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When the abortion pills arrived in her mailbox this summer, she felt anxious but also in control, knowing she could end her pregnancy entirely in the privacy of her own home.

“I was happy that I was going to be able to do it myself and I did not have a nurse there or doctors there staring at me and judging me,” she said, asking to be identified only by her middle name, Marie, because she did not want people outside her immediate family to know about her abortion.

Marie is part of a small but closely watched research effort to determine whether medical abortions — those induced by medicine instead of surgery — can be done safely through an online consultation with a doctor and drugs mailed to a woman’s home.

At a time when access to abortion is being restricted on many fronts, advocates say being able to terminate a pregnancy through telemedicine and mail-order drugs would provide a welcome new option for women. Opponents of abortion find the concept dangerous and deeply disturbing.

The idea builds on a trend that is helping women obtain birth control more easily. A growing number of smartphone apps and websites now make it possible to get prescription contraceptives without visiting a doctor’s office first. The pills Marie and the other women received through the study are not allowed for sale in pharmacies and are usually available only at hospitals and abortion clinics.

Australia and the Canadian province of British Columbia allows women to get abortion pills by mail after consulting with a physician or other health care provider via phone or the internet. Several international organizations offer mail service in countries where abortion is otherwise unavailable or severely restricted. The oldest group, Women on Web, based in the Netherlands, has provided abortion medications to about 50,000 women in 130 countries since 2006. The service is not available in the United States, and the Food and Drug Administration warns against buying the drugs over the internet.

Having the pills delivered to her home in Hawaii meant that Marie could avoid the cost and time of traveling by plane to the nearest abortion clinic, over 100 miles away in Honolulu or Maui. Once she received them, she set the package aside for a week in her bedroom, waiting until she could schedule time off from her job at McDonald’s.

The first pill, as expected, had little effect. The next morning, with her mother at her home to watch her toddler, she took the second. Almost immediately, the bleeding and cramping began. Within three hours, her eight-week pregnancy was over. She described the pain as a five on a 10-point scale. That night she cooked dinner for her family, and the next day she went back to work.

The study Marie participated in is being conducted in four states — Hawaii, New York, Oregon and Washington. It is being funded and organized by Gynuity Health Projects, a nonprofit research group focused on reproductive health services that seeks to improve women’s access to medical abortions. The FDA has allowed the experiment. Women learn about it when contacting the abortion clinics in the study and other health providers who are aware of the trial and the website telabortion.org.

Danco Laboratories, the company that makes the pills, has no plans to seek wider distribution of the medication either through mail-order pharmacies or physical pharmacies, a spokeswoman said. It would have to seek the FDA’s permission to do so; the agency can also ask companies to change how their drugs are distributed.

“Abortion is a politically charged issue in this country, and there is an extra degree of caution,” said the spokeswoman, Abby Long, explaining that research would be needed to support changing the drug’s distribution.

Of the first 12 women who participated in the study, all in Hawaii, 11 reported they had no complications and one did not take the pills, researchers said. Ten who completed surveys afterward said they were satisfied with the service and would recommend it to a friend, according to the researchers.

“It’s absolutely an important step forward to expanding access to abortion that is safe and effective and creating options for women,” said Susan Wood, director of the Jacobs Institute of Women’s Health at George Washington University, in Washington, D.C. She was not involved in the study.

Anti-abortion groups are outraged by the experiment.

“We have grave concerns about handing out dangerous, life-ending drugs without medical supervision because women face great risks for chemical abortions,” said Kristi Hamrick, spokeswoman for Americans United for Life.

Carol Tobias, president of the National Right to Life Committee, also raised safety concerns.

“If pills are sent through the mail, who are they supposed to call if they have a problem?” she said.

“There are serious downsides from the pills,” she said, adding, “and just talking to someone over a computer and sending pills in the mail, to me, that is just reckless.”

