Women On Waves Abortion Provider Sparks Controversy (VIDEO)

07/06/2009 05:12 am ET | Updated May 25, 2011

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The recent assassination of abortion provider Dr. George Tiller has brought attention to the dangerous front lines of the abortion debate. His death is a sobering reminder that, though our laws tenuously protect the right to choose abortion, they cannot always protect those who provide the service. But what of the realities in countries that lack the support of the law?

Dr. Rebecca Gomperts is a Dutch abortion provider, and an activist on the global front lines, fighting to liberalize law for providers and women of countries that do not yet have the law on their side.

She does so by providing direct services to women in the public eye. Her organization, Women On Waves, sails to countries where abortion is illegal, providing abortions on a ship in international waters. The public controversy that follows is the cornerstone of her strategy to ignite debate and, ideally, to change the laws that force women to take extreme measures to terminate pregnancy.

Last October, she sailed to Spain, where abortion was criminalized in 1985 except in cases of rape, malformation of the fetus, or if a psychologist deems the woman unfit to carry the pregnancy to term. Working with 33 Spanish activist groups, Women on Waves established a local hotline to communicate with women seeking abortions and, when possible, transported them 17 miles offshore outside of Spanish jurisdiction.

There, onboard doctors provided medical abortions using a cocktail of two drugs. The first pill, mifepristone, is used to terminate the pregnancy. Most providers conclude this is the moment of abortion, and because of this, mifepristone is unavailable in countries where abortion is illegal. The second pill, misoprostol, is legal by prescription in most of the world as an anti-ulcer medication, but is used off-label by innumerable women to induce miscarriage. When used with mifepristone, it helps to eliminate the terminated pregnancy - a process that may have minor effects for days, even weeks, but normally is not debilitating after the initial few hours.

The campaign attracted impassioned media attention, adding energy to a mobilizing effort intent on liberalizing Spain's abortion laws. Two weeks ago, the Spanish parliament began debating a new bill that would legalize abortion on demand up to 14 weeks.

Concurrently, Women on Waves and the abortion doctor who commissioned the Spanish campaign, Josep Carbonell, were called to court to defend the abortions they administered at sea. Although the abortifacent drug was administered in international waters, outside of Spanish jurisdiction, the Spanish court claimed that the abortions were not complete until the effects of the second medication, misoprostol, concluded.

Gomperts is a well known advocate of the abortion pill, citing it as "revolutionary," and sees this lawsuit as an attempt to limit the potential of medication abortion. Medication abortion, which is 95% effective when used correctly, is an economical and more accessible alternative to surgical abortion, and one upon which women in illegal environments have relied for years, through the black market.

With the correct use of these pills, Gomperts argues, a woman can terminate a pregnancy in the privacy of her own home, without the discomfort or expense of a hospital or clinic visit. This advancement towards autonomy in abortion practice poses an enormous threat to anti-abortion factions, as it becomes more difficult to control who has an abortion and when. Indeed this autonomy gives pause even to pro-choice medical professionals, who prefer to administer abortions in the controlled environment of a clinic or a hospital.

Gomperts has traveled to Ireland, Poland and Portugal and Ecuador to provide abortions. On her 2004 campaign to Portugal, the Portuguese government blocked Women on Waves from entering their port with two military warships. In response, Gomperts established an informational hotline that assisted women in finding medication abortion. The blockade and its response produced a media firestorm. Six years later, Portugal ratified a law legalizing abortion, and last February, Gomperts won a lawsuit on the basis that the Portuguese government had blocked her right to freedom of expression, as defined by the European Convention on Human Rights. Gomperts and the Spanish consortium hope for similar success in Spain.

An alternative ruling could limit the future activities of Women on Waves, and indeed limit the potential of medication abortion.

World Health Organization research shows that abortion rates are consistent regardless of prohibitive law, and demonstrates that where the procedure is illegal, women turn to unsafe means. Women in lower income brackets, who cannot afford the high prices of underground providers, or the travel costs to countries where abortion is legal, are especially vulnerable.

Complications due to these unsafe methods - for example inserting coat hangers into the uterus or drinking turpentine - cause upwards of 67,000 deaths and 5 million hospitalizations, and orphan a quarter-million children, every year. These statistics suggest that the global abortion debate is not about whether or not abortions happen; it is about whether or not they happen safely.

If a country is to claim to protect the right to a safe abortion, it must be a hospitable place for its providers. In the States, this is not the case. Medical Students for Choice cites 87% of counties in the States as having no abortion provider and references the "graying" of providers working today (57% of whom are over the age of 50). Those who make it less safe to provide abortion in the States, by imposing restrictions that compromise a provider's ability to work, and in hypocritical acts of violence like the murder of Dr. Tiller, discourage the training of new providers. The global reality demonstrates that this only leads to more women seeking out unsafe solutions.

Nevertheless, the growing predominance of medication abortion, the evolution of which Gomperts argues to be inevitable, and which allows a woman the autonomy to be her own provider, suggest that these violent anti-abortion factions are fighting a losing battle. VIDEO: In Spain the docking of the ship became a literal tug-of-war, and a consequent media spectacle. As the boat carrying the abortion doctors attempted to dock in Valencia amid a crowd of protesters and supporters, a smaller boat manned by the harbor patrol lassoed the helm of the ship and attempted to pull it away from the dock, but Rebecca Gomperts found a novel solution. WATCH:

Diana Whitten and Anita Schillhorn van Veen are currently fundraising to complete the feature documentary Vessel, about the work of Dr. Rebecca Gomperts and Women on Waves. Vessel has been entirely funded by the generous donations of a growing community of supporters. For more information about the film or to make a tax-deductible donation, please visit the website at: VesselTheFilm.com and please visit their blog at VesselTheFilm.wordpress.com

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