Monday, August 30, 2010

What are you doing here? Go read this Nation article!

In the past year-and-a-half-ish, there's been a lot of noise (well, relative to the usual silence, at least) about women self-medicating with misoprostol to induce an abortion. The first piece, the New York Times article "For Privacy’s Sake, Taking Risks to End Pregnancy," was short on data (which is unfortunately bound to be the case with reports of activity that is both rare and hidden) and long on extrapolation (which is unfortunately bound to be the case with NYT trend pieces). It implied that lots of Dominican women in New York are endangering themselves via illegal abortion despite easy access to cheap legal procedures. (Lots of broad brushstrokes in there, don't you think? Technically a self-induced abortion isn't even "illegal" in NYC!) The letters to the editor included some thoughtful additional information (most of it anecdotal), by the way. More to the point, there were substantive critiques (like "Side Effects: Complications at The New York Times from DIY Abortions" at RH Reality Check) of how the paper was written and that extrapolation I mentioned, including objections from the researchers involved in the study cited.

This summer, Nicholas Kristof wrote a surprisingly nice column ("Another Pill That Could Cause A Revolution") about misoprostol's revolutionary power to save women's lives in multiple ways. Considering that he's been reluctant in the past to even mention abortion, even when writing about pregnancy-related mortality, and considering that his writing tends toward simplistic reduction of complicated problems and even toward cavalier moralizing about the decision-making of the poor, well, that was a pretty nice column, considering.

And this week, Laura Tillman at the Nation brings us "Crossing the Line," which explores in a bit more depth the reasons that in many situations -- even among US residents, even among speakers of English, even among US-born women -- it might be entirely logical to obtain medication under the table and induce an abortion at home. I'll just post an excerpt here to give you an idea, but you should read the whole piece.

A single mother of two boys, Diana was unemployed and in the hospital when she began to suspect she was pregnant. It was December 2006, and she had missed her period for two months. Her doctor conducted a urine test, which came back negative, but when Diana still hadn't gotten her period in January, she started to panic. She knew it wasn't the right time for another baby. She wasn't working and had been suffering severe symptoms of brittle diabetes, a rare form of diabetes that requires frequent hospital visits and brings bouts of depression. She felt unstable and wasn't able to afford her medications. "I thought, If I am pregnant, I want to take something to not be pregnant," she says.

For most women in the United States, this would mean a trip to a doctor or abortion clinic. But where Diana lives, in Brownsville, Texas, just north of the border, Mexican pharmacies are only a few miles away. Items said to be abortifacients—including pills, teas and shots—are well-known to be cheap and accessible just across the bridge. Misoprostol, a pill that makes up half of the two-drug combination prescribed for medical abortions in the United States, is easy to purchase over the counter in Mexico because of its effectiveness in treating ulcers. When used alone and taken correctly, it will produce a miscarriage between 80 and 85 percent of the time. ...

Go read the rest! And have a good week!

PS: Lots of very interesting research has been done on misoprostol (and mifepristone too) in the past year or few -- on both clinical and psychosocial aspects of medication abortion -- and I hope to talk more about all that in a few upcoming posts. Hope that sounds good to you :)

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