Go easy on the RU486 celebrations

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On August 30, Marie Stopes International became the registered importer of the abortion drug RU486. Writer and broadcaster Clementine Ford listed this event as one of 20 greatest moments for women this year. But should we reserve our celebration?

The majority of terminations in Australia are surgical, and usually take place in hospitals or special clinics with a much smaller number occurring as medical abortions using RU486, a synthetic steroid drug given in early pregnancy.

A medical abortion typically consists of the use of RU486 (mifepristone) which interferes with the action of the body’s progesterone, responsible for preparing the uterine lining, and a prostaglandin drug called misoprostol, which causes uterine contractions.

In an article on Mamamia blog last week, the Federal Health Minister, Tanya Plibersek stated her support for the right of women to make their own decision regarding abortion asserting that, ‘no termination is without risks, but the risk of dying is higher from taking viagra than from medical termination.’

Opinion polls suggest that 75% of Australians support the use of RU486. The President of Reproductive Choice Australia, Leslie Cannold welcomes the registration of the abortion drug RU486 declaring it a crucial victory for women and choice. Cannold claims that  female politicians across four political parties – Labor, Liberal, Greens and Democrats  have banded together to fight for access to the drug which she claims has proven health benefits for women.

Screen shot 2012-12-26 at 5.38.08 PMOn the subject of health benefits of the abortion drug, feminist and long-term women’s health researcher and  co-author of RU486: Misconceptions, Myths and Morals, Renate Klein notes there have been no large scale trials on RU486 conducted in Australia and that the strict guidelines that accompanied the licensing of the drug, such as only to be used by women who could not undergo a surgical abortion, have been undermined.

The RU486 abortion option has been marketed as a ‘private’ way to have an abortion, one you can have at home, but this is far from reality.

In contrast to a surgical abortion which takes around half an hour, an abortion by means of RU486/PG requires that a woman visits her doctor three times.  On the first visit there will be a medical examination and the woman will be given the abortion pill RU486 to swallow. On her a second visit she will be given the second medication, misoprostol which causes her uterus to contract, expelling the contents.  On the third visit the doctor will examine the patient to determine that the abortion has occurred and that there are no complications such as bleeding or infection.

Overseas RU486 has caused deaths  due to sepsis, and severe blood loss. There has also been one recorded death of a woman in Australia from RU486/PG in 2010 with few details available other than that the woman died from sepsis after the abortion.

And it is not as if the drug is more effective that suction abortion: The  RU486/PG having a lower success rate of around 91-93% whereas a suction abortion successfully brings about an abortion in 99% of cases.

The issue of abortion and particularly the access to the medical option has always been political.

The Prime Minister has indicated she won’t stand in the way. In a speech to the Australian Medical Association recently, she said:

Women must have the right to health care and women must have the right to choose. So the Federal Labor Government will be there supporting … a woman’s right to choose through Medicare-funded services. That’s my commitment to Australian women as Prime Minister.

Opposition Leader, Tony Abbott has been avoiding questions on the TGA listing of RU486. In 2006, when he was health minister he voted in Parliament to maintain his veto power over RU486 as he wanted to keep RU486 a special case so he could prevent it being imported into Australia. Supporters of RU486 are anxious to know where Mr Abbott presently stands on this matter as there is a real chance he may become our next prime minister.

Feminists and health researchers Renate Klein, Janice Raymond and Lynette Dumble writing in RU486 Misconceptions, Myths and Morals suggest that there are many reasons why individual women and women’s groups have led the campaign for access to a medical abortion. First the ‘packaging’ has been very successful; there have been loads of positive information about the drug in the mainstream media and journals such as Science magazine plus the silencing of any criticism has added to the popular demand. There is an ever present fear that women’s rights to abortion may be eroded which no doubt leads to the support of the medical option. The authors of  RU486 Misconceptions, Myths and Morals state that ‘ this defense of RU486/PG has been too much defined by a reaction to the right wing ‘.