The process does not allow women to avoid the doctor’s office entirely. Using a video hookup on a home computer, a woman first consults with a doctor (or other clinician such as a nurse practitioner) at one of three participating abortion clinics who evaluates her medical history and explains how to take abortion pills and what to expect afterward. She must then get medical tests including ultrasound and bloodwork.

If the tests show she is eligible for the study, the clinic sends her a package with pills and instructions via overnight mail. After taking them, she has some additional tests, such as an ultrasound to verify that the abortion is complete and also a phone consultation to review the results.

Access to abortion has been declining steadily in the United States as dozens of clinics have been forced to close under new state restrictions. In Texas, the number of clinics fell to 18 in 2015 from 41 in 2012. Five states have just one clinic that offers abortions.

Medical abortions require women to take two drugs that together induce a miscarriage. The first, mifepristone (marketed as Mifeprex), is typically taken in a doctor’s office or clinic while the second, misoprostol, is given to the woman to take at home the next day.

In the United States, the FDA has approved medical abortion pills for use only in the first 10 weeks of pregnancy, while surgical abortions can be done later than that.

Medical abortions make up a quarter of all abortions in the country. About 2.8 million women in the United States have used mifepristone to terminate a pregnancy since the drug’s approval in 2000, according to Danco Laboratories, its manufacturer.

The American abortion study using overnight mail comes nearly a decade after Iowa became the first state to offer medical abortion counseling via telemedicine from a physician. But in Iowa and the three states that followed — Alaska, Maine and Minnesota — women must still go to a clinic that stocks mifepristone to receive the pills.

If the study shows the telemedicine and mail approach works, that could encourage the FDA to stop restrictions on mifepristone, Gynuity’s principal investigator, Dr. Elizabeth Raymond, said.

“All kinds of dangerous drugs are prescribed and available at pharmacies, including drugs for heart disease and Viagra,” she said. “There is no justification for why this safe drug should not be in pharmacies now.”

But even if the FDA were to lift its restriction on where abortion pills are dispensed, 19 states ban the use of telemedicine for abortion and require a physician to be physically present when consulting a woman, according to the Guttmacher Institute, a reproductive rights research group.

“While this has the potential for being the future of abortion delivery for a good segment of the population, that vision might not be fulfilled due to the politics around the issue and restrictions in many states,” said Jessica Arons, president and chief executive of the Reproductive Health Technologies Project in Washington, an advocacy group.

http://khn.org/news/abortion-by-mail-delivers-promise-for-better-access-but-political-questions-remain/

Source: Kaiser Health News

10-nov

Donald Trump made some pretty scary threats during the election about cracking down on abortion. Here’s a quick refresher on his campaign promises — and why women have every right to be very worried.

Trump has flip-flopped on abortion, and seems to have adopted a rather extreme stance on the issue. Back in 1999 on an episode of “Meet the Press”, Trump said he “hated” abortion, but being from New York, admitted that he is “pro-choice in every respect”. Fast forward to the recently concluded election, and it’s clear that Trump has changed his tune. In a September 2016 letter addressed to “Pro-Life Leader”, Trump made his position on abortion painfully clear, saying he’s committed to:

  • Nominating pro-life justices to the US Supreme Court
  • Signing into law the Pain-Capable Unborn Child Protection Act, which would end painful late-term abortions nationwide
  • Defunding Planned Parenthood as long as it continues to perform abortions, and reallocating its funding to community health centres that provide comprehensive health care for women
  • Making the Hyde Amendment permanent law to protect taxpayers from having to pay for abortions

Earlier this year, Trump said that abortions are “not acceptable”, and that women who try to obtain them should be subject “to some form of punishment“. Following a public outcry, Trump backtracked on his remarks, saying it’s not women who should be punished for having an abortion, but the doctors who perform the procedure.

As noted in his September letter, and as he remarked during the final presidential debate on October 19, Trump is particularly opposed to so-called “partial-birth” abortions, or what doctors call intact dilation and extraction. According to US federal law, this late-term procedure is acceptable if the life of the mother is at stake. But during the last debate, Trump didn’t seem to care, saying, “in the ninth month you can take the baby and rip the baby out of the womb of the mother,” adding that it can happen “as late as one or two or three or four days prior to birth.”

