“Women on Web stays open no matter what,” says Women on Web, a feminist nonprofit that connects abortion seekers with abortion pills. “Abortion is part of our lives and should be freely available to all.”
As Republicans push the FDA to restrict mifepristone, the international online abortion service Women on Web is reassuring Americans that they will continue to support access to abortion pills in all 50 states, no matter what. Women on Web has served over 130,000 people worldwide since 2005 and began serving the U.S. in July 2024.
Based in Canada, Women on Web is a nonprofit organization that has team members located across 20 different countries who connect abortion seekers with prescriptions for abortion pills and to pharmacies that will mail mifepristone and misoprostol to people up to 14 weeks of pregnancy.
Venny Ala-Siurua, executive director of Women on Web, was recently named to the Top 100 Canada’s Most Powerful Women by the Women’s Executive Network (WXN) Academe.
Ms. spoke with Ala-Siurua about how their service connects people with pills, how they’re removing medical gatekeeping and how they’re defending abortion access against digital censorship.
This interview has been lighted edited for clarity.
Carrie Baker: Why did Women on Web begin serving the United States?
Venny Ala-Siurua: We’ve always had care seekers coming from the U.S. to us, but we would always refer them elsewhere. We’ve always focused on countries where there are high restrictions on abortion. Unfortunately, the situation in some of the states in the U.S. qualifies now.
Baker: How does Women on Web help people get abortion pills?
Ala-Siurua: We are a referral platform. We’re not storing medicines, and we’re not sending them. We are connecting the abortion seeker with prescriptions and then pharmacies.
When people come onto our website, they do an online consultation, which is basically a survey asking questions around their health and their pregnancy. We do not require any form of identification and try to keep questions to a minimum. The survey is then submitted into our system. In most cases, there are no contraindications, so they will automatically receive a prescription. That prescription is filled by an overseas pharmacy, and the pharmacy dispenses the medicines to people’s home addresses. The pills arrive in a discrete package, and we email the care seeker the instructions on how to use them.
We’ve always focused on countries where there are high restrictions on abortion. Unfortunately, the situation in some of the states in the U.S. qualifies now.
Venny Ala-Siurua, Women on Web
Baker: How long does it take to get the pills?
Ala-Siurua: It’s not unusual for people to have the medications within a week. After filling out an online form, care seekers generally hear from our team within 24 hours.
We ask people to donate toward our service, after which they receive a prescription, then the medication within three to five days. We send one mifepristone tablet and 12 misoprostol tablets and charge $120 or less, depending on what the care seeker can afford.
Baker: How can pharmacies abroad get the pills to people so quickly?
Ala-Siurua: Things have just developed a lot over the years. When we started 20 years ago, there were not a lot of pharmacies to work with, but that’s not the case anymore. Many pharmacies and providers have stepped up internationally to support the U.S. and found ways of dispensing and shipping medicines really, really fast.
Baker: What do you charge for the service?
Ala-Siurua: Basically, it’s a sliding scale, from paying nothing to $120. And it’s really important for us that it’s very, very simple to access that sliding scale. At the moment around 30 percent of care seekers receive the service at zero cost and another 30 percent request a reduced payment.
We encourage people to tell our help desk if they experience any kind of financial hardship, and then, in a matter of a couple of emails exchanged back and forth, we’ll then assess the case and then try to accommodate people. We’ve never had to turn anybody away.
Many pharmacies and providers have stepped up internationally to support the U.S. and found ways of dispensing and shipping medicines really, really fast.
Ala-Siurua
Baker: How can you afford to offer a sliding-scale fee?
Ala-Siurua: The way Women of Web has always operated is that there is a global solidarity that’s built within the system. There are always people who are able to afford more, and then others who cannot. We always encourage people, if they can afford to donate more, to pay a little bit more to go toward somebody who cannot afford to pay at all. So the system, which is now almost 180 countries, is cross-subsidizing itself.
Baker: How do you support the people you serve as they use the medications?
Ala-Siurua: Women on Web maintains a dedicated help desk for U.S. care seekers with a bilingual staff who speak English and Spanish. The help desk operates seven days a week, promptly responding to requests for abortion pills, information and sharing resources. A team of doctors is available to answer medical questions or care seekers are referred to the Miscarriage and Abortion Hotline in the United States, which provides free and confidential medical advice about using abortion pills. The global help desk responds to over 15,000 emails per month around the world in 16 languages.
We’re not storing medicines, and we’re not sending them. We are connecting the abortion seeker with prescriptions and then pharmacies. … It’s not unusual for people to have the medications within a week.
Ala-Siurua
Baker: How do you ensure people’s privacy?
Ala-Siurua: Women on Web is very careful to protect patient information.
We’ve been doing this for 20 years now, working in pretty hostile, very legally complicated contexts. We have an information security person on the team. All our systems are developed for us. We’re based in Canada, and no information is stored in the U.S.
We’re very careful in how we protect information and where we store it. We also try to keep the information that people need to share with us to a minimum, because the less information you’re holding onto, the less there is to breach at the end of the day.
Baker: How many Americans do you serve and where do they come from?