And it seems that this state of affairs prevails in 2012 with the uncritical acceptance by many feminists of RU486 as an alternative to a safe surgical abortion.

The medical abortion depends on a women taking chemicals, with possible fatal complications for women living in rural areas where there may not be adequate emergency assistance.

Sadly RU486 doesn’t challenge any of the sexual politics that are a huge part of women’s lives. From puberty till middle age and the years beyond women consume harmful drugs either  to prevent pregnancy, stave off old age and now to facilitate an abortion that can be performed safely surgically. And we must be concerned that once the medical option becomes a popular and relatively cheaper option, whether a safe surgical abortion will be procurable.

There is much more to RU486/PG than is reported in our uncritical press. Politicians, health policy makers and feminists should take this on board rather than simply proclaim the latest developments in access to RU486 as one of the 20 most important achievements for women in 2012.

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10 Comments

  1. GPs who wish to prescribe the drugs can undergo online training and offer it as an option for women seeking termination. This will be particularly important in areas where there’s restricted access to surgical abortion or no abortion facilities. They would have back-up through Marie Stopes International should there be any need for it, that is support from after-hours Marie Stopes providers.

    Reply
  2. LIKEWISE, because of the high (four per cent to seven per cent) failure rate of RU-486 abortions, women in France must sign in advance a document agreeing to a surgical abortion backup.

    Reply
  3. Abortion advocates aggressively promote abortion drugs in developing countries because the lack of medical infrastructure, transportation to emergency centers, water and other supplies make surgical abortions less accessible and more risky. Yet these same obstacles exist for treating the greater risks associated with medical abortion. One frequent and necessary treatment is surgery. In Vietnam, researchers found one out of four women had to undergo a surgical abortion for an incomplete misoprostol abortion.

    Reply
  4. GPs who wish to prescribe the drugs can undergo online training and offer it as an option for women seeking termination. This will be particularly important in areas where there’s restricted access to surgical abortion or no abortion facilities. They would have back-up through Marie Stopes International should there be any need for it, that is support from after-hours Marie Stopes providers.

    Reply
  5. That is really interesting, You are an excessively skilled blogger. I have joined your rss feed and look forward to in search of more of your fantastic post. Also, I’ve shared your web site in my social networks

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  6. While swallowing a pill is easier than a 10 minute surgical abortion, that is the only easy part of the drawn out, multi-drug, multiple visit RU486 procedure that can take weeks to complete. During the patient’s first visit, a comprehensive medical exam must be undergone. Because of decreasing “effectiveness” of the drugs as the baby grows, (RU486 should not be given past the seventh week of pregnancy), careful dating of the pregnancy is important. The woman must not have any physical conditions which would make the drugs dangerous or deadly for her, must be responsible enough to return for the multiple follow-up visits, and must have a support system to help her receive emergency care if needed.

    Reply
  7. Drug of choice No where is the shift in public opinion more obvious than in the increased percentage of women currently choosing this method of abortion where it already is legal. In September 1989 the drug was being used in 15% of elective abortions in France.

    Reply
  8. Abortion advocates aggressively promote abortion drugs in developing countries because the lack of medical infrastructure, transportation to emergency centers, water and other supplies make surgical abortions less accessible and more risky. Yet these same obstacles exist for treating the greater risks associated with medical abortion. One frequent and necessary treatment is surgery. In Vietnam, researchers found one out of four women had to undergo a surgical abortion for an incomplete misoprostol abortion.

    Reply
  9. At a news conference on 17 May 2002, Dr Richard Hausknecht, medical director of Danco, the company which manufactures RU486 for the American market, admitted, “it (RU486) is not safer than a surgical abortion”.

    Reply
  10. Whereas those who undergo surgical abortion only imagine what their unborn children look like and go through, women who have abortions with RU486 have vivid memories of their encounters with their children.

    Reply

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