This Doctor Moved Her Clinic to the Middle of the Ocean to Help Women Get Safe Abortions

IN FOCUS, 12 Jan 2015

Think Progress – TRANSCEND Media Service

Dr. Rebecca Gomperts on her ship

Dr. Rebecca Gomperts on her ship

“How could we create a space in which the only permission a woman needs is her own?”

That’s the question Dr. Rebecca Gomperts poses at the beginning of Vessel, a new documentary that follows her work sailing around the world to teach women how to safely use abortion-inducing drugs. Nearly 15 years ago, Gomperts took to the sea in search of that space for the women who lack reproductive health options.

Gomperts, a physician and former Greenpeace activist, made international headlines after launching the organization Women on Waves, which relies on the use of offshore spaces to advance abortion access. She and her colleagues traveled to countries like Ireland, Poland, Portugal, and Morocco to help women use abortion-inducing pills called misoprostol — also referred to simply as “miso” — to safely end an early pregnancy. They administered miso in a clinic aboard their ship, which was registered in the Netherlands. There, under the jurisdiction of Dutch law, they were able to bring safe abortion to countries where the procedure is otherwise illegal.

Miso is used around the world for multiple medical purposes, like inducing labor, treating post-partum hemorrhages, and preventing ulcers. In many countries, it’s stocked on pharmacy shelves primarily for those purposes. But women desperate to end a pregnancy don’t always realize that the right dosage of miso — 12 pills over the course of 12 hours, according to the World Health Organization — can also be used to induce a miscarriage.

The pills also have an incredibly important benefit for women who live in countries where they risk jail time for having an abortion: After using miso, there’s no way for a doctor to tell the miscarriage was anything other than a natural pregnancy loss.

Vessel, which premiered at SXSW in March and will open in New York City this week, charts Gomperts’ mission to get that information into the hands of women who need it the most. This education campaign isn’t contained to her ship. Eight years ago, Gomperts also helped launch Women on Web, a separate group that functions as an online consultation service for women who want to know how to use miso to induce an early abortion.

“You don’t need to be dependent on other people. All of the women can do it themselves, if they have the medication and know how to use it,” Gomperts told ThinkProgress in an interview. “I think that is what makes medical abortion so significant, and so revolutionary, and so important. You don’t need a doctor to take some pills. That’s the bottom line.”

The form of medical abortion considered to be the gold standard includes another ingredient, mifepristone, in addition to miso. That’s the combination in the abortion pill that’s currently legal in the United States. This two-ingredient method is highly effective, and Women on Web recommends using it, if possible. But researchers have also confirmed that miso is safe to take alone, which makes it a viable option for women who don’t have any other choice — especially since many countries have banned mifepristone, which has no medical purpose other than inducing abortion. The World Health Organization has approved miso as a valid method of terminating an early pregnancy when mife is not available.

One scene in the film depicts Gomperts appearing on Portuguese television, using her platform to tell women across the country how to end a pregnancy with 12 pills of miso available in their local pharmacy.

“It was quite bold, what I was doing — it was the first time anyone had ever explained on television how to do medical abortion,” she recounted. Now, she’s hoping that Vessel will continue what she started. One of the reasons Gomperts is excited about the upcoming screenings of the film, she said, is because “anybody who sees the documentary knows exactly how to do an abortion.”

When Vessel was first screened in Austin this past March, there were some obvious parallels between the situation for women depicted in the film and the situation for impoverished women in Texas. There, pregnant women have increasingly been crossing the border into Mexico to buy miso on the black market, now that a harsh state law has shuttered dozens of abortion clinics.

“The landscape has changed so dramatically since I started making this film eight years ago,” Diana Whitten, who directed Vessel, told ThinkProgress. “What I thought was a foreign story has become a local story.”

The headlines coming out of Texas over the past year have been dire — “Texas Women Forced to Use Ulcer Medication to Induce Abortion,” for instance — and often fail to capture the full story about miso. It’s not necessarily the drug itself that puts women at risk; however, there are serious concerns that women don’t have instructions for using it properly, or that some of them are getting duped by counterfeit pills.

“It would be very useful to have more information available in Texas,” Gomperts said. “Women are doing it without proper information, and they run legal and health risks. The problem there is that, as we know in the U.S., we have seen women go to prison for taking misoprostol by themselves.”

Of course, unlike the places where Women on Web works, abortion is legal in this country. But it’s still illegal to self-induce an abortion; just last year, a mother in Pennsylvania was jailed for buying miso and mife online to help her daughter end a pregnancy. Reproductive rights groups working in the the United States want to be careful about staying within their legal bounds, although Gomperts and Whitten both acknowledged there are activists in Texas starting to explore the possibility of disseminating more information about taking miso safely.

“I hope this film will be a mobilizing tool. I hope it educates people about medical abortion,” Whitten said. “I understand that there are legitimate fears — these underground networks are already happening, but we’re up against some real legal boundaries.”

Vessel is currently on a 100 city international tour, but Whitten has also launched a community screenings campaign so activist groups can host their own viewings of the documentary. It will also be available on demand beginning January 13.

There’s already been some evidence of the power of the information in the film. After it was screened in Ireland — which has one of the harshest abortion bans in the world — women hung a giant banner from a cathedral in Galway advertising Women on Web’s resources.

“NEED A SAFE ABORTION? SAFE PILLS AT WOMENONWEB.ORG,” the banner declared.

“That was extremely moving,” Gompert said. “If that’s what the film does, if it inspires people to take action and help spread the word about medical abortion — that it’s safe, that women can use it, and how to find it — that would be an amazing outcome.”

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