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Abortion. Yet another age-old debate.
Nicholas D. Kristof of the New York Times thinks that there is a solution. In a recently published article, he voices excitement over a potential gynecological revolution. What is it, you ask? Mifepristone and Misoprostol. What are those? The two pills involved in a medical abortion.
This pill, he says, will render politicians unable to make abortion illegal and sway people stuck in the middle of the argument towards the liberal end of things. He states:
What do these pills mean for the political battles over abortion? To firm opponents of abortion, the means of ending a pregnancy doesn’t matter. But my hunch is that, for those in the middle, taking pills at home may seem a more natural process than a surgical abortion, and the result may be a tad more acceptance.
In any case, it would be tough to carry out a ban on medical abortion. Indian companies are producing mifepristone and misoprostol in a big way, and blister packs with the combination of drugs can be purchased for less than $5 — and then shipped anywhere.
In addition, misoprostol on its own can be found all over the world, from Internet sites to over-the-counter pharmacies in Delhi. In India, misoprostol costs just pennies per pill.
Misoprostol is likely to become even more widely available, because last year the World Health Organization expanded its uses as an “essential medicine” to include treatment of miscarriages and incomplete abortions.
Like in the article I wrote about long term contraceptives, I’ll say again: that all sounds awesome. A cost effective way to end an unwanted pregnancy that would be hard to make illegal due to multiple uses …
… Yeah. I wish it were that easy.
Kristof’s article is quite concerning to me, for similar reasons as in my previous article on contraception. It’s great to see that there’s hope in making abortion legal and accessible to all women, however, you cannot just publicize these pills without explaining the side effects.
Medical abortions do not involve surgery, but they still require the oversight of a medical professional. The success rate of a medical abortion is in the 90-95th percentile, but there is the risk of an incomplete miscarriage (which is just awful) and infection. Like with any large amount of hormones, the two pills can wreak havoc on some women’s bodies, and being ill-informed about the major decision you’re about to make is highly disconcerting, especially in light of these side-effects.
In the US, a medical abortion proceeds in the following way: the Mifepristone pill is taken while you are at the clinic. You then go home, and take the Misoprostal pill 24-36 hours later. These two pills in combination induce a miscarriage, and you feel like you’re getting a super-bad period. You have a follow up appointment with your doctor, who makes sure that everything has been expelled from your uterus and that there is no infection. Preterm, a well respected abortion clinic in Cleveland, stresses the importance of follow up with a doctor:
A follow-up examination is very important. After any procedure there can be undetected problems, and follow-up care will help insure that your procedure was successful and you have a healthy recovery. There is no additional cost for a follow-up exam.
You must return 14 days after a medication abortion to be sure that the procedure is complete.
Meanwhile, Kristof is practically jumping out of his seat because pill #2, Misoprostol, which can cost “pennies,” has an 85 percent success rate at inducing miscarriages when taken alone. That is a significant success rate, but when the risks are fatal infections and other medical emergencies, we can’t be touting it as a “safe” over the counter drug for women who find themselves facing an unplanned pregnancy. It is true that women who don’t have access to legal, sterile abortions will turn to alternatives that are much less safe than taking Misoprostal (alone or with Mifepristone), but why offer something as a safe, subtle alternative when there are risks equally as dangerous? What if a woman in a country where surgical abortion is not legal hears that these drugs can induce a miscarriage, takes them without medical guidance, and they are not successful? She’ll still be terrified of going to a hospital and explaining the situation.
And those are just the potential physical consequences.
I’m not saying there are not advantages to a medical abortion. There are. However, I’ve said it before and I’ve said it again: you can’t just publicize things like the “abortion pills” without explaining how to use them properly. Especially if they’re being advertised as useful for places where there is not access to proper gynecological care and education. It ends up doing more harm than good — people will misuse them, face awful side effects, and give those who are against abortion and contraception more fuel for their fires.
And once again, and feel free to say it with me: the world needs better sex education.
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I really don’t know about this stuff so I’m asking bluntly – if you have an abortion, is the foetus going to be small enough for you not to see it? Because I for sure wouldn’t like to take these pills and then see the foetus in my toilet. Just asking. As for the pills, I think they could be given over the counter providing they came with very clear instructions on their use.
you will not see a fetus when the abortion happens. it’s just like a bad period.
