Empowering women and de-stigmatising abortion with pills

Access to abortion information and support saves lives – from today women across Africa and worldwide have a new source of help

whwheroSept 28 logo

Abortion is a common and normal experience in women’s lives. We must reclaim women’s right to abortion and to information about reproductive health and rights.



Clear information on the safe use of abortion medicines must be made more accessible across languages and cultures.

To meet this need, guidelines and information needed for the use of abortion pills at home, regardless of a woman’s geography and legal context, are posted on the Women Help Women website. The information is also shared via email with anyone who contacts the site.

partnerwhwWomen Help Women is a nonprofit that works with local partners in Africa and worldwide to disseminate this reliable, evidence-based and life-saving information as widely as possible. WHW offers trust and support to each woman in making the pregnancy decision she feels is best for her at this point in her life, including the method she chooses, whether done privately at home or in medical facility.

Women Help Women runs a multilingual information centre about the use of abortion pills. Requests for information and for help come mostly from women living in settings where access to abortion is legally restricted. They can request abortion pills and/or contraceptives online. A small package is then sent to their home address.

Although self-management of medical abortion presents enormous potential for the empowerment of women and studies document that safety and efficacy of medical abortion, the experience of individual women is often deeply stigmatised. Abortion stigma can be found at each and every level of our social lives, in communities, in mass media, in institutions, such as health care facilities and in legal regulations. While stigma is culturally specific in each region, it is also multi-level and multi-faceted.

Abortion stigma is cumulative – it builds on other forms of discrimination and structural injustice. Ultimately, abortion stigma serves to marginalise an essential medical process, discredit those who would provide or procure it, and undermine those who advocate for its legality and accessibility.

The international counseling team of Women Help Women is spread across 4 continents and consists of about 25 pro-choice activists and local trainers with extensive experience in information provision on abortion pills. The team works in 6 languages 7 days a week and receives thousands of emails, with a significant increase in volume every month. Many women share their feelings, intimate thoughts and stories. Women assure us that their decision has been thought through many times and that there is no possible alternative. Women write to justify their decisions, expecting to be judged, and their narratives relate to the stigma that abortion must be 'earned' through suffering. The pervasive stigma labels independent use of medical abortion as a method of last resort, instead of one of many proven safe and effective methods that should be available to all people seeking abortion alongside care in hospital and clinic settings.

Interestingly, many times the feelings and perceptions after the abortion are different. Despite expressing anxiety and fear throughout the process, astonishment is expressed when all is over, because most commonly there are no complications, the process was successful and straightforward, and some women experience tremendous relief at the safe resolution of the stress caused by an unwanted pregnancy.

The ability to control one’s body is a fundamental matter of freedom and the right to self-determination. Abortion pills and contraceptives belong in women’s hands. Women do not need to 'earn' their right to abortion or justify their reasons for ending an unwanted pregnancy.

It is our right to decide our own fates, and to safely end an unwanted pregnancy by whatever method we choose. To truly de-stigmatise the experience, we must expand our options, and women should be presented with the possibility of freely choosing the method, be it at a clinic, under the care of a clinician, or independently managed at home. Any restrictions or obstacle to abortion care decrease our rights and the quality of care.

Access to all forms of abortion care should never depend on what local governments or institutions deign to make available, or acceptable. WHW supports all people’s pregnancy decisions and always provides information about all possible choices that are medically safe, including referrals to clinics or information about the use of misoprostol obtained locally. Advocacy for choices, for a variety of methods, as well as for de-criminalisation and legal changes are at the centre of WHW’s messages.

In restrictive settings, independent use of abortion pills constitutes a political act of resistance against local regulations and oppressive laws, whether consciously or not. By taking control with their own hands, these women are rejecting systems of law, local medical practice, societal norms, religious norms and sometimes deeply held personal beliefs often rooted in gender discrimination and patriarchy. The experience can be transformational.

The stories of women and the growing demand for unbiased information call attention to the need to exponentially expand the availability of information about independent use at home of abortion medicines. This requires building alliances and collaborations at the local level both with activists working to expand information and with advocates working for legal change.

In Africa, WHW currently works with organisations in Kenya, Nigeria, Tanzania, Malawi, Zambia, the Democratic Republic of Congo, Burundi and Uganda to build a jointly conceptualised network hosted by TICAH in Kenya. The program is called MAMA - Mobilising Activists around Medical Abortion and is supported by AmplifyChange. MAMA will improve the quality of information and services locally, create new resources for women and community health workers, strengthen the outreach and visibility of local hotlines through joint action. The program mobilises community health workers and lay activists to become information resources and advocates for abortion rights.

The building of skills of community health activists is grounded in the World Health Organization’s 2015 report which highlighted the pivotal role that lay community health workers can play to expand access to information about medical abortion. In countries with shortages of medical professionals or where medical professionals do not want to engage in abortion care, lay groups can be a game-changer for improving access to this life-saving information and care. The approach is reflected in the WHW’s vision of woman-to-woman provision of safe abortion information and reliable medicines supported through strong networks of community organisations.