Friday, February 17, 2006

Abortions at home are safe - pilot study

Polly Curtis, health correspondent
Thursday February 16, 2006
The Guardian

Women who are less than nine weeks pregnant can safely have medical abortions at home, according to the head of a government-backed pilot project.

Abortion services for the 20,000 women who seek a chemically induced abortion every year could be transformed should the Department of Health's official evaluation of the pilot confirm initial findings. But it is also likely to provoke controversy from anti-abortion campaigners who will claim that home abortions would make the procedure easier and therefore lead to more women having terminations.

Shirley Butler, the project manager of one pilot which has tested the abortions with 172 women patients since 2004, told the Guardian: "We haven't had any significant problems apart from one woman who had a slightly heavy bleed. In my opinion medical abortions outside of acute hospitals seem to be safe." She added that women who took part in the trial were positive about it.

Ms Butler stressed that the results were preliminary and were now being officially evaluated. She also asked for her hospital not to be named for fear of reprisal attacks from pro-life campaigners. St Mary's hospital in London confirmed that it is undertaking the second trial.

Chemical abortions are available before the 12th week of pregnancy. Women who request it take one tablet of mifepristone at a hospital then return two days later to take four doses of misoprostol which causes a termination within hours. Usually women remain in hospital after taking the second pills until the abortion is complete. Under the trials they took both sets of pills within local community clinics to test the theory that it is safe to be outside hospital, and therefore at home.

A Department of Health spokeswoman said the scheme, which was revealed yesterday by the journal Nursing Standard, had not yet been evaluated. "No changes to the way abortions are carried out will be approved unless we are content that there is no risk to the women's safety."

Anne Weyman, chief executive of the Family Planning Association, said: "Medical abortion is a highly safe and effective procedure. Completing the second stage at home can provide greater comfort and privacy."


Jennifer said...

courtesy of the lovely Jane

yrautca said...

Do you really believe this? And more importantly, do you really support this? It just makes it easy to get drunk, have unprotected animal sex, get pregnant and bingo do a self-abortion. Decadent.

Jennifer said...

Fuck off Yrautca, finding out that you have an unwanted pregnancy and deciding to, and going through an abortion are all traumatic experiences for any woman. Anything that the medical establishment can do to make it less traumatic is an important step.

I read a statistic recently that if you factor in a lifetime of cycles from begining of menstruation to menopause with a consistently applied birth control regimen with their standard faillure rates that it can easily calculate to 3 unwanted pregancies.

Yrautca, if you faced the possibilty of ever having to go through an abortion you'd never have said such an ignorant and disgusting thing.

And for that matter, I don't know about the US, but in Canada having sex with a woman who is drunk means that she can't form consent and therefore that means that she has been raped.

So you are suggesting that this hypothetical raped woman should have to jump through more hoops and have it be more expensive and miss more work to get an abortion.

I'm so disgusted that you said this.

yrautca said...

Thanks for the kind words first of all.

Secondly, you need to calm down. I was going to do a post on this and maybe I will in my blog. I consider myself a pretty liberal guy. However, I will never be in a pro-choice vs pro-life debate because I think this issue is not as simple as people make it out to be. There is NO RIGHT ANSWER.

Here is what I was and am getting at (if you don’t like then that too bad):

I will allow abortion ONLY in these circumstances: rape, health issues, poverty.

Abortion should not be allowed in every case. You can’t have a rule that all encompassing, that addresses every goddamn situation there is out there. I will not allow abortion in cases where it is obvious that the biological parents (not just the girl) were negligent, such as, yes getting drunk at a party and having sex (no matter how many times you try and convince yourself, it happens everyday). Or at least if they are allowed abortion there should be some kind of accountability.

Now don’t be a stubborn liberal woman and just discard everything I said. You need to let your ideas be challenged. Open up your mind and take a couple moments to think about what others think.

Jennifer said...