Abortions should not be over the counter. Ever. The risk is far to great in terms of both potential side effects and the risk of the “abortion pill” becoming easy birth control. Since birth control pills aren’t available over the counter, if abortion pills were, every idiot who gets poked with a dick would probably go for the abortion pill. I would much rather we eliminate the need for abortion and make birth control more accessible.
However, this did make me think about the circumstances surrounding an abortion. If abortion were illegal in my state/country, you can bet that I would rather use this pill instead of a wire coat hanger.
“Since birth control pills aren’t available over the counter, if abortion pills were, every idiot who gets poked with a dick would probably go for the abortion pill.”
The people I’ve known who’ve had drug induced abortions have said it’s as painful as other abortions, or even labor. Less invasive than a surgical abortion, which is a plus, but NOT the kind of thing people would do out of laziness.
@ Erin – Why would it be more convenient to end a pregnancy then to prevent it? “Idiots” don’t just go out getting “poked with a dick” looking to get pregnant just for the joy of an abortion. Abortion is a last resort, (I am afraid you underestimate the intelligence of the general public,) most people realize that. As my doctor told me when I found out I was pregnant and considering abortion the goal of the medical community is to keep abortions safe, legal and rare, and if they are available safer and more conveniently it should be an overall good thing.
And, just as a side note to any prolifers, I made the choice *key word* to continue my pregnancy and become a mother, and I STILL support (and am very grateful for) the RIGHT to choose what to do with a pregnancy.
“shampoo as lube” Hah! And the animal huggers say there is not need for animal testing. I bet those kids would agree that “no more tears” formulas are well worth a few rabbits.
Woops! Meant to reply to Erin!
There’s another issue – the combination of pills only works in the first few weeks of pregnancy (so, no visible “baby” in the blood and tissue that are expelled) when a lot of people, particularly irresponsible people in denial (high school kids) don’t yet realize they’re pregnant. Also, there is a not huge but also not negligible risk of hemorrhage when using these drugs. Now it’s certainly true that there is also a risk of hemorrhage with a surgical abortion or for that matter childbirth, but the thing is in those situations you’re already in a medical facility – they have the ability to recognize and respond to a hemorrhage immediately. If you’re home alone, have told nobody that you’re pregnant and having an abortion (and face it, another major advantage of this method is that it would be far easier not to tell anyway, which is good from a privacy perspective) and collapse while losing blood, it’s going to end badly.
As an option that is ethically no worse than surgical abortion, more private, less painful, less expensive and confined to the first trimester, there is a lot that’s (comparatively) good about chemical abortion. But the risks and downsides are real, and not enough people are talking about that. Good for you for posting it here.
@ Erin. You are a fucking moron. Morning after pills are actually available without a prescription. So by your logic every idiot that gets “poked with a dick” must be out there every day buying up mad supplies of those. And yet….I don’t recall ever hearing about a shortage of Plan B or a run on pharmacies. Huh. Imagine that.
Erm, anyway, back to reality where people aren’t responsible (I’m thinking high schoolers here) and don’t stand up for themselves and use protection during sex, don’t communicate with their parents about their lives, and think that using shampoo as lube can keep you from getting pregnant. High school aged kids and younger were kind of what I had in mind, and a lot of the people I went to high school with were idiots. Good for you for having a higher opinion of the intelligence of the people around you, I certainly didn’t. It was with this in mind that I reached the conclusion that a lot of people would rather be lazy than take preventative measures. If kids are going to have an abortion, I want it under the care of a qualified doctor.
I think it’s great that this may mean we continue to have the liberty to be pro-choice…however.
I fear the repercussions of having access to such a powerful drug without the requirement of a doctor ONLY because like all drugs, it has it’s possible serious side affects. People OFTEN ignore warnings on medications.
Once in college I went to my doctor for the morning after pill. She warned me of the serious side affects, thank goodness, because I was bed bound feeling the sickest I’ve ever in my entire life. She warned me and I thought to myself, “Ah, I’m sure I’ll be just fine.” I happen to be home for T-giving so luckily my parents were around to keep an eye on me but there was a good couple of hours where I literally felt sick enough to die right there. They saw how sick I was and wanted to take me to the ER until I fessed up as to why I was so sick. I can’t imagine what would have happened if I hadn’t been warned by my doctor and didn’t have someone around to take care of me.
I guess that’s the bottom line. These pills must come with some access to comfort and care. If only doctors could write a RX for that.
i appreciate the post
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