I have been working as an online abortion and reproductive health counselor for 8 years now. I rarely have a pleasure to look in the eye of the people I counsel. Sometimes I hear their voices, but usually what I see are letters they type to my screen.
Yet we manage to build a relationship.
Sometimes people ask me how it feels to communicate by email with people in need of reproductive health service? Does the written form limit the conversation, or does it actually make it easier? Can you support women without seeing them? Is it even safe?
Internet knows no borders and email seems to give an impression of certain anonymity. I have an incredible privilege to correspond with people from so many places in the world. I would never be able to meet them otherwise, and hear their stories. A lot has been written in the last years about undeniable added value of the online communication for health issues, especially for more difficult or stigmatised ones.
Some women write me asking for an advice what to do in their situation and expect me to suggest a solution.
But I am not an advisor. I am a counselor. It would not be fair to decide for you.
I might have more factual knowledge on the subject of reproductive health, but you, out there on the other side of the screen, have knowledge of yourself. I provide information in most comprehensive way I can and in relation to what you ask me and tell me, and I will support you, but I will not diagnose, I will not recommend what you should do. You make your own choices. There is no secret knowledge I have that anyhow positions me as the one with THE answer that can solve your dilemma. YOU have the answer. You really do.
At times you feel the urge to tell me how it happened that you are in this situation. You give me the reason why you have an unwanted pregnancy.
I listen and am grateful that you share with me. But I do not need to know. I will not write to you differently, there is no better more ethical reason than other. I will say though is that 1 in 3 women has an abortion in their lifetime, it is a common fact of our lives that we should embrace. Abortion is health care and your right, no matter why or how many times you need it.
As a counselor I try to frame my communication in a way that is responsive, supportive & non judgmental, clear & concise, medically accurate and empowering.
The empowerment is not in a moment of having found the best solution for you. It is not just a concrete, single event in time, it is rather the process of finding it and acting upon it. It surely was for me.
And lastly – the safety of medical abortion has been extensively proven, and you can read about it in the Questions and Answers section of Women Help Women website.
The follow-up model based on self-assessment is steadily used more and more for provision of early abortion with pills. Women call, text or email the personnel that support them in case of questions.
Here is a link to a recent excellent scientific article: Cameron S.T. et al., Can women determine the success of early medical termination of pregnancy themselves?
The short answer to the question in the title of the article is: yes, they can.
And they often prefer to do so, themselves.
I trust them.