Abortion boats, robots, and drones: 'Women on Waves' founder talks US backsliding and new solutions in the wake of Roe v. Wade reversal

• Rebecca Gomperts has founded several organizations that provide medical abortion access to women around the world.
• She spoke to Insider this week in the wake of the Supreme Court overturning Roe v. Wade.

For more than 20 years, Rebecca Gomperts has been providing medical abortion access to women around the world by land, sea, and sky.

The Dutch doctor founded "Women on Waves" in 1999 in an effort to prevent unsafe abortions and provide access to hundreds of thousands of women living in countries where abortion is illegal.

The organization's most famous campaigns — its sea voyages — employ vessels which dock in abortion-restrictive countries. Women seeking to terminate their pregnancies board the ship and sail into international waters where they are then given access to the abortion pill (or a medical abortion, or medication abortion). The one-hour trips offer a legal loophole thanks to Dutch law, which governs the ships while they remain at sea.

In subsequent years, the team has expanded outreach by implementing several additional methods to provide abortion pills in innovative ways, including the use of drones and robots, which are operated in countries where abortion is legal but deliver the medication to women in countries where the act is criminalized.

And in 2018, Gomperts founded Aid Access, a nonprofit organization that provides access to medical abortion by mail in the US and around the world.

She's been busy. But the work never stops.

Gomperts spoke to Insider about the future of abortion rights in the wake of the Supreme Court overturning Roe v. Wade, offering an "outsider's" perspective on the country's backward movement.

What prompted you to start Women on Waves more than 20 years ago?

It's always hard to trace back why things happen, but it is a combination in that I'm trained as a doctor, and I started working in this abortion clinic, and as part of my following, my passion, I also started working with Greenpeace. So the two came together, and [I had] the idea to start a mobile clinic onboard a ship — because it's Dutch law that applies to a ship in international waters — in order to provide abortion services to women in countries where abortion is illegal.

Before that, I had been confronted with the impact of the restrictive abortions based on restricted laws when I was doing my internship in Africa, and I also saw it in Latin America, so it was an idea to solve a problem.

Throughout the more than two decades of work you've been doing in this sphere, do you have any estimated numbers on how many women you've been able to help with abortion services throughout the world?

Well, if you combine Women on Web, Women on Waves, and Aid Access together, I think it'll probably be around 200,000 or 300,000.

When it comes to some of your most famous campaigns — the abortion ships and the abortion robots — can you explain the legality of operating these services in countries where abortion is outlawed?

So in a sense, what we do is very similar to what many multinationals do. They look for the jurisdictions where they are able to develop things that they don't have; to either not have to pay taxes or whatever regulation that's different from the countries that makes it possible for them to go to do things. It's just that we do it to advance women's rights. So we use different jurisdictions in order to set up services, so that women can actually access abortion pills in this case.

With the drone, the way it works is that when you're flying the drone from one country where abortion is legal and where pills are legal to a country where it's illegal, the drone controller stays in the country where the abortion is legal. So then the drone delivers the pills, and the women take the pills off the drone.

With the robot, it's a similar situation. The robot can be controlled from anywhere in the world, actually, because they're WiFi connected. So in this case, for example, some of the campaigns, my son was controlling the robots to deliver the abortion pills to the women.

What is the "abortion ship" like? Can you describe what that process looks like for the women on board?

So actually, we don't have a ship. We buy ships for specific campaigns and we sell them afterwards, or we rent the ship. It depends. So the last campaign was in 2017 in Mexico, when abortion was still illegal in most states. And what happens is that we go with the ship to a country, and we sail in international waters in the harbor. They would take women onboard that need an abortion. Then you sail to international waters where they can take the abortion pill, and then you sail back. So it's a one-hour trip into international waters, and then you sail back, and they have the miscarriage in that country where they're from, and then we can check them up if everything goes well.

In light of the news that Roe v. Wade has been overturned here in the US, I'm wondering if you would ever consider bringing a ship or starting a campaign here?

Well, it was interesting, actually, a couple of years ago, we did do a full analysis about bringing the ships to Texas. So we know actually what it would require, where we would have to go, which harbors, what is the law that applies, et cetera. But it feels like at this moment in time, that's not the right response to what's happening.

The campaign is something that takes a few days. It's a strategy to expose what impact restrictive abortions have on women. But that is usually in countries where abortion is illegal, and it's meant to catalyze change. So the idea is that if you work with organizations, it will create a public discussion, a public debate, and we want it to catalyze a legal change so that [abortion] becomes legal. And that is what we've done in Portugal and also with Women on Web in other countries. So we really want to create change.

I think what is happening now in the US, is of course, it's the other way around, where something that was legal becomes illegal.

With Aid Access, the idea's always been to do the research and to show what's happening. Even when we started in 2018, when this [SCOTUS] decision was not even imaginable, there was already a huge problem with access to abortion in the United States. And we published about it because we want to publish about what's going on so that this knowledge can be used by different parties in order to try to create change and to make sure that women do have access and that the situation changes.

And now, what we are doing with Aid Access, with the research now, we are really measuring the impact of the restrictions by reporting on the number — the increase that we're seeing for people in the states where it's been banned. So the service is actually tracking what's really happening on the ground so that the anti-abortion groups cannot say that they were actually effective in reducing the abortion rates. Because of course, that's not the case. There's still abortions, but they go underground.

