On the Interplay of Abortion Access and Digital Rights: A Conversation with Venny Ala-Siurua, Women on Web’s New Executive Director

Can you tell us a bit about yourself?

I’m originally from Finland, but I ended up in Canada after working 10 years in the international development sector, in social and health protection. In the past, I worked in various countries including India, Kosovo, Ukraine, and Laos. I did most of my career in non-profits, but I also did some work for the Finnish government and the United Nations. In my work, I have been mainly focusing on service delivery, but I remember when I started, I was very interested in policy work and decentralized healthcare, questioning to what extent the decentralized health services are delivering on the promises of being more responsive and gender-sensitive. Working in Laos for example, I came face-to-face with the reality of communities having very limited access to sexual and reproductive health services and supplies, and there was no access to safe abortions. From Laos I moved to Montreal where I shifted from working directly in communities, to defending human rights on the Internet.

One of the focus of your work has also been digital rights and security. Can you tell us a bit about that work?

Before I joined Women on Web, I was working for a non-profit organization based in Montreal that provides website protection and censorship circumvention tools for human rights defenders and journalists. I was very inspired by digital rights work and the Internet Freedom community. I really enjoyed working with people who had a totally different background than mine. We were all human rights defenders, but the people I was working with were also coders, engineers and data analysts. So, when I started working for Women on Web, of course I was very inspired by the work and the impact that the organization had, but I was also very curious and excited about the digital nature of our work. Because in fact, digital security and digital rights are very connected to what Women on Web is doing. On one hand, they relate to our policies and practices that we adopt as an organization to keep our staff safe and to keep our service secure and private, and on the other hand, it’s very much about the censorship we’re facing around the world. Internet is like a double-edged sword for us: while it enables us to reach a greater number of people and democratize access to information, it also exposes us to a totally different set of challenges and threats. The Internet is not the democratic and inclusive space that people hoped for years ago, and it has a lot of gatekeepers, governments, and big companies deciding what information is acceptable and what should be accessible. Running a digital service like ours means that we are dealing with online censorship, misinformation, and algorithms that carry their own gender bias, and I’m eager to tackle these challenges and raise more awareness around them.

You already addressed it a bit, but I still want to talk about telemedicine abortion, especially that it has become a silver lining amid the pandemic. Considering its digital nature, do you foresee any additional challenges and shortcomings for telemedicine abortion services?

One challenge for telemedicine is to continue to shed light on the growing scientific evidence on the safety and effectiveness of medical abortion. Medical abortion is a modern and widely used method, but there is a lot of misinformation on the Internet around it, and we have artificial intelligence and algorithms that proliferate this because it receives a lot of engagement and reactions from people. Another challenge with telemedicine is that, despite its many advantages, we need to consider the existing digital inequalities. When using digital technologies to deliver services, we should also address and be aware of the disparities in accessing modern technologies and the Internet. A digital solution in one context may not be available in another.

Now that several countries allowed telemedicine abortion within the context of the pandemic, how do you see the role of telemedicine abortion during and beyond the pandemic?

It’s very exciting to see how telemedicine has been adopted as a solution to maintain access to abortion services and even expanding services during the pandemic. For example, in the United Kingdom, the adoption of telemedicine abortion has resulted in individuals accessing care faster and having terminations in earlier gestations. Barriers to abortion access existed before the pandemic, but COVID-19 has certainly made these barriers more visible. So, for example, many people were already traveling long distances to access abortion. During the pandemic, travel was restricted, flights got canceled and some countries had nation-wide lockdowns that made travelling no longer an option. In other countries, abortion services were already scarce and the overburdened health services were used as a pretext to roll back existing abortion services. Luckily, the pandemic also necessitated the introduction of telemedicine in countries like the UK, France and the US. Now it’s very important that telemedicine remains available beyond the pandemic and that we also recognize that there has always been a preference for self-managed abortion simply because of the privacy and convenience it offers to people.

Now maybe I will shift more to Women on Web, because in this context where telemedicine abortion loomed large as a solution during the pandemic, Women on Web, being one of the first telemedicine abortion services, has a big role. How do you see the journey and the role of Women on Web?