Ala-Siurua: At the moment, we are receiving around 30 requests per day from people in the U.S., though that number can rise during major political moments—for example, when Trump was elected or took office. Our U.S. care seekers live primarily in states with abortion bans. Globally, we currently handle approximately 4,000 requests each month.
Baker: What do you hear back from the people you serve?
Ala-Siurua: Care seekers find the service to be compassionate. We want their experience to be judgment-free and positive.
Testimonials from U.S.-based care seekers:
“This website saved me in a professional and caring manner. The pills arrived fast and with simple instructions. I am thankful I found this group. Having someone there to guide me through such an overwhelming and frightening moment made all the difference. In a way, it was the support I needed to get through it all. Thank you and bless you for what you provide women everywhere.”
—Women on Web abortion care seeker
“I’m grateful for this website and those who run it. I live in a state where it’s not legal, and on top of that, I’m trying to get out of an abusive relationship while also having three children. I am so very, very, very grateful to you.”
—Women on Web abortion care seeker
Baker: Can women order the pills in advance to have on hand?
Ala-Siurua: Yes. For many who request abortion pills in advance, this is microactivism. They tell us how they have seen what’s happening in their states and country, and how they have decided that they are not going to care about the restrictions. They are going to stockpile and make sure that they have pills available for themselves, their families and for their community.
Baker: How do people find you?
Ala-Siurua: Most people find us through search engines, and we get a lot of referrals of course through Plan C Pills too. We’re also getting more and more referrals from ChatGPT, something that didn’t exist at all a year ago, and now it’s becoming quite a significant referral channel.
Baker: Many groups sharing information about abortion pills face censorship on social media. Has Women on Web experienced that?
Ala-Siurua: Yes, we are currently censored in six different countries, and we are litigating in three of them. We have experienced a lot of censorship on search engines as well as on social media. It’s been countless number of times that our posts and accounts have been taken down and suspended. Digital rights advocacy is actually a big part of the work that we’re doing because we rely on having access to open and free internet to disseminate information and deliver services.
We’ve recently launched a new digital rights program and we will soon introduce a new resource for our movement called A-line. Through A-line, we can assist organizations that are facing digital suppression on social media or search engines. We can also connect them with our project partners for things like secure website hosting, cyber threat mitigation, help navigating doxxing attacks and adopting pro-abortion tech that we’ve tested and trust.
Baker: If the Trump administration restricts mailing mifepristone, how will you respond?
Ala-Siurua: No matter what the U.S. does as far as restricting mifepristone, Women on Web will continue to provide mifepristone and misoprostol to people in the U.S.
Baker: On your website, you say Women on Web is shifting toward a demedicalized model of abortion care. Can you explain this?
Ala Siurua: Instead of identifying as a telemedicine provider, we see ourselves as an online abortion service that supports self-managed abortion. We’ve updated our protocols to remove medical gatekeeping, revised our online intake and updated all our help desk scripts, giving people more autonomy and trusting both SMA and the people seeking care.
We think telemedicine alone doesn’t challenge the provider-patient power dynamic or always consider the care seeker as a legitimate source of knowledge and expertise. Our goal is to treat abortion knowledge and care as something that belongs to communities, not to medical spaces.
Internally, we’ve shifted from a physician-supervised structure to a model where tasks and expertise are shared across teams. We no longer have doctors in senior management. I’m not a doctor either. And we actually removed the medical director role, two years ago. Now, experienced non-clinical team members coordinate the service, and our trained help desk staff handle most interactions with care seekers. Physicians are still part of the team, but in a supportive role. They advise the help desk team as needed or if requested by abortion seekers and they actively support our demedicalized approach.
Baker: Can you explain how feminist values shape your work?
Ala-Siurua: We put our feminist values into practice through a culture of trust, care and respect, listening and acting in solidarity with each other, with care seekers and with the global reproductive justice movement. Everything we do, our service, research and outreach, is the result of collective work and in the service of transformation. Too often, community-based, activist knowledge is dismissed and undervalued, and we refuse to participate in that hierarchy.
We’re not trying to be a medical authority, nor are we trying to capture the market. Instead, our role is to support and complement local efforts, and to share our work, infrastructure, data and procedures with other activists and feminist movements that are already leading the way. We trust that people know what’s best for themselves and their bodies. We also recognize that many who reach out to us are navigating complex situations and are often experiencing multiple forms of discrimination in their lives.
Baker: Why do you do this work?
Ala-Siurua: Abortion is a part of our lives, and no one, whether it’s lawmakers, politicians or doctors, should control what we do with our bodies or our futures. We’re here to support people in having safe, dignified and empowering abortion experiences that center their autonomy and agency. The decision to end a pregnancy belongs always to the person having the abortion.
Baker: Is there anything else you want Ms. readers to know?
Ala-Siurua: Women on Web recently celebrated our 20th anniversary and launched a new strategic plan. We’re really excited about the direction we’re heading, continuing to explore new ways to lower barriers to our service and get more abortion pills in people’s hands.
To support Women on Web, you can donate here and volunteer your time. To stay up to date, sign up for WoW’s newsletter here. To read WoW’s latest research on self-managed abortion, see here.