Yrautca, get your head out of your ass.
1. The example you gave of drunken sex IS rape. Sex with a woman who is not competent to give consent is rape. I don't know how to say this more clearly.
2. You are right there is no right answer, some women don't like abortion because of their religion, some think it's no big deal, so the right answer is to let every woman decide for herself.
3. Women will get abortions whether you (that phrasing in your post, "I will only allow abortions in these circumstances" was chilling) or the governement allow it. The thing about abortions is that they happen no matter what, and the question is, how safe will they be. Make it illegal and only women who have the money to travel for an abortion will be able to get them, the rest will risk their lives at the hands of an amateur, clotheshanger abortionist. So making abortion illegal is essentially a death sentance to women who had the misfortune to have an unwanted pregnancy, that like I said most of us will experience at some point in our lives.
4. What the fuck business is it of yours, you will never have an unwanted pregnancy, so why are you weighing in on this? I thought America was all about freedom, the problem is that none of you can seem to mind your own business.
5. If I was subborn I would have deleted your post, or never put this article up there in the first place, so obviously I am prepared to have dialogue about this. And I'm exposed to oposite opinions to mine regularly when I pass my local abortion clinic and see (likely American, definitely American funded) anti-choice protesters harrassing the unfortunate women who have to go in there. Congratulations Yrautca, you're in that club.

yrautca said...

Fuck you too. You are better at insulting than making your argument, although you have made your point.

Whatever dude, your asking me what business it is of me since I will never be pregnant myself is ignorant of you. You think only women can think or talk about this.

You telling me my statement of "I will allow" was chilling. You just looked at the words, not the context. I am not a lawmaker or God to allow or disallow shit. I am just using a writing style. Geeze.

Third, maybe you can convince me. I said I am neither this way nor the other. If you can just calm down and try to change my view I am open to it.

If you can only tell me the answer to one question it will help:

Do we have any accountability in place for concensual irresponsible sexual acts. Or do you think it is none of my business why and how anyone wants to have sex.

I need some stats to see whether people reached out more for contraception when abortion was not an easy option.

Like I said whatever dude. I can deal with your tone of voice and your insults and whatnots. But I dont necessarily like it when you make judgements about me.

yrautca said...

You feel strongly about it. You need to make a decent argument. Convince me. Show me some data, some numbers. Give me some good reasons. You feel so strongly about it, then convert me if you can.

yrautca said...

And I apologize if I offended you. Sorry.

Jennifer said...

Why focus on people not using birthcontol and not wanting to be pregnant? Why do we have to punish women and make them have babies they don't want to have? Do you have any idea how punishing pregnancy is on the body? Why stigmatize women for exercising control over their own bodies? What difference does it make to you whether women used birthcontrol or not, when they have unwanted pregnancies? Are you suggesting that life begins at conception?

What about the morning after pill? Should that only be available to women who bring in the broken condom to prove they were trying?

It doesn't matter whether you were using birthcontrol. The methods of birthcontrol available are not perfect. They have side effects. They don't always work. And why does someone else need to be judge and jury over what happens to my body?

I'd never want to have to go through an abortion, I've never met anyone who thought it was no big deal. I don't even like going for my annual pap test. Being spread eagle on the table with your feet in cold metal stirrups is not fun. I've never met another female who felt differently.

As for accountability, yes, we all have accountability for everything we do. If you get pregnant whether you were using contraception or not you are accountable in that you either have to have the baby or have an abortion.

The anti-choice movement would have you believe that there are women out there who use abortion as a method of birth control and have them all the time. Firstly this isn't true, I'm told that it's really not fun to get an abortion. Secondly, even if it is true, why does it matter? It's not your body and it's not your money, so what difference does it make to anyone else but the woman getting the abortion?

I do actually think that it's none of your business how anyone has consentual sex. As a former Canadian Prime Minister, Pierre Trudeau, once said, "The state has no place in the bedrooms of the nation." Whatever two consenting adults want to do to eachother sexually is none of our business.

It's hard to say what the statistics are on whether women were more vigilant about contraception when abortion was less safe and availble, because both issues have been so stigmatized. When abortion becomes less safe and available, it just goes underground and women die as a result of going to unskilled abortionists. Better contraception in the form of the pill has only been availble since the 1960s and shortly after abortion was legalized by Roe v. Wade in the US.

The point is, I don't understand how it would affect anyone else but me if I wanted to have an abortion. This is a service that I would be paying for, to be done only to my body. What difference does it make to you? Does everyone else get to be the morality police? 'You had sex without adequate birthcontrol, now we will punish you by making you be pregnant.' What purpose does that serve? And for that matter, do we really want a bunch of children whose mothers didn't want them running around? Don't we have enough people in this world? You can't force people to be responsible. Say you do take away the right to an abortion from all but those you deem worthy, then what? Those 'irresponsible' people who had none of your sense of accountability when it came to getting pregnant - what are they going to do? Do you think they are going to quit smoking and drinking and drugs and eat all the right foods and take their vitamins? I sincerely doubt it, so then you get the foster system jammed full of kids who have fetal alcohol syndrome and were born addicted to crack, or just with neural tube disorders cause mom didn't take her follate. Where does that get us? If we want to force these women to be good mothers, do we have to lock them up to prevent them from damaging the fetus? Some sort of pregnant lady camp maybe?

