Friday, June 27, 2014

DIY abortion

In the Atlantic, Erica Hellerstein has a must-read on the rise of Latin American abortion methods in the US. using misoprostol.
As policies restricting access to abortion roll out in Texas and elsewhere, the use of miso is quickly becoming a part of this country’s story. It has already made its way into the black market here in Texas’s Rio Grande Valley, where abortion restrictions are tightening, and it is likely to continue its trajectory if anti-abortion legislation does not ease up and clinics continue to be closed.
Over the past several years, dozens of states have restricted abortions. Since 2011, at least 73 abortion clinics in the nation have shut down or stopped providing services; and more than 200 abortion restrictions were legislated throughout the nation. Despite the passage of Roe v. Wade more than 40 years ago, states with pro-life politicians are still gunning to reverse the ruling—in the words of Rick Perry in 2012, “my goal is to make abortion, at any stage, a thing of the past.”
Yet these myriad restrictions on women and abortion providers have set the stage for women to skirt medical institutions to take charge of their own health. A similar story has already been written in many countries around the world, where pro-life legislation has inspired similarly creative solutions. Today, throughout Texas—from the Rio Grande Valley to El Paso—miso’s story is being drafted anew. And in this narrative, it is Latin America that has answers for the United States.
Proper dosage is essential, and improper use can lead to disaster.

According to the World Health Organization, more than 21 million women annually have unsafe abortions worldwide, which account for nearly 13 percent of all maternal deaths. Miso is a much safer alternative. If taken in the correct quantities (four to 12 pills over the course of at least nine hours) in a women’s first trimester, the drug is 80 to 85 percent effective.
But miso’s safety is also a function of the information that comes with it. In Texas’s Rio Grande Valley, according to Carreon and others, many women are using the drug improperly because they don’t have access to basic facts about the correct dosage. That ignorance can lead to problems.
One woman I interviewed at a Mexican restaurant in Brownsville told me her good friend nearly died after taking pills that her husband bought in Mexico. Instead of ingesting four of the 12 pills every three hours, as is recommended by the World Health Organization, she took two pills under her tongue, then four pills vaginally, then two more under her tongue, then four more vaginally. She began to bleed profusely, doubled over in pain. But because she was undocumented, she was afraid to seek medical help at a nearby hospital or clinic. Instead, she crossed the border to Mexico with her five children—all the while hemorrhaging—in search of medical assistance. She has since recovered but is still in Mexico with her children because she can’t cross the border back into the United States.
Self-abortion or providing advice to those who seek to self-abort is illegal in many states. The WHO report (pp. 46-7) Hellerstein links to discusses the use of misoprostol alone.

What does the future hold for women in anti-abortion states? Hellerstein writes:
 Today in Texas things are starting to look a lot like the early years of miso in places like Brazil and Chile: The simple guidelines about miso haven't yet made it to women in the state. But eventually, in those countries, the Internet and the democratization of information prevailed. Unless, and until, abortion restrictions change again, Latin America’s DIY-abortion culture might be the future of women in South Texas.
and much of the rest of the US. Read the whole thing.

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