“Abortion pill warning” was the front-page headline in a recent edition of Dutch newspaper AD. The main message of the article - subsequently picked up by other Dutch media - is that women should not use abortion pills obtained via the internet without seeking professional medical help first. However, Women On Waves - a Dutch organisation which campaigns to give women access to safe abortions in countries where this is difficult or impossible – says the pills are safe.

A number of abortion pills are officially approved and used – also by the medical services - in the Netherlands. However, Dutch gynaecologist Gabie Raven tells AD that they are “life threatening” if not used “under professional supervision and before the tenth week of pregnancy”.

It’s a strong warning and one which also has the backing of Health Minister Edith Schippers - quoted by AD saying:

”They are highly dangerous if not used properly. The [Public Health] Inspectorate needs to warn the countries where these websites are registered. Also, we’re going to make this part of our campaign against internet medicine sales.”

Serious complications
Just one day after the front-page report in AD, Women On Waves – an organisation which promotes global access to abortion for women and is involved in a number of local telephone helplines (see RNW article on the abortion helpline in Pakistan) that help people obtain the abortion pill - issued a press release, which opens by stating that the public health minister “has made an inaccurate pronouncement on the safety of using abortion pills. The minister incorrectly states that pharmaceutical abortion via the internet is dangerous. Fewer women in the Netherlands die as the result of safe abortion than do from carrying their pregnancy to full term.”

Gabie Raven, who also chairs the Netherlands’ professional association of gynaecologists, tells AD that women who use the pills on their own “run the risk of serious complications. Moreover, home use also takes place without the use of ultrasound, which means you don’t know if the abortion has been completely successful.”

Vehemently
The AD article says women can even end up becoming permanently infertile – a statement which the paper does not directly attribute to a medical expert. However, the paper does attribute one quoted comment “Those who use these pills on their own initiative can literally bleed to death” to unspecified “abortion doctors” - a statement which Women On Waves vehemently contests in its press release:

“Dutch women have been using the abortion pill at home for ten years. Never once here has a woman died as the result of a complication.” 

“Scientific research has demonstrated that medicinal abortion at home is safe, even when this have been acquired via the internet. Reference to a risk of death as a result of medicinal abortion is needless scaremongering.”

Would do better
The organisation also argues that the infertility argument is spurious:

“Infertility results from unsafe abortions with dirty instruments in countries where abortion is forbidden, but not from pharmaceutical abortions. This is why the death rate from illegal abortions in African countries is much higher than in Latin America where women themselves can bring on a medicinal abortion with Misoprostol, one of the abortion medicines at issue here."

The Women On Waves press release, issued in the name of its chairperson  gynaecologist Dr Gunilla Kleiverda, also voices criticism of Health Minister Edith Schippers who, it says:

“Incorrectly makes pronouncements about internet abortion being unsafe. The Minister would do better to concentrate on good access to pharmaceutical abortion […] and the provision of objective information by abortion clinics.”

At the time of writing there had been no formal response – from the minister, at least – to the contents of the Women On Waves press release. Meanwhile, although Ms Schippers has warned women against using the abortion pill independently, she can do little to stop them acquiring the medication online; most of the sites offering them are foreign and beyond the legal control of the Dutch authorities.

* Lead image: from a 13th-century manuscript of Pseudo-Apuleius's Herbarium, depicting a pregnant woman in repose, while another holds some pennyroyal in one hand and prepares a concoction using a mortar and pestle with the other. Pennyroyal was historically used as an herbal abortifacient.