I don't know what to say to change your mind, I suspect that you are so fasitidious in the way you live your life that you could never imagine getting into a situation that was beyond your control, whether through carelessness, honest mistake or no fault of your own. But stretch your mind and try to imagine what it might be like just for a minute. And then let me know what you think of what I've said.

I did a little research to give you some history and statistics (I used the book, "Our Bodies, Ourselves" for most of the following information:
-abortion was not illegal in the eyes of the law or the church until quite recently. In fact there was very little moral opposition to abortion even when authorities began to attempt to outlaw it. The movement to outlaw abortion came about at the same time as, as a backlash to, the women's sufferage movement in the mid 19th century (women's sufferage = women's fight to be allowed to vote). This was around the same time that male doctors were trying to edge out mid-wives and deliver babies themselves, and take over that arena to increase their own economic and social power. Doctors began to oppose abortion as a way of taking power away from midwives who performed them routinely.
-In the late 1880s the US government and the eugenics movement began to fear that white birthrates were down to the point that whites might be commiting 'race suicide'
-also women who didn't have children had much more power to rise out of the roll of domestic help and other menial jobs, the economy relied on this labour and therefore it was in the interests of the powers-that-be to take away women's control over their own reproduction.
-in the 1890s doctors estimated that there were 2 million abortions a year in the US, compared with 1.5 million today.
-women who want abortions and can't get safe ones have used various dangerous methods from inserting knitting needles and coat hangers into the uterus or douching with dangerous chemicals like lye, or swallowing dangerous chemicals in the hopes of aborting the fetus without killing themselves. Having done this it was hard to seek medical help for the damage done, because of the danger and stigma attached to being found out.
-In the 1950's it's estimated that 1 million illegal abortions were performed each year, with and estimated 1000 women dying every year as a result.
-In 1969 75% of women who died as a result of clotheshanger abortions were women of colour. Of all legal abortions performed in the same year 90% were performed on white women.
-Roe v. Wade legalized abortion in the US in 1973, but still left a lot of the descisions in the hands of doctors, hospitals and governmment, and this right has been under attack ever since.

So in answer to your question about whether there is a connection between available abortion, and contraception use, abortion has been legal for most of the amount of time that the pill has been available.
On the other hand, we can see that using the 1890s stat of 2 million abortions at a time when modern contraception was not available and abortions were much more dangerous because of lack of medical knowledge and sterile techniques, compared to the number today of 1.5 million today at a time when abortion is much safer, the population of women of childbearing age is much higher and birthcontrol is more accessable and effective. I'd say that this is a pretty good indicator that women do reach out to birthcontrol instead of abortion much more than they rely on abortion even in an age where abortion is much less dangerous.

yrautca said...

You make general statements about me which are unwarranted. I havent attacked your character or your personality. I always said I think you are a very smart person indeed. You have impressed me, not that its of any value to you. I would rather that you dont make generalizations about how I live my life because you dont know me.

As for the issue at hand, you have made a strong argument that has merit. I see that you have done some good research on it. I cant make up my mind in a single day. I said again and again that I am undecided on the issue. I never said that I want to ban abortion.

Jennifer, it may seem trivial to you but when you make judgements on people, it could hurt them, even when they dont know each other in person. I am a very understanding person with a very soft heart. I can never see anyone in pain and I would not see a mother or a sister or a daughter in pain due to her pregnancy either.

I wish you wouldnt just relegate my to the group that lacks any understanding of the drama we call human life.


Princess Pessimism said...

Yrautca - You said "I am a very understanding person with a very soft heart. I can never see anyone in pain"

HOWEVER, you have NO problems coming to my blog and making jokes about someone being "brokeback" because they watch men's figurskating.....Has it ever occurred to you that THAT comment, and comments like those are ALSO hurtful to some.

How do you know who erads my blog? Are you certain that I have no gay friends who read and post in my comment section? And then they see ignorant bullshit comments like that???

