Stock Up on Abortion Pills Now

Why self-managed abortion may be the future of reproductive healthcare

This week in the New York Review, I interviewed Rebecca Gomperts, a Dutch doctor who provides abortion-inducing medication by mail to women around the world. Her work is radical, and controversial: Instead of relying on the clinic-based model that is standard for abortion care in the United States, she gives women the tools to self-induce their own abortions at home, in private, with simply a telemedicine appointment. And it doesn’t matter what a country’s law on abortion is — Gomperts helps any woman who asks, regardless of where that woman lives, and regardless of whether her government says she has the right to end a pregnancy.

It may be the future of abortion care, including for American women.

This model, which abortion rights advocates call “self-managed abortion,” is controversial even among feminists, and it certainly gives a lot of average people pause. In the US especially, we have a not-so-far-away memory of the bad old days when abortion was outlawed, and when women resorted to back-alley procedures that left a lot of them traumatized, maimed, or dead. American feminists rightly fight hard for abortion to be safe and legal and accessible — which, especially for poor women, it is not — because we believe abortion is healthcare, and should be no harder to get than any other basic medical procedure (and I would wager that nearly all of us believe that nearly all basic medical procedures should be easier to get and more affordable in the US). Legally marginalizing abortion means that a lot of women won’t be able to access safe procedures. It means that any woman who has an abortion is doing so in a climate of shame and stigma, made to feel like a criminal — and operating under the real threat of criminal penalty — simply for deciding that she isn’t ready to be a mother.

In other words, a permissive legal landscape is the ideal: Abortion and contraception both broadly legal, free, and easily available, in whatever form women choose. For abortion, that would mean women could decide between going into a clinic for a surgical procedure, or collecting the pills over the counter at a pharmacy, consulting with a health care provider over the phone or video call, and inducing a miscarriage at home.

But where the ideal doesn’t exist — and it doesn’t exist in the United States, even now, before the Supreme Court guts Roe v. Wade — giving women the ability to self-induce their own abortions outside of the reach of the state is the next-best option.