It’s Sunday morning, less than a week after the US supreme court signaled that it was ready to pave the way for new restrictions on abortion rights in the US, and I’m on the phone with a Dutch abortion provider who has watched the proceedings from half a world away.
Dr Rebecca Gomperts tells me that she’s shocked with the situation in Texas, which recently enacted a near total ban on legal abortion – not because the state government passed the law, but because doctors in the state are largely complying with it.
“I would have thought that all these clinics would have said, ‘We’ll just do it,’” she tells me.
For decades, Gomperts has been doing just that. Gomperts has made her career providing free or very low-cost abortions to patients in need around the world, regardless of local law. In 2018, she founded Aid Access, a site that allows women in the US to get abortions with the help of 10 US-based providers.
The doctors “do it [via telemedicine] in their own states, like New York, California, Washington.” Doctors write prescriptions for drugs that induce miscarriage, which then get sent to a pharmacy in India that Gomperts vetted herself. And from India, the drugs get shipped to women’s homes – including in states, like Texas, where abortion is practically inaccessible and legally all but banned. Founded especially to help American women – and to evade legal challenges in the US – Aid Access is one of the most affordable ways to get a safe abortion in America. “They only charge $150,” Gomperts says. The website says they try to help women who cannot pay, too.
The project has already come under fire from the anti-choice powers that be. In 2019, the FDA issued Gomperts a cease-and-desist letter. She didn’t comply. When Trump health department secretary Alex Azar began blocking payments to Aid Access and seizing its packages from the mail, she sued him.
But Gomperts has been helping women who face restrictive legal regimes get safe abortions since long before the advent of Aid Access. Her career as an abortion rights activist didn’t start online, but on a boat.
In the late 1990s, when Gomperts was a young activist, she travelled to countries where abortion was illegal and met woman after woman whose lives and health had been warped by unwanted pregnancies or unsafe procedures. But Gomperts had an idea. Twelve miles off a coast, in international waters, local laws don’t apply – instead, vessels must follow the laws of the country whose flag they fly. Gomperts was from the Netherlands, a nation with some of the most permissive abortion laws in the world. A boat flying a Dutch flag could legally dock in a country that banned or criminalized abortion, pick up local women in need, and then take them out to sea, to perform safe abortions on the water, beyond the reach of misogynist laws. The project espoused a kind of radical pragmatism – clever in its evasion of the law, defiant in its determination to grant women the choice that their governments denied them. Women on Waves was born.
It was the beginning of Gomperts’ career as perhaps the world’s most inventive abortion access activist. Few human rights campaigners have been so daring and incendiary in their tactics, and few have provoked the ire of so many different national governments. In Morocco, she was chased out of a port. In Poland, a group of rageful men greeted her at a dock, screaming that she was a Nazi. She didn’t even make it to Portugal – the government sent two warships to stop her boat from entering territorial waters.
But the massive and hostile resistance to her work didn’t make her back down; it made her diversify her tactics. She came to see her job as a combination of direct provision, legal challenges, lobbying, public health education campaigns and scientific research.
“I think the combination is extremely important,” she says. “A lot of our work is advocacy. Direct provision makes visible the obstacles to abortion care, and that’s also where we do most of the research … We were the first ones that were writing about the safety of telemedical abortions and self-managed abortions.”
Gomperts never visits another country without an invitation from a local women’s group, and once she arrives, she not only provides abortions but also shares best practices for helping women end their pregnancies once she’s gone. “We have trained all the women’s organizations” that they work with, she says. “We started training them to run [abortion help] hotlines in 2008. So, we’ve done all of it.”
Much of her work, too, has involved publicity. For years, wherever the boat went, cameras followed, and Gomperts, for all her radicalism, proved a savvy and skilful manipulator of the media. “When I was founding Women on Waves, that was one of the criticisms actually,” she tells me. “Many of the classic abortion rights activists, they said, ‘You cannot combine these two’” – provision and publicity – “‘because it’s about vulnerable women.’ But what I found is actually that women that need abortions, that are living in a situation where their rights are being denied – they want to be a part of [changing] that.” She recalls one woman she met on a trip to Mexico, who had been offered a way to have a safe, but clandestine, abortion in her home town. “She says, ‘No. I want to have a legal abortion.’” The woman insisted on boarding the boat.
