It seems that doctors may be increasingly unwilling to carry out abortions, leaving a potential gap in provision. So a goal for abortion activists is to increase the ‘abortion workforce’ by encouraging and training, more doctors in abortion provision and by enabling nurses and midwives to become more involved in abortions.
But that is not all. When more doctors refuse to abort their unborn patients, what is a pro-abortion industry to do? One answer is direct-to-patient marketing.
The first strand of this is to encourage more self-administration of medical abortions, which means taking pills at home, removed from medical supervision.
However medical abortions are not as safe as usually implied, especially when carried out on a do-it-yourself basis. One peer-reviewed study found that 78 per cent of participants had excessive bleeding, 13 per cent had severe anaemia, 63 per cent had incomplete abortion and 23 per cent had failed abortion. Surgical evacuation had to be performed in 68 per cent of the patients.
Even one of Ireland’s most vociferous campaigners for abortion, obstetrician Peter Bolyan, recently admitted: ‘There are serious dangers when women take [abortion pills] without supervision. We have knowledge of women who have taken them in excessive dosage and that can result in catastrophe for a woman such as a rupture of the uterus with very significant haemorrhage . . . And if that happens in the privacy of a woman’s home or perhaps in an apartment somewhere, that can have very, very serious consequences.’
The later in gestation that medical abortions take place, the less effective and the more dangerous they are. It is more painful later, with an increasing rate of haemorrhage and complications after just seven weeks gestation. Therefore having an accurate knowledge of gestation is essential, as abortion advocates realise, and yet even advocates find large variations when women self-calculate gestation. One‐third of women who were followed up after medical abortions had pregnancies of ten weeks gestation or more, and some even had pregnancies of 18-28 weeks, far more than the recommended maximum.
Two pills (mifepristone and misoprostol) taken 24 to 48 hours apart are needed for a medical abortion, but campaigners want women to be encouraged to take the pills simultaneously in the interests of convenience – and perhaps to stop them changing their minds, which is still possible after taking the first pill. However taking both at the same time causes more side-effects and is less effective. One study (by pro-abortion authors) found a high abortion failure rate if taken together: for women under 49 days’ gestation, the failure rate was 27 per cent while for women between 50-56 days’ gestation, it was 31 per cent.
Women are also being encouraged to bypass legal restrictions by obtaining pills via the internet. However, self-administration of abortion pills removes any control over who takes the pills, where they are taken, whether they are taken, when in the process they are taken or if an adult is present. It also removes an opportunity to ascertain if abuse or coercion is involved. Several news stories have described abortions forced on a woman by a partner who has given her a drug in food or drink without her knowledge. Just last week a US doctor was jailed for spiking his pregnant girlfriend’s cup of tea with abortion pills, causing her to lose the baby.
Some online abortion providers encourage women to tell lies to get hold of abortion pills. The chemicals involved are contained in pills with different brand names for different conditions, and one well-known provider suggests on its website that to obtain one of these medicines, you could say that your grandmother has such severe rheumatoid arthritis that she cannot go to the pharmacy herself. Or ‘say it is for an ulcer (Cytotec) . . . Don’t stop after the first “no”!’ It adds ‘helpfully’ that Cytotec can be bought on the black market ‘in places where you can also buy Marijuana’.
Campaigners suggest that post-abortion check-ups can be carried out by using mobile phone apps instead of attending a clinic. This is highly irresponsible, since complications (such as haemorrhage) resulting from medical abortions are common, not rare. An abortion pill provider, Women on Web, found from its own data that 12–21 per cent of women needed surgical intervention, with almost half (45 per cent) who were over 12 weeks gestation requiring it. Information about abortion history is critically important when evaluating women for infection after abortion but despite this, Women on Web and Women help Women tell women they can lie to their doctor and claim they are ‘having a miscarriage’.
Also on the camapaigners’ wish list are greater involvement of nurses and pharmacists in prescribing and providing pills (and doing abortions?), removing doctors from the process, and getting rid of as many legal restrictions as possible; see here too.
So much for the well-worn mantra: ‘Let’s make abortion safe, legal and rare’.
Not only does all this encourage illegal and dangerous practices, but with no medical professional involved there will be no objective gestational age dating, no guarantee that women read and follow the instructions with the pills, no objective screening for medical and psychological contraindications (more common than for surgical abortion), no medical follow-up with scans or visit, no access to emergency services. Also . . . no potential malpractice issues to deal with.
We may not be quite there yet, but this is the direction of travel.