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.
Not that I'm in any way defending it (since I'm from the US), but we have a lot of problems in many unrelated fields that all have a common factor. Land mass. There are many places a person can live where they'll have to drive several hours to get things that an average person would think is a day to day item. 3G/4G wireless service, high speed internet, etc. This also goes for medical facilities, especially "specialty" things like abortion clinics.
With a population of 307,000,000 you would think the 1,500,000-ish yearly abortions would drive more systems to be built, but considering the majority of the population is either east coast or west coast, a place like Idaho in the article is kind left out. Those major metropolitan areas are pretty well covered (I'm assuming). But hell, there are places in Idaho you can drive and not see another living person for an hour on the road.
In any event, I think that unless the US ever evens out it's population per acre, we're always going to be caught in things like this. Yeah it stinks she had to drive 7 hours, but then again it was her choice to live in the sticks.
Firmus, abortion clinics are so few and far between in America that you don't have to live in "the sticks" for there to not be one available. Some states have hardly any such clinics at all. I looked into it when I was staying there and was trying to find out where my nearest one would be. Incidentally, didn't find one in my town.
It's really hard to get them built and many are closing, because anti-choice groups are attacking their sources of funding and physically attacking their employees.
I am lucky to live in the UK, I am not sure I will be able to move there knowing my health will be at such risk in America.
1, My principal message is to women wherever they live. Delivering mife into inexperienced, scared hands to self-administer is criminal - in India, Paraguay, US, Uk, wherever. Unknown pharmacies in unknown places delivering god-know-what from god-knows-where are not to be dealt with. Any woman considering medical abortion (RU-286) MUST be ready to follow-up with a surgical abortion. It is guaranteed that the foetus will be damaged.
2. I do not want to dilute that message. Nonetheless, my atlas says there are 3700 counties in the U.S. To have no abortion services in 90% (98% in, as you point out, places such as Idaho) forces women into illegal abortions and using the stuff I describe in my original post. Legalizing abortion did not increase abortions in the U.S. or anywhere else. It simply moved them from seedy motels to proper clinics. Making them difficult to obtain will not decrease the rates; it will increase the risks women will take. China has roughly the same land area as the U.S. and the population is similarly concentrated. Yet, every Chinese woman has reasonable access. There is a clinic within several miles of her home. Any man can get a vasectomy or even a prescription for Viagra. A woman cannot get a drug for a uniquely female problem. Don't give me that lives in the sticks crap. For twenty years I was the only surgeon for more than an hour's trip. I have practiced medicine in the sticks. I did no abortions but was required by law to refer any woman past her 17th birthday who requested same.
I just did a Google search (after checking my atlas) for medical clinics in Boise, the state capitol. It includes that the Planned Parenthood Center offers medical abortion. It is also the only site in the state that offers same. I do not know why the woman in the story did not go there.
The point remains: It is dangerous to order mife online and self-medicate. That is my message.
Sadly this is something that landmass isn't really a problem for. The politics behind the lack of support for even a referral process at a local medical center is. I wonder if her not going to the PP in Idaho had anything to do with the many new laws some states have been trying to enact to get rid of their funding.
Umm, I don't wish to appear to be pernickity just for the sheer hell of it but why not look a bit closer to home: Northern Ireland? Oh, while you are at it Eire or Southern Ireland or, until recently Malta. I could go on, but that would be churlish and would not validate the cruelty and 'criminality' that goes on in the USA. And of course there are the Nadine Dorries of this world who would only be too happy in their vacuousness to see the rest of the UK to parallel the USA, Ireland etc.
Churlish? No. Childishly being defensive by introducing a red herring and distracting from the main point of possibly lifesaving medical advice - yes.
Well said, fun, all six of his posts have sophomoric and ignorant. Thinks he is impressing but .... Does not even use the language very well.
Malta!!??