So you're tracking where and when and how women are continuing to have abortions —

And why.

Do you have any plans for other Women on Waves campaigns or are you primarily focusing on Aid Access these days?

Actually, Aid Access is not my main focus at the moment. It's very important and it's there, but it's functioning and it's working and it's there. It's there to help women.

But I'm always interested in, okay, what's next? What is in 10 years, what makes sense? What is important then, and how do we change the paradigm…and how do we break through these barriers? So actually, my main work now is to work on making Mifepristone in the lower doses, 50 milligrams, available as a weekly contraceptive, an on-demand contraceptive.

Mifepristone is the abortion pill, and it has amazing health benefits for women. It works really well against endometriosis. It works really well against myoma. It's a very effective morning-after pill, and it's a very effective contraceptive pill once a week that doesn't have the side effects of hormonal contraceptives. And there hasn't been any new invention in oral contraceptives for 50 years, since combined hormonal contraceptives became available. And so, because it's not patented anymore, the pharmaceutical companies are not interested in investing the money to make it available for other uses. So, that's what we took on. And we decided this is a medicine that needs to be liberated from the restrictions that have been put on it so that it becomes widely available for women to use for all its indications.

This work you're doing with Mifepristone, is this happening under one of your organization's umbrellas?

Yeah. Well, the thing is, we are now fundraising because we have the ethical approval of the Ministry of Health of Moldova to do the study there, because [50 milligrams] is available there already on the market for treatment of myoma. But we don't have the money to implement the study yet. So we are now fundraising to be able to do the study. And then we think it'll take five years, and then we can start applying for registration as a contraceptive with the FDA and [European Medicine Agency]. So then it should be available within 10 years. And then we hope that it will really change women's lives.

Do you see this as a possible solution or response to what just happened with Roe v. Wade here in the US?

Yeah, it is. Because the thing is that instead of focusing on abortion, if you can liberate the Mifepristone from that status and can show the other health benefits, and it can be registered as a contraceptive, a weekly contraceptive with a lot of health benefits for women, and the FDA will approve it like that, then there's no way that the states can stop it from being distributed.

Do you anticipate any blowback? There's some conversation around whether or not contraception could be the next battleground here in the US. Is that something you're at all concerned about?

Yeah, but I think the battleground in the US is now — of course, I don't know the US that well. I'm an outsider, so when I reflect on things, it's from an outsider perspective, it's not from a really strong knowledge base. I just want to say that. But how we see it from afar, from Europe, is that basically the country has been taken over by a bunch of non-elected, conservative, fundamentalist Christians basically.

And they are really upsetting the whole social structure of the United States because it's not only abortion but the gun laws. There was this verdict where now…the states cannot regulate access to guns anymore. So that is creating a whole different battleground. And then there are also the decisions that are coming up, where the Supreme Court is trying to diminish the discretionary power of federal agents with the Clean Air Act decision coming up.

The whole fabric, I think, of the way the United States used to work is being upset now. So it's not just abortion.

How did you respond to the ruling? Did it surprise you at all?

Yeah. Well, surprising is — of course, this has been a strategy that has been worked on by the anti-abortion groups for years. And this is not just happening in the US. They're implementing or trying these strategies as well in Poland and in Hungary and a lot of these Eastern European countries, but also in Africa.

I think that nobody would have foreseen that Trump was able to install three Supreme Court judges. That is what made this happen. That's what you're facing now. And I don't think that has been a normal process. That's just an outlier, but it's going to be there for the next 20-30 years because these people are young. And they'll be there for their lifetime. It's ultimately frightening for you, I guess.

Do you have other abortion rights organizations now coming to you and asking for help or guidance? Is that something you do?

Yeah, we always work together with many women's rights organizations around the world. So we always look at places where there is an opportunity to work and to really participate in change and to catalyze change or to support local women's organizations. So we've done that in Ireland before abortion was legalized there, we've worked really closely together with the Irish groups. We've done it in South Korea, even in Argentina, and many other places. So that's part of our work to do that, to look at where there are opportunities where you can really intervene, where it'll make a difference. That's how we work, but I think the US is going against that trend, where most countries are legalizing abortion.

I want to ask — is there anything you think, when the media or reporters write or talk about abortion and Roe v. Wade, that we're missing? What do you wish was being mentioned in these stories?

I think one thing that is really missing is basically…the advance provision part. So any doctor can prescribe Mifepristone and Misoprostol for women that are not pregnant because the laws are all addressing when people are pregnant. So when you can make sure that people have these medicines in their home, like the morning after pill, then there's no criminalization because there's no pregnancy. And so they cannot be prosecuted for that.

And also, Misoprostol is still widely available in all the states. Mifepristone is sometimes difficult to get. But it feels that people are more intimidated to not doing anything anymore. And I think it's really important to try to look for what is possible, what is still possible. And I think there's still a lot possible, but the laws are really intimidating and scaring people away.

Of course, the US has a lot of social and legal injustice. Many people…they're admitting to crimes they never committed because it's almost impossible to pay the legal fees and to fight that. So the legal system is broken, the medical system is broken, and that makes it so hard for people to act against these laws and restrictions.