Dr. Rebecca Gomperts began her career as a primary doctor performing abortions in her native country The Netherlands. But while working for Green Peace in 1999, she began to worry about all the women who suffered the consequences of botched illegal abortions in parts of the world where they had no legal options. That's when her medical mission turned political.
So Gomperts envisioned "creating a space where the only permission a woman needs is her own."
Gomperts rented a ship that she and other pro-abortion rights advocates called "Women on Waves," and sailed to countries like Ireland in 2001, Portugal in 2004 and Morocco in 2012 -- fighting against government blockades and protesters to provide women with the pills to end their unwanted pregnancies.
The ship was always under threat of seizure in national waters, but sailed safely through international seas -- getting calls from desperate women to make appointments. On its first stop in 2001 in Ireland, 120 women sought help.
Now, her renegade global campaign to get the World Health Organization-approved drug misoprostol to women desperate for abortion, is the subject of a documentary film, “Vessel,” which premieres Sunday, Mar. 9 at the SXSW Film Festival in Austin, Texas.
"Our mission is to make sure women know about medical abortion and don’t harm themselves putting sticks in their vaginas," Gomperts, 47, a the mother of two children, told ABCNews.com.
Since the filming of "Vessel," she has created an underground network of activists and a website that educates women about use of the drug misoprostol, which is legally available in most of the world as a gastric ulcer drug that also causes miscarriage.
Film director Diana Whitten, who spent seven years following Gomperts for her first feature film and used earlier footage donated by other filmmakers, said she was drawn to the idea of providing medical care offshore -- "the idea that it wasn’t used for personal gain, but for social justice."
"I also immediately appreciated the metaphor of women leaving sovereignty to reclaim her own," said Whitten, 38. "I had also lived in Indonesia and witnessed what happened when women don’t have access to safe abortion and it made an impression on me. I knew it would make a great story."
The film comes on the heels of a new Texas law approved by the legislature in 2013, which is one of the strictest in the United States. It bans abortion after 20 weeks of pregnancy and hold abortion clinics to the same physical standards as hospital surgical centers.
Its supporters say that the strengthened regulations for the structures and doctors will protect women's health, but critics worry that women will turn in greater numbers to do-it-yourself remedies, including obtaining non-FDA approved misoprostol, smuggled over the board by relatives in Mexico.
Cheryl Sullenger, senior policy advisory for the Texas-based anti-abortion rights group, Operation Rescue, said that “women are taking their lives into their own hands,” in campaigns like Gomperts’.
“To use just one drug that was never meant to be used for abortion, which is totally off-label and can cause strong contractions and hemorrhaging – that’s crazy, in fact the standard of care is never to put women in labor without careful monitoring,” she said.
Operation Rescue just completed an investigation of state abortion clinics that resulted in their shutdown this week because they did not meet new safety standards.
“Handing out pills at a flea market or over the Internet or on a boat on the ocean endangers women’s lives out of ideology that doesn’t care that women get sub-standard treatment or risks, as long as they are providing abortions. Women deserve better than that.”
In the United States, where abortion has been legal since 1972, the Food and Drug Administration requires that a two-drug combination -- misoprostol and mifepristone or what used to be known as RU-486 -– must be used under the supervision of a medical professional.
Alone, misoprostol is routinely used off-label for obstetrical and gynecological procedures such as cervical ripening, labor induction and mid-trimester terminations. It can be used to induce miscarriage, typically up to nine weeks, but can also be safely given in through the second semester, according to the FDA.
In combination, the two drugs are 95 to 97 percent effective. Taken alone, misoprostol is only 80 to 85 percent effective, and is suspected of causing birth defects if it fails.
"The combination of drugs is the gold standard and the best method,” argues Gomperts. “But the problem is it’s not always available and this is the second best one of the drugs. With misoprostol, you don’t have to wait to go to the pharmacy -– women can buy it themselves."
According to the World Health Organization, 21.6 million women experience an unsafe abortion worldwide each year; 18.5 million of these occur in developing countries. Of those, 47,000 women die each year from complications, close to 13 percent of all maternal deaths.
"I think of medical abortion as a miscarriage –- that’s what it is," said Gomperts. "In any pregnancy, there is a 20 percent change it will end in miscarriage and you have complications that it can be incomplete and some vacuum extraction is needed."
The procedure is explained in the film: Women are given 12 pills in all, which are dissolved every four hours by mouth. Cramping and bleeding begin, as well as fever, nausea and vomiting. Gomperts advises women to seek medical attention if fever lasts more than 24 hours or there is extreme pain. The completed abortion needs to be confirmed with a pregnancy test three weeks later.
"If she goes to the hospital, the woman can say she had a miscarriage and the doctor will never know," said Gomperts. "They are not breaking the law."
Two years after the Women on Waves campaign in 2007, abortion was legalized in Portugal; laws were changed in Spain in 2009.
In the film, Gomperts ultimately realizes she can use the Internet to bypass laws and creates Women on Web, where women can buy the drugs online and learn how to use them safely. She also launched a grassroots campaign in Africa and other parts of the developing world to make these drugs more available to women and to train volunteers.
"I started thinking about the bigger good," said Gomperts.
Director Whitten hopes “Vessel” will also have an impact in the United States and perhaps help “change the landscape” in Texas, where pro-abortion rights advocates plan to rally at the film's premiere.
“I don’t know what to expect,” she said. “I suppose anything could happen. We have been working with a consortium in Austin of reproductive rights organizations. The goal of the film is to have them use the film as a tool for their agenda and to raise awareness and help educate and inspire people to join the movement.”