The tiny white pill saving women’s lives
A study just released by the Guttmacher Institute finds that the approval, in 2000, of the drug Mifepristone (known to others as RU-486 or the Abortion Pill) for medication abortion did not have the anticipated effect of extending new abortion access to rural and under-served areas of the U.S.
This is disappointing news, given that there’s still so much to be done to ensure access to abortions in the U.S., where 87% of counties still have no abortion provider. Persistent and pernicious actions by anti-choice lawmakers have continued to erode abortion access all across the country and what the study makes clear is that we can’t take access for granted.
Looking beyond the U.S., however, the study provides an opportunity to highlight the way in which the use of misoprostol alone is expanding access to safe abortion services in the developing world, where the vast majority of unsafe abortions occur. (Misoprostol is Mifepristone’s companion drug, or the second drug given as part of a medication abortion.)
Misoprostol is widely and cheaply available in many parts of the world, and it can be used safely to induce an abortion. In fact, it has been used for years by clinicians and by women on their own, in order to terminate unwanted pregnancies, treat complications of incomplete abortions, and address excessive bleeding after birth. In 2006, a study from Ibis Reproductive Health showed that misoprostol-only use had a positive impact on reducing maternal mortality in low-resource settings.
On a recent trip to Kenya, where around 800 women a day seek unsafe abortions, I met a group of nurses who had been trained by PPFA in the use of misoprostol for post-abortion care (PAC). PAC is a legal procedure which involves treating a range of complications that women face after having an unsafe abortion or incomplete miscarriage. Without it, many women die and others are left permanently injured. Utilizing Misoprostol in treating complication increases options for women and allows them, in certain cases, to avoid surgery.
These nurses were selected for training because they run their own tiny clinics in out-of-the-way places (meaning no nearby hospital or other health care access). Before they were trained, the nurses told me, they’d have to send women away to the closest hospital an hour away. Many women couldn’t afford the measly bus fare, and others would bleed to death on the way. Now, armed with medication and training, they can treat women with complications on the spot. This is a real-life example of how misoprostol use is expanding access to safe reproductive health care, and literally saving lives.
Compared to places outside of the U.S., the use of misoprostol isn’t unheard of here at home. In January, the New York Times ran an article on the common use of misoprostol among immigrant women from the Dominican Republic in New York City, which they had friends and relatives send them from the DR to “bring down their period.”
It seems like whether or not a woman lives in one of the biggest cities in the world, where abortion is legal, or in a tiny, remote village where abortion access is a pipe dream, women want to be in control of their own bodies and fertility. The use of misoprostol is still catching on, but it’s already revolutionized access for many women worldwide.
J.Mack is a global feminist residing in New York City.