In the Netherlands, the abortion pill is available on request via an online platform

Implementation of a WHO recommendation 

In the Netherlands, so-called ‘medical’ abortion (involving the ingestion of the RU-486 pill) is permitted up to 9 weeks of pregnancy, or 11 weeks of amenorrhoea.  

Upon simple request by completing a form, the responses to which are processed by one of the doctors registered with the platform, a woman residing in the Netherlands will thus obtain the necessary prescription to collect the abortion medication from a pharmacy. The procedure will be covered by the Dutch National Health Service provided the woman resides in the Netherlands, and the prescribing doctor will receive the amount set by the authorities for the standard cost of an abortion. 

The initiators are basing their approach on an official recommendation from the World Health Organisation (WHO) stating that, worldwide, a pregnant ‘person’ should be able to independently access ‘medical’ abortion up to 12 weeks of amenorrhoea (10 weeks of pregnancy), outside a healthcare facility.1 

The initiative was so successful upon its launch that the doctors behind the platform were unable to cope with the flood of requests (more than 30 per day). The site had to be taken offline for a week. It is now operational again.  

Criticism and doubts regarding legality 

The main medical associations in the Netherlands (the Dutch Association of General Practitioners, the Federation of Doctors and the Association of Doctors Practising Abortion)are criticalof the platform because they believe that a conversation between the doctor and their patient is necessary prior to an abortion, something which is deliberately absent from the proposed system. The website is, moreover, clear on this point: ‘If you need a consultation or personalised support regarding your unwanted pregnancy, our online service is not the most suitable option. In this case, please contact your GP, Fiom or a clinic that performs abortions. ” Or again: “The application form replaces a consultation”; “We do not provide personal follow-up”. Patients are, moreover, referred to their GP or an abortion clinic in the event of complications following the ingestion of abortion pills. However, it is well known that medical abortion is not without consequences for the woman, both physically and psychologically. The psychological impact of a home abortion, which often takes place in isolation, can be severe. These are not taken into account or managed by the platform’s staff at all. 

This raises serious doubts, not only regarding the medical credentials (what therapeutic relationship?) of these staff members, but above all regarding the legality of the website. Dutch law stipulates that an abortion cannot take place without a prior ‘discussion’ between the doctor and the patient.  

In Belgium, such a procedure would be illegal: Belgian law requires that an abortion take place within a healthcare facility (even though, in practice, ‘medical’ abortion strictly speaking – the expulsion – generally takes place at home). Furthermore, it is mandatory to wait six days after the first medical consultation before proceeding with the abortion. 

Those left behind 

Nowhere on the website is there any mention of the embryo, the foetus, or the developing human life within the woman’s womb. Yet this is a reality that very often crosses the minds of, or even preoccupies, those who become pregnant even unintentionally. Doubts regarding the decision to have an abortion are, moreover, not taken into account by the team behind the screen: if a woman is struggling to make a decision, she is advised to seek advice elsewhere.  

Finally, anyone with even a modicum of conscience will wonder how the process in place allows for the authenticity of the request to be verified. When asked whether a partner could request the abortion pill using his pregnant wife’s details, collect it from the pharmacy and secretly add it to her food, the platform replies that this is theoretically possible. It then adds: “Although we strongly deplore this unacceptable behaviour, it does not prompt us to deprive the many other women of this form of care.” One could also reasonably imagine a woman making a request with the aim of subsequently passing the abortion pill on to another woman – a friend, an acquaintance, or even as part of a cross-border order. 

There is a clear desire on the part of the platform’s founders to facilitate medical abortion, regardless of any unfortunate consequences and the drastic weakening of the therapeutic relationship. 

This example confirms a general trend in abortion worldwide: there is indeed a clear shift towards self-induced abortion with the ever-increasing accessibility of the abortion pill. Healthcare professionals are, as a result, becoming less and less involved, their role often limited to prescribing the drug, and frequently remotely. 

For further reading on medical abortion, see the IEB Expert Flash:RU-486 ou l'avortement médicamenteux : les femmes de plus en plus seules face à l'avortement