But as noted by the Guttmacher Institute, 90 per cent of all abortions take place within the first 12 weeks of pregnancy. A mere 1.5 per cent of abortions take place beyond the 20 week mark, the vast majority of which happen before the 24 week mark. Thankfully, this issue won’t affect most women, but that’s small consolation for those whose lives might depend on it.

The Trump Administration’s approach to Planned Parenthood in particular is all but certain to be a nightmare. The organisation provides services for millions of women (and men), including sexual education and reproductive healthcare. But that hasn’t done much to thwart a largely Republican effort to completely strip it of resources and power. It’s a coordinated campaign that’s been taking place at the Congressional level for some time now; a Trump administration could bring an entirely new dimension of power into the mix.

Mike Pence, in particular, has consistently positioned himself as an opponent to the organisation. In October, during a speech at Liberty University, he promised that “a Trump-Pence administration will defund Planned Parenthood and redirect those dollars to women’s health care that doesn’t provide abortion services”. In 2011, the House of Representatives passed a bill co-sponsored by Pence to defund the group.

“He’s been called a one-man crusade against Planned Parenthood, and he got his start going after them earlier than most. I would definitely call him an extremist,” Jan Schakowsky, a Democratic representative for Illinois, told the Guardian in July.

Following Trump’s victory yesterday, pro-life activists cheered. It’s an ominous sign of what’s to come, though public opposition will be formidable. “Trump would ban abortion, and eliminate women’s ability to have birth control covered by health insurance,” noted Dawn Laguens, the executive vice president of the Planned Parenthood Action Fund, in a CNN article. “A Trump presidency would be a disaster for women.”

Indeed, Trump could threaten women’s procreative liberties by making it much more difficult to acquire birth control. As it stands, birth-control pills are free under the Affordable Care Act, but Trump says he wants Congress to repeal this act as soon as possible. In the very near future, it could be more difficult for women to avoid getting pregnant and getting an abortion. It suddenly feels like the 19th century.

American pro-choice women are not going to relinquish their right to an abortion without a fight. What’s more, Trump and his Supreme Court justices will have their hands full trying to repeal or find loopholes to Roe V. Wade, the precedent that upholds a woman’s right to an abortion.

Yes, women have a right to be worried, but it may be more difficult — and politically damaging — for Trump to go through with his threats. Sadly, this is a man that doesn’t seem to care about the consequences.

http://www.gizmodo.com.au/2016/11/donald-trump-is-about-to-declare-war-on-womens-bodies/

Source: GIZMODO

3rd-nov-post

Women from Northern Ireland who seek abortion are “second-class citizens”, the Supreme Court has been told.

On Wednesday, the court heard a legal challenge brought by a mother and daughter who want women from Northern Ireland to be allowed access to NHS-funded abortion care in England.

Women from Northern Ireland are not entitled to free NHS abortions in England.

Judgement in the case has been reserved until a later date.

In Northern Ireland, unlike the rest of the UK, abortion is only allowed if a woman’s life is at risk or there is a permanent or serious risk to her physical or mental health.

‘Desperate and stressful practices’

The case at the centre of the hearing was originally brought in 2014 by a young woman, A, and her mother, B.

The young woman was 15 when she and her mother travelled to Manchester to have an abortion, at a reported cost of £900.

According to the British Pregnancy Advisory Service (BPAS), last year 833 women were recorded as having travelled from Northern Ireland to England and Wales for abortion care.

Analysis: Clive Coleman, BBC legal affairs correspondent

If A succeeds it could open the way for women from Northern Ireland to be permitted abortions on the NHS in England.

She argues that the Secretary of State for Health failed to discharge his duty under section three of the NHS Act 2006 to “meet all reasonable requirements” in England for services – including abortion.