In the two decades since she began Women on Waves, the organization has spun off into multiple different projects, all meant to increase practical access to abortion in places where it is illegal. There are the sister sites Aid Access (for the US) and Women on Web (for the rest of the world), which stretch the technicalities of the law to ship pills to women in the mail. There is the Safe Abortion app, which helps users calculate gestational time, tells them which abortion methods could be effective, and provides instructions for how to use World Health Organization– approved drugs.
And there are the hotlines and email addresses that Gomperts and her team have set up in countries around the world, where women can speak to a real human being who will give them accurate information about how to access drugs without a prescription, how to take the medication, and how to stay safe before, during, and after the termination.
Her interventions range from the strictly practical to the intrepidly cheeky. In 2015, she travelled to Frankfurt an der Oder, a German town on the border with Poland, where abortion is illegal. Once there, she flew abortion pills over the border into the Polish town of Slubice in a drone.
These pills – mifepristone and misoprostol – are Gomperts’ real life’s work. The boat, the websites, the drones – all these are mere vessels for the true message that safe abortion is possible with medication, even in countries where it is illegal. Women need not ingest poison, or insert long, sharp objects through their cervix. They can just take some pills.
In our conversation, Gomperts is adamant on this point: there is no reason, she argues, to require extensive medical exams or interventions before administering abortion pills.
She cites studies showing both the safety of the medications themselves, and the reliability of prescribing them without the expensive and often inaccessible prerequisites of in-person doctor’s visits and ultrasounds. Recent pandemic history backs her up. Since the advent of Covid, “The UK has been massively returning to telemedical abortion,” she says, “without ultrasounds, without any of those things.” The results? Women in early pregnancy have been having perfectly safe, effective abortions on their own.
“Women are capable of doing this,” Gomperts says. “I mean, it’s not very different from a miscarriage, and we trust women to have miscarriages on their own without medical intervention.”
In fact, if a self-managed abortion patient does run into complication – a rare event –Gomperts and her organizations recommend that she go to a local doctor, and tell them that she is having a spontaneous miscarriage. A doctor can’t tell that she’s taken pills, and the treatment is the same.
To Gomperts, there is little question that the risks of providing abortions to women who lack legal permission to get them are outweighed by the moral righteousness of her mission. This is part of what is so refreshing about her: the frankness of her feminist commitment. Many people will say that abortion access is a human rights issue, but too few are willing to treat it with the urgency that that label demands. This is part of Gomperts’ argument: that principled people have a moral obligation to break unjust laws.
Which brings us to the question of dignity. I’m struck, again and again, at the sheer amount of effort – logistical, legal, monetary – that Gomperts and her colleagues must put into providing abortions.
On the one hand, this effort is a testament to their dedication; on the other hand, the fact that such exertion is necessary at all in order to allow women to control their own lives is degrading and cruel. But to Gomperts, her great effort to grant abortion access signifies a great respect for her patients. “One of the things that we try to do, actually, by providing the services, is to strengthen their dignity and empowerment,” she says. “It shows them that we trust them.” In this way, her work gives women back some of the respect that abortion bans take away from them. All her projects are based upon this radical premise: That women are adults, who can be trusted with their own lives.
On the phone, Gomperts is friendly and vivacious. Even in hostile interviews, she projects an almost preternatural calm. The writer Michelle Goldberg once referred to this quality as Gomperts’ “serene audacity”.
Towards the end of our call, I ask her how she manages to retain her composure, even in conversations where people challenge women’s right to refuse pregnancy – the cause to which she has devoted her life. I expect her to tell me about her media training or her self-discipline, the strategies she deploys to keep her face straight and her voice steady.
But for the first time in our conversation, the line goes silent. “That is a hard question,” she says, finally. “I don’t know … I don’t know how to answer that.” Later, I realize that it is as if I had asked her how she remains calm while explaining that the Earth is not flat, that the sky is not green. She has the confidence of a bone-deep conviction: Women deserve to choose.