We Europeans see the U.S. as the most socially conservative (repressive?) society in the developed world with respect to gay rights, women’s health, immigration, distribution of wealth, etc. Last week’s Economist, most widely read newsweekly in the world, had a story from Idaho (a mountain state in the western U.S.) that reinforces this Euro-view.
A mid-20s, single mother of two missed two periods. The oh-my-god fact was 90% of U.S. counties, and 98% of rural counties, have no abortion services or referrals available. The woman of the story faced a seven hour drive to have an abortion, done twice because the state involved required a “waiting period.” She turned to the internet for RU-486, the U.S. name for mifepristone, or “the abortion pill.” This is not to be confused with morning after pills that will prevent, but not terminate, pregnancy. I was unaware of internet sources for this rather dangerous medication, so I went looking. I was appalled at finding dozens of sites advertising RU-486. None of them indicated their nationality nor the source of the drugs they were peddling. They had mutually contradictory advice as part of their competitive advertising. One site offered a convenient, online, medical approval and mail delivery. I could not resist.
I presented myself as a 23 year old, unmarried, healthy woman with no previous pregnancies, children, miscarriages or abortions who estimated the current pregnancy to be at nine weeks (a handy calendar with cycle questions helped here). I reported a positive home pregnancy test but stated there was no ultrasound available or conducted. There was a rather thorough medical history gathered but which could easily have been faked. Some interesting items: “Is there an emergency room within 100 km (60 Miles)?” “Have you a friend or family member who can drive you there?” “Have you a friend or family member who can be with you while taking the medication?” I continued right up to the point of authorizing a credit card payment of €300 (other currencies accepted) when, it was explained, the history would be reviewed by a doctor and I could expect delivery within 7-10 days. I went for a bike ride to process what I had just seen and am upset.
Each nation has its own guidelines for this procedure which includes two different drugs. Various regimens have a woman taking the first followed by varying doses of the drugs over the following twenty-four to forty-eight hours. The first drug kills the foetus; the second, causes expulsion. A woman can expect the worst cramps imaginable, a real mess flowing from her and nausea and headaches for a few days. In the news item cited, the woman delivered a complete, but not yet viable (according to the pathologist) foetus of about eighteen weeks development, about double the time for which RU-486 is approved.
The possible side effects, in addition to the above cramps, etc., are serious and experienced by 5-10 percent of women inducing abortion with the drugs. Any drug that can kill something in a uterus can kill the woman, herself. The most common problem is incomplete evacuation of the uterus which can leave the woman bleeding until the evacuation is complete, or death, whichever comes first. Most countries require that that mife be administered by medcial personnel, in a clinic setting. Some require an overnight stay at the clinic until the critical time has passed.
Some of the current pressures to restrict abortion around the world, especially the U.S., will most likely lead to more “mail order abortions” and very few women are aware of the risks involved. I read an editorial in a medical journal suggesting that this will take the place of the coat hanger, knitting needle and seedy motel abortions of earlier days. Women, if you want an abortion that is your decision, do not even consider it by mail order.