A also argues that her human rights under Article 8 and Article 12 of European Convention of Human Rights, have been breached and she has been discriminated against – by reason of being treated differently from other women in England.

However, the fact that abortion is illegal in Northern Ireland – save in exceptional circumstances – remains a major obstacle.

Their challenge against a ruling that prevents women from Northern Ireland having free NHS abortions in England was unsuccessful at the High Court and the Court of Appeal, but they were granted permission to appeal to the Supreme Court.

In court, a lawyer for the two women said that women in A’s position “find themselves in desperate and stressful practices and become second-class citizens in abortion”.

He added that B said it was “more stressful, humiliating and traumatic for a 15-year-old girl than it needs to be”.

Lady Hale, the deputy president of the Supreme Court, told the women’s lawyers that she was far more interested in the human rights arguments in the case than the NHS Act arguments.

http://www.bbc.com/news/uk-northern-ireland-37837283

Source: BBC

 

GOP out of bedroomA US News and World Report article (12/31/14), What the Battle Over Abortion Will Look Like in 2015, should remind all of us concerned about reproductive justice that Republicans will control the Senate and the House of Representatives beginning this month. As much as Republicans claim to favor small and less government, we all know that when it comes to issues relative to human sexuality, they espouse as much government intrusion and regulation as possible. Although many Republicans are pro-choice, the party continues to allow its extreme right wing and Tea Party darlings to steer the votes and priorities. Reproductive decisions, sexual orientation, and even personal sexual activity preferences are of greater concern to John Boehner, Mitch McConnell, and friends than ensuring that every child has food to eat, that people are working and earning a fair wage, or that the U.S. government is protecting business from cyber-attacks, and so on. It makes no sense, but it is a reality.  It is reasonable to expect more attacks on reproductive rights in 2015.

Rick BrattinThe Republicans are on a roll. Just last month Missouri Republican Rick Brattin reintroduced a bill to require women seeking abortion to get permission from the father of the zygote/embryo/fetus.  According to Mother Jones, Brattin’s bill would exempt “legitimate rape” victims. For a pregnancy resulting from rape to be exempted and the claim of rape “legitimate,” a police report must have been filed immediately after the rape. Oh yes, the Republicans are on a roll, seemingly even including distinctions about rape – Todd Akin style. Always claiming that the legislation is to “protect women,” these mostly male representatives apparently believe they know more about what is best for women’s health than, well, legitimate women.

Thomas State legis LoCPro-choice Americans have got to step up to the plate in 2015.  They must resolve to at least let their elected
representatives know their views. As fellow blogger and former lobbyist Pat Richards can confirm, it is very easy to contact members of Congress.  One website that provides direct contact information of each congressional member is https://www.congress.gov/members. For state and local legislative representatives, The Library of Congress Thomas website provides links to each state legislature. Pro-choice people need to take a page from the playbook of the zealously anti-choice organizations like violence-promoting Operation Rescue and the various evangelical groups that pressure church members to attend sessions to write emails and make phone calls en masse. It can make a difference in the extent to which a member of Congress maintains interest in sponsoring or defending restrictive anti-abortion or other family planning legislation.

During my years directing a clinic, countless state and federal legislators shared with me that the primary reason they hesitated to have a stronger public pro-choice position was because they seldom heard from their pro-choice constituents, but they constantly heard from the anti-abortion groups. That needs to finally change – there is too much to lose if it does not.  While NARAL and Planned Parenthood supporters often initiate outreach activities, they simply cannot compete with the church-sanctioned and sponsored groups in terms of numbers. It is also worth noting that politicians actually like to hear the views of individuals speaking from the heart instead of an organized script.

minds changeAs much as we may see reproductive rights as an issue in which people do not change their positions, there are studies that illustrate that people do change their minds about polarizing issues such as abortion and gay rights. Minds change through personal experience or learning about the firsthand experience of someone they know, love, or in some way care for. Minds can change when we interact with others with whom we share general values and recognize that on polarizing issues with which we disagree, things are not so black and white, all or none propositions. No one should be fooled into believing that when minds change about abortion it is only to the anti-choice position. National Right to Life has done some great messaging in that regard. In fact, pro-choice groups could do the same.

