortion restrictions and the anticipation of a potential challenge to Roe v. Wade. That Supreme Court ruling legalized abortion at a national level. Such providers stipulate on their websites that a woman ordering drugs should not do so without access to a health care provider, but they have no way to ensure that this is the case.
The WHO guidance highlights the importance of accurate information for those seeking to self-induce abortion, but provides little help in ensuring that women are obtaining it. It also presumes that women who seek abortion-inducing drugs online or by mail are receiving the drugs and dosages they expect. It also leaves unaddressed the question of how mail-order abortion pills and other black-market sources can put women at risk of being administered abortion drugs without consent by abusive partners, parents, or others, such as human traffickers.
Earlier this year, Mother Jones published a story about a woman who decided to sell abortion pills by mail from her home. She was caught when a man ordered pills twice from her website, and slipped them into the drink of a woman who was pregnant with his child.
The WHO guidance expresses concern that the use of self-care interventions, such as injectable contraceptives, could increase the risk of violence to women. Yet it does not address the issue of how the interventions could be a means of inflicting violence on vulnerable women and children, and how providers ostensibly trying to help women in crisis to obtain abortions could become the unwitting accomplices of their abusers.
Rebecca Oas writes for C-Fam. This article first appeared in the Friday Fax, an internet report published weekly by C-Fam (Center for Family & Human Rights), a New York and Washington DC-based research institute (https://c-fam.org/). This article appears with permission.”