I can totally see why this would so upset you @Brandye.It does send shivers up my spine,and I feel for women who have no choice but to resort to such 'mail order abortions',or other back yard procedures.I am thankful that I live in a country where abortion is legal as I did have to have one for medical reasons midway through my second pregnancy.My son was diagnosed as having neural tube defect during the 18 week ultrasound,and I was immediately sent to see my gyno who told me straight up that I needed an abortion.This would be conducted by inducing my pregnancy approximately two weeks later.
I was always of the view that abortion was only permitted in very extreme cases such as rape or where the mother or foetus's health were at risk.At age 26 I fell pregnant with twins not long after meeting my boyfriend and we married only 3 weeks before their birth.Abortion was not an option for me,and he chose to support me and our children.I did believe in pro choice,that a woman has the right to decide as it is her body and she is the incubator so to speak.But I wasn't given a choice in this case,I was told 'this is what you have to do'.If I was in the U.S.A I would have been told that I had to carry my son to full term and give birth,knowing full well that he would not survive the birth and if he did he probably wouldn't be treated and would have been left to die.As it was I had to be induced and go through 22 hours of labour which was traumatic in itself.My ex husband a Catholic called me a murderer,and belittled and humiliated me for months afterwards.
The "Right to Life" movement and the "My Religion Trumps Your Phyiscal Autonomy" movement and the "Hey, it's my baby too" men's movement have effectively stopped abortion and is now attacking contraception in the United States. Yes, men can get Viagra (etc.) but women cannot get "morning after" or mife - undoubtedly because we women aren't 'responsible' enough to keep our legs closed and are therefore incapable of making such a huge decision on our own.
The Malaise of Male Dominance Seeking Control over Women's Sexuality is alive and well in the US.
That being said, I completely agree with Brandye that taking any drug, esp one as dangerous as mife, acquired over the Internet is excessive risk.
She would have been wiser to take a mini-vacation in a hotel near the clinic.
Let me just ask the guys how they'd feel if they found that the lady he inpregnated died from taking unknown mife at home - because he didn't want to wear a condom and/or didn't demand she use birth control? Women don't do parthenogenesis.
It's entirely possible Boise was the 7 hour drive to which the young woman refers. Boise to the tiny town I found (through Google maps) at the northernmost border of Idaho is a 9.5 hour drive.
There's no one magic bullet to fixing this. It's partly land mass, it's partly inadequate management of land mass issues**, and it's partly Right To Lifers. Ironic, isn't it? People who claim to be defending the lives of the unborn don't seem to understand the risk to the alreadyborn.
**In the state in which I live, until recently there were two hospitals available to provide medical care to people on public medical assistance. One is dead center of the state, a 3 hour drive from any corner of the state, and is only open to residents of the county in which it sits. The other is an hour and a half drive to its east, and serves the rest of the state. One or two more providers have opened in the last 2 or 3 years.
I do appreciate the clarifications offered regarding space and attitudes in the U.S. I had no idea one could travel all day in Idaho! EEK is still spot on: Dangerous drug, unknown source, lack of knowing the dangers.
The sites I found promised shipping anywhere in the world in 7-10 days. Frightening.
Boise?!? Boise is down and to the left of the state and I was stationed at Mountain Home which is just one hour away from there - to the right of Boise, between it and Pocotella. Not a bad drive but it is a great lot of nothing to look at, I'll admit.
Yeah, Brandye, my Midwestern, I'd say mid-sized, state is roughly a 6 hour drive across, from east to west, as are many if not most of the states around me. Add the fact that so many tiny towns are hell and gone from interstates, and you add time to the drive. County roads and even state highways incur lower speed limits than major interstates, and loop around more--often built around farms instead of through them--instead of taking a straight shot. Then logistical issues are compounded by the fact that Rural America is notoriously much more conservative than Urban America--many small towns literally cropped up around a church building and grew from there into what they are today.
And that's all the farther I'm going on my Political Soap Box tonight ;)