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More Abortion Stuff - July 10, 2019

I came across a couple of abortion articles to share with you this week.

First of all is this New York Times story about how women getting abortions are more likely to be poor.

Women getting abortions today are far more likely to be poor than those who had the procedure done 20 years ago.

Half of all women who got an abortion in 2014 lived in poverty, double the share from 1994, when only about a quarter of the women who had abortions were low-income, according to the Guttmacher Institute, a research group that supports abortion rights and conducts a national survey of abortion patients every six years.

The abortion rate has declined by nearly 40 percent since the mid-1990s. But the United States still has a higher rate of unplanned pregnancy than many other developed countries, and a growing share of women who respond by having an abortion are impoverished.

The article gives a couple of reasons for poor women to be the ones getting abortions - demographics and financial assistance being the two primary ones. However, it gives short shrift to what I think is the most likely reason for poor women to be most likely to have crisis pregnancies: lack of access to effective contraception.

When Colorado provided low cost or free long-acting hormonal contraception to women throughout the state, they saw the pregnancy rate, abortion rate, and teen pregnancy rate all decrease. Not only that, but their health care costs decreased as well. We have also seen the abortion rate decrease in the last 15 years as the use of such contraception has increased throughout the United States. It seems clear that we can help reduce the need for abortions by providing effective contraception.

The second topic is actually a couple of different articles, starting with this one from the Huffington Post about "abortion reversal bills". In the pro-life community, there has been talk of reversing medical abortion by taking progesterone very early in the course. Medical abortion is done by taking an anti-progestin (mifepristone) and then, 48 hours later, taking misoprostol. The idea is that taking progesterone early enough can undo the effects of the mifepristone and stop the abortion before it really begins.

The rise of so-called “abortion reversal” bills has alarmed leading medical groups that say such legislation forces physicians to give misleading, unscientific and potentially dangerous advice to women, undermining the trusted doctor-patient relationship.

So far this year, five states ― North Dakota, Nebraska, Oklahoma, Kentucky and Arkansas — have passed legislation mandating that physicians counsel women that a medication abortion, a safe and common method for ending a pregnancy before 10 weeks, can be reversed. Similar laws are already on the books in South Dakota, Utah and Idaho. Arkansas expanded an existing law.

Medical groups are concerned about the state mandating what doctors have to tell their patients.

Leading medical groups, including the American Congress of Obstetricians and Gynecologists and the American Medical Association, oppose this experimental practice, as it has not been clinically tested or approved by the Food and Drug Administration.

They note that medication abortion is most effective when patients take both drugs, and about half of women who take only mifepristone will continue their pregnancies. Taking progesterone to offset the effects of mifepristone has not been evaluated for safety.

However, pro-life groups have their own take on things.

Five states in 2019 have passed pro-life measures requiring abortionists to inform women using the abortion pill about the possibility of abortion pill reversal. But the simple act of providing potentially life-saving information to women has been viciously opposed by pro-abortion activists — for instance, in North Dakota, where the pro-abortion American Medical Association (AMA) joined with the Center for Reproductive Rights to launch a legal challenge against the new mandate in court.

To justify their opposition, abortion activists are engaging in fear-mongering and the spreading of misinformation about abortion pill reversal. A recent article published in the Huffington Post is a good case study in these types of deceptive scare tactics, which abortion activists are using with greater frequency.

They contend that the little bit of anecdotal information about the use of progesterone is adequate to allow its use for the interruption of medical abortion. But, they are correct that progesterone has been used at relatively high doses throughout pregnancy without damage to the fetus.

I don't like the government mandating what physicians tell their patients. Patients trust their physicians to do what is right, and that relationship is sacrosanct. I'm also not happy with the idea that women should be told that they can interrupt their abortion if they change their minds. We don't have enough data to know if or when using progesterone can interrupt the procedure. We don't know the dose. The whole procedure is fraught with uncertainty. If women choose to end their pregnancy with medication, they need to be absolutely sure about it and their doctors need to determine that before prescribing the medication.

Whatever else happens, these two article show that abortion is going to remain on the radar as a major social and political issue for the time being. Again, as I keep saying, the best way to reduce abortions is to provide low-cost long-acting hormonal contraception for women who want it. And prevention of abortion through legal means is not a good strategy.

What do you think?

Catherine

 

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