For me, Women on Web has always started from the finish line. Meaning that the organization has clearly defined what the ultimate objectives are, which is basically individuals accessing abortions in a way that corresponds to their rights, autonomy, and needs. Women on Web has made very little compromises along the way. For that reason, it has been able to imagine a very different reality around abortions right away. I think this has been very inspiring for people who have followed our work. When we started fifteen years ago, we were working on the fringes and telemedicine was in the margins. Now, after fifteen years of hard work, we see that what we have been doing for all these years is becoming a standard form of care in some countries. One of the critical elements in this change for telemedicine to become mainstreamed in such a way is the research Women on Web has been publishing for years on the safety and effectiveness of telemedicine abortion.

Indeed, Women on Web has been combining research with public action, advocacy and service provision. What do you think of the role of Women on Web among other social justice and sexual and reproductive health and rights movements?

Women on Web is a compelling example of how a digital service compares favorably with in-person services. We set an example on how to lower barriers of access and center the service around the individual, managing and delivering care in a feminist way that considers the person’s privacy, bodily autonomy and self-determination. I see Women on Web as part of the digital transformations that sexual and reproductive services, and abortion services in particular, are going through. More and more people are using digital technologies to access information and services and because we operate from the intersection of safe abortion and digital rights, that makes up part of the critical debates around technology and its impact on right to health, non-discrimination and participation.

Despite its digital nature, Women on Web also seems to work a lot with grassroots organizations. How do you see Women on Web’s connection with grassroots activism?

The on-ground, offline action makes our digital work as a collective of doctors, researchers, activists and human rights defenders possible. Sometimes we initiate collaborations with local groups and other times we amplify what is already happening in the local settings and resonate what local civil society actors are bringing to our attention. It is essential to be part of this global network of digital and on-the-ground initiatives and alliances.

With the pandemic and travel restrictions, activism and advocacy had predominantly remained online. How do you see the future of digital activism and advocacy?

Digital activism and advocacy can be very powerful, and the Internet has always been a great tool of resistance and collective action, connecting people and ideas across the world. Digital activism is flourishing at the moment and it’s important that new digital activists and collectives are mindful of keeping their communication private and secure and stay safe working and organizing online. It is also important to remain cognizant of how big companies like Google and Facebook are influencing and shaping online activism. For example, at Women on Web, even though we are an abortion provider, we cannot use the word “abortion” in our own ads! These kinds of invisible barriers require creativity and perseverance from digital activism! That said and despite its challenges, the Internet is still safer and more accessible for many, including people with disabilities and gender-diverse people, to engage in activism.

You mentioned that Women on Web is a digital collective of doctors, activists and human rights defenders. Could you tell us a bit more about your team at Women on Web?

Women on Web is quite a big team at the moment. We have growing team of 11 doctors working with us who advise us on different country contexts and provide supervision for our service. Then we have 23 helpdesk members working for Women on Web and they are really at the heart of our work; they respond to emails throughout the abortion process, 7 days a week. It’s also a very young and dynamic team, and certainly a multi-cultural one. We speak 17 languages! The way we stay in tune with a very large number of countries, relies on the talent and expertise of our helpdesk members. They keep us connected with the countries where our services are available.

And now you are becoming the Executive Director of Women on Web! Could you please tell us about your vision for the future of the organization?

There continues to be individuals who will depend on services like ours and for whom our service is the only safe and affordable way to access abortion. Our services and support are able to reach some of the most remote places in the world and we continue to localize our website and service to reach more and more people. At the same time, in countries where abortions have recently been legalized or have been legal for long time, there is still a lot of work to be done. Just because abortion is legal, it does not mean that they are accessible. This is why it is very important to analyze and shed light on barriers to access. We will continue working towards a future where at-home abortions are a part of modern and inclusive healthcare. Self-managed abortions should not only be endorsed during a time of crisis, and they should not be considered as the last resort that individuals turn to after all other options have been exhausted.

Following up on that, can we ask what’s next for Women on Web or will it be a surprise?

There are a lot of exciting things happening this year: we are eagerly monitoring our court case against the Spanish government for blocking our website last year in the midst of the coronavirus crisis; our visual identity just went through a revamp by a very talented artist named Jeanine Ros, and I encourage everyone to come listen to our talk at the Rights Con festival in a few weeks where we are talking about how the updates to the Google algorithm are penalizing online abortion services and delaying and preventing access to care.

But more generally, I think we are heading towards a new exciting era of telemedicine and Women on Web, where we will be responding to people’s positive preferences to access abortions remotely on their own terms.