Maria Rivera

Maria Rivera/Photo from Trust.org

In 2015 we can probably expect to see more legislation proposed to ban abortion as early as 12 weeks, more verbatim scripting for medical professionals to impose on patients regardless if true, and more unnecessary and invasive ultrasound or other testing. Before you know it, every woman who miscarries will be subjected to a law enforcement report and inquiry. Think that sounds extreme? Just take a few minutes to learn about Maria Teresa Rivera in El Salvador where all abortion is banned. She did not even know she was pregnant when she miscarried, but the judge did not believe her and sentenced Rivera to 40 years in prison for aggravated murder. Each and every anti-abortion bill proposed in the U.S. under the guise of women’s health is another step towards a total ban.

Time is of the essence for reproductive justice. When and whether to have children is a personal choice. Abortion is a personal choice in which women do not benefit from, and can be harmed by, governmental interference. Medical professionals do not need the input of politicians in the private relationships they have with patients. Please, be it resolved that you will share your pro-choice position and dedication to reproductive justice with your elected representatives beginning this first month of 2015.

There are anti abortion activists who stand outside abortion clinics with the genuine belief that their presence helps women, that they are heroes in the war against abortion, and that their help will solve all of life’s little unwanted pregnancies. But their beliefs and women’s realities are, as the saying goes, a horse of a different color.

For the better part of eight years, I’ve come to realize that most anti abortion activists assume women choose abortion solely based on financial reasons. However, they are erroneous in making such a sweeping generalization. In other words, their beliefs don’t match the realities of women’s lives. According to the Guttmacher Institute, 74% of women chose abortion because having a child would interfere with her education, work or ability to care for dependents. As with many of the anti abortion activists, the difference between their beliefs and a woman’s realities never matters. For many who stand outside abortion clinics, their mission, to save babies and end abortion, is more important than a woman’s desires for her own life. These antis believe their pamphlets and offers of money, a free pregnancy test and a free ultrasound are enough to change an abortion-minded woman’s mind.  They find nothing odd with their invitation, as a stranger on the street, to get into their car for a ride to a prolife doctor’s office for a free prenatal visit. They assume that talking to strangers about the content of the uterus and traveling with strangers in their car to an unknown doctor’s office for free health care is perfectly normal.

But even with the questionable value of their freebies, there remains the reality of the emotional, physical and financial burdens of a pregnancy. The antis have difficulty accepting the reality that some women do not want to be pregnant, either now or ever. Their pro-natalist rhetoric leaves no room for the statistical evidence that early abortion is safer than childbirth, that post partum depression affects 10-15% of women, or that post partum psychosis occurs in 1 to 4 cases out of 1000 deliveries. Their optimistic rhetoric about adoption as an alternative leaves out the evidence that confirms that some women have a lifetime of regret and anger about giving up their child. They also fail to acknowledge well-documented, scholarly research that details resentful and angry adopted children, some with serious adaptive problems.

For a financial perspective, the government’s latest statistics reveal that they annual child-rearing expenses for the average middle-income, two-parent family range from $11,650 to $13,530, depending on the age of the child. Imagine, a single parent of one child, pregnant with a second child, who is considering her options for raising a second child on a salary of $18,700. The annual expenses for the first child, according to the government’s calculator, are $7,410; the second is $7,188.  So, where does that leave the mother? What are her options for education, being promoted beyond her entry-level position, helping her children become first generation college students?  These are only a few of my questions for these folks who badger women with their maternal guilt trips. One year, two years, five years, ten years from now, where will these pronatalists be? Where will these “love the mom, love the baby” people be when the fetus they saved needs braces, a reading specialist, a counselor for an eating disorder, bail money for their fourth underage DUI or financial assistance for college?

