It is telling that, when Hulu released a highly anticipated adaptation of The Handmaid's Tale—a 1985 dystopian science fiction novel in which fertile women are stripped of their humanity and essentially reduced to ambulatory wombs—most reviewers drew parallels to our current political reality. Rather than praising it as a startling work of speculative fiction, critics called it "chillingly real" and noted its "unexpected resonance in Trump's America." The New Yorker went further, posting an essay titled "We Live in the Reproductive Dystopia of The Handmaid's Tale."
The situation around reproductive rights has grown increasingly dire over the past decade: Abortion access is under constant siege, and pregnant women are increasingly denied basic civil rights in the name of protecting their fetuses. Under the Trump administration, advocates fear, things will only get worse. It's in this political climate that Women Help Women, an abortion-by-mail service that serves women in countries where the procedure is illegal, announced that it would begin providing individualized counseling to American women attempting to self-abort at home.
"While abortion in the US is legal, it is not accessible for everyone," said Kinga Jelinska, the executive director of Women Help Women. "Abortion pills are a safe and effective option for ending pregnancy. It is important that women in the USA have more resources about how to use them."
The service, called "Self-managed Abortion: Safe and Supported," or SASS, will allow women who wish to take the abortion pill at home to directly contact trained counselors, who will walk them through the process of using the process of self-inducing an abortion with pills, based on protocols recommended by the United Nations. Over email, the counselors will answer questions before, during, and after the termination process and provide guidance specifically tailored to the US context. (The WHW website also contains information on protocols for taking the pill, as well as on how to find and purchase the it.)
The abortion pill consists of two different medications: mifepristone and misoprostol, both of which are on the World Health Organization's List of Essential Medicines. When women induce their own abortions at home, they frequently use misoprostol alone, as it's available over-the-counter in several countries as an ulcer medication; on its own, misoprostol is 75 to 85 percent effective at inducing abortion in the first trimester.
Over the past few years, activist groups have been fighting to make the abortion pill accessible for women throughout America, and for legal protections for those who use it outside of a clinical setting. Huge hurdles remain, however—most notably, there are dangerous legal ambiguities surrounding self-abortion. Though DIY abortion is only explicitly illegal in a few states, overzealous prosecutors have charged women with a range of serious crimes, including fetal homicide and aggravated assault, for trying to terminate their own pregnancies.
"When someone has decided to end a pregnancy, they should be able to do so safely and with dignity," said Jelinska. "WHW has been providing information and support to thousands of women around the world since 2014. We are now expanding this information service to the US because the new Trump administration and anti-abortion legislatures in many states are moving swiftly to push abortion out of reach."