Do It Yourself Medicine

A report in Monday's New York Times, discussing the "off-label" use of misoprostol to end an unwanted pregnancy, has echoes of Captain Renault's claim to be "shocked, shocked to find gambling [at Rick's]." Since the beginning of time, we know that women who feel trapped - for whatever reason - by an unwanted pregnancy will take steps to end that pregnancy. It doesn't matter if it's legal or not. It doesn't matter if it's safe or not. To some women, carrying the pregnancy to term is unbearable (pardon the pun).

As the article points out, women in the US have other, more effective methods for early abortion. But should we really be surprised that some women will opt for do-it-yourself medicine particularly in this climate when health care access is out of reach for ever more Americans and when abortion itself is so stigmatized? For some women, going to a clinic, interacting with protestors and staff can be an alienating or even traumatizing experience. Keeping the experience to oneself or a close friend or family member could be a welcome alternative. Using a medication that explicitly warns against use by pregnant women may correctly be understood as a way to make something happen.

The problem, as Matthew Herper at Forbes.com notes, is that our regulatory structure lacks any incentive for makers of generic drugs to develop new indications - particularly an indication that involves use by pregnant women. As a result, patients and providers are left to improvise. Fortunately, there are well conducted studies which show misoprostol alone is about 80% effective in ending an unwanted pregnancy up to 9 weeks and does not involve more risk than other methods of early abortion. Knowing that some women will take matters into their own hands, a group of public health experts and advocates developed "Instructions for Use: Abortion Induction with Misoprostol in Pregnancies up to 9 Weeks LMP". Let's face it, sometimes its better to refer to the manual.

Comments

[JEP57]

Putting aside rape, accidents, etc., why don't these same woman take the time and initiative to prevent their pregnancies to begin with. If they can't afford birth control, I'm sure there are plenty of free clinics who will provide it for them.

[omo]

Why don't the men these women are involved with "take the time and initiative to prevent their partners' pregnancies" ? Why is their VIAGRA covered by insurance but not women's BCP's ?
Why do we continue to tolerate such a ridiculous double standard when it comes to conception ?
It's almost as if EVERY conception were immaculate ! From the guy's perspective at least . . .

[kathy001]

So well said!!

[kathy001]

Very good question. Why can't we spend all the time, money and effort that is going into the fight against a woman's right to choose into educating women on birth control? Abortion isn't the problem, lack of education and lack of access to contraceptives are the problems. And you can forget those free clinics. If they get federal assistance then Bush's new regulations make getting birth control much more difficult for the women who need them.

Nice little double edged sword we have here. If you need financial assistance for birth control, you won't be able to get it and if you get pregnant your right to an abortion may be taken away. Seems to me we are simply punishing poor people for being poor and, in the process, helping to create more and more and more poor people

My head is spinning just thinking about the absurdity of it.

[gfk]

Even with using birth control, it isn't always effective. Condoms break, women get pregnant even while on the pill, etc...

[kathy001]

Those health professionals who developed the instructions are doing what their profession dictates, helping to keep women healthy. I applaud them. Women who somehow gain access to Misoprostol and those instructions are women who won't wind up in the emergency room, bleeding to death of a punctured uterus from a botched abortion - or the morgue because they couldn't make it to the emergency room.