From my perspective it comes down to a rather straightforward question: What is the antiabortion activist’s responsibility for each fetus they save? Does the responsibility include prenatal care or should it include food, shelter and housing? And how long should this commitment last? Should these antis’ commitment to the fetus continue after it’s born, like biological parents commitment to their offspring? Should antis ensure estate planning for not only their own children but to all those fetuses they save? Or does the commitment last only until birth?

It seems to me that most antis will do whatever it takes to stop an abortion including offering to pay for a pregnancy test, an ultrasound or a visit to a doctor. Some goes as far as throwing a baby shower, purchasing maternity clothes or buying diapers and formula.

But these piecemeal efforts are like giving a person a fish to eat for a day. What is really needed is an entirely different approach. Rather than give a woman a fish to eat for a day, as the old parable goes, it seems wiser to teach her to fish. In other words, it makes more sense to provide all that a woman would need for her lifetime (including access to her choice of family planning, parenting help, babysitting, job skill development, education and such) and for the lifetime of the fetus saved from abortion.

So, let’s be clear. Assuming that women choose abortion because of financial reasons doesn’t make it a fact.  Assuming offers of freebies are wanted is ignorant and demeaning. But assuming that women accept strangers on the street to invade their privacy AND to accept their offers of health care is a horse of a different color—more like the color of a jackass.

Abortion Law

Abortion Law

Many years ago, the U.S. Supreme Court declared that unmarried people were actually allowed to use birth control.  Can you believe it! Yes, on March 22, 1972 the Court confirmed this outlandish notion in Baird v. Eisenstadt – a case that was seen as the precursor to Roe v. Wade, which legalized abortion just a year later.

And now it’s fifty years later.  Since that decision men have walked on the moon, the computer was invented, it was discovered that there are homosexuals in our community, we started drinking non-fat milk and the Red Sox finally won a World Series.  And, amidst all of this progress, today the Republican candidates for President are talking about birth control again.  Talk about going Back to the Future.

Abortion

Abortion

Now, to be fair I have yet to find any of the candidates declare outright that they would “ban birth control,” although that is what many Democrats and left-leaning pundits are suggesting.  But where Rick Santorum, et al made a mistake is that they just started talking about birth control in the context of the Obama health care bill – and their opponents jumped all over it.

Santorum has acknowledged that he and his wife do not use birth control, hence his seven kids.  Good little Catholic he.  And ole Mitt Romney has said, well, I haven’t checked today to see what he said last night.  I’ll get back to ya on that one.  But the fact that they are even talking about this issue boggles my mind, especially in light of the fact that 95% of the Catholics in this country use birth control anyway – the Pope be damned.

R v W March

R v W March

But there is a method to their madness.  They are talking about this issue and religion in general because, to get the Republican nomination, they need to go as far right as possible.  I mean, to the right of Genghis Khan.  You’ve heard the speeches:  “I am a true conservative in this race, I’ve always been a true conservative, I wear conservative shoes and use conservative toothpaste.”  And, early on, they learned that if they just mentioned birth control and religion and Obama’s secret plan to deport every Catholic, the right wingers at the rallies sucked it up big time.  Hey, this is a good stuff, I gotta keep this up!

It’s gotten so crazy that a few days ago Ron Paul made headlines in certain media when he announced that, when he was a practicing Ob-Gyn, he actually – I hope you’re sitting down – PRESCRIBED birth control.  OMG!  A Republican running for President actually participated in this pernicious practice (one, by the way, that would reduce the number of abortions).  Lynch him, cried the Tea Partyers!

Of course, the good news is that all of this talk about birth control – in any context – is welcome news to the Obama gang.  They’re just sitting back and having a hell of a good laugh.  And I’ll betcha anything that they got the commercials in the can right now warning women that the nominee is gonna take away their pills.  The good news is that Republicans talking about that nasty little pill may win them the nomination, but it will lose them the election.  Keep it up, boys.