Maybe, MAYBE you should take your OWN advice, and learn to be a little more sensitive to people. The world doesnt revolve around you, you maybe you should take OTHER people into consideration when you are ALSO putting your opinion on the line.

Where was this "sensitive and caring" side of you when you made "brokeback" jokes on my blog? Try not to be such a hypocrite's a disgusting quality you know.

Trib said...

Wow. All this just from a poorly written article. I had to read the article three times just to understand what the hell they were talking about. Here's what's up: the current protocol calls for the patient to take the first dose of mifepristone (RU486) and then come back and spend a little time at the hospital until the endometrium finishes sloughing. The only difference here is that they don't have to hang around the hospital. As you probably know, progesterone is what maintains the endometrium and RU486 is an antiprogestin.
I'm not very into law, but in a legal sense if a woman has one drink she is no longer considered competant to decide whether or not she wants to have sex. Isn't that a little insulting? And what if they've both been drinking? Who raped whom? Is the more sober party automatically guilty?

Jennifer said...

Yrautca, I'm sorry if I hurt your feelings, I assume when you mentioned personal comments you meant my calling you fastidious, I didn't actually mean it as an insult, I was just trying to say that nobody is perfect.

Trib, in your medical opinion, do you think the sloughing endometrium is something that can safely happen at home?
As for the ability to form consent and alcohol. I don't think it's insulting at all, it protects women from being prayed on by gross guys who try to pour alcohol down their throats to get them drunk. And if I go home drunk with some guy from a bar and have 'animal sex', it's not like the cops are going to come and knock on the door and take the guy away without my say so. It just means that if I wake up in the morning in a fog, remember parts of what happened and I'm not OK with it, then I have legal recourse, which in no way takes away the pain of being raped.
I've encountered many of these kinds of creeps over the years and it makes me happy to imagine that I'd have the law behind me if I ever ended up at their mercy. As it is, way too few women come forward and report date rape because they are embarrassed or feel it's their own fault, or don't think that people will support them.
Also, no one ever said anything about one drink. We were talking about 'drunk'. I'm not sure where our law stands on how many drinks it takes before you can't form consent, but in my jurisdiction you can still drive a car after one drink, so I think you'd still be considered competent to consent to sex. But in Canada, being drunk while committing a crime doesn't protect you from prosecution. I know that will make all you guys squirm to think that somewhere through the years if you'd been in Canada doing what you were doing, then you'd have put yourself at risk for a date rape conviction, then there it is. There are plenty of guys out there who call gin 'panty remover' who need to learn that that's not cool, and who will hopefully one day learn what the woman felt like when they drop the soap in the shower of one of our lovely Canadian federal penitentiaries.

Everyone else can correct me if I'm wrong about what I've said regarding rape laws in Canada, I'm no legal expert and I know there's a lawyer or two reading the blog who could step in and clarify.

Oh, and Trib, you never told us what Bukake was, don't make me Wikipedia it...

yrautca said...

Alright then jennifer, I think we are cool. At least you feel strongly about issues that matter to you. I can be persuaded to rethink issues. Run for office.

Trib said...

Yeah, I think it's pretty safe. And maybe I should clarify about my feelings on the drinking consent thing. Where I went to school in MN the law was, as explained to us by the administrators, that consent could not be given after one drink. I've never taken home somebody that was completely hammered or even had lost motor coordination. I've always been respectful of them and very careful to get consent for whatever was happening. I'm a little uncomfortable with the fact that I could piss her off and she could effectively end my life without even lying. Of course, guys that are having sex with gals that are in and out of consciousness are rapists and I have the disgust towards them that any man should have. All I was saying was that there should be more common sense applied.
Bukkake :) is a japanese thing. It's when a bunch of guys essentially jerk off onto a girl. It's very gross.

Jennifer said...

Yeah Trib, I'm with you, as a nice guy it's scary to imagine that some vindictive girl might say she was raped just to get her own back on you, but it's so incredibly unlikely that I wouldn't focus too much energy on it. For one thing if a girl wanted to falsely charge you with date rape, whether she was lying or not probably wouldn't stop her, and for a second thing, anyone who had ever tried to report a date rape will tell you that it's so horrible and embarrassing that you'd have to be a special kind of crazy to do it just for kicks.
The fact is that rape is way more under-reported than over-reported.
And for that matter, if you want someone to thank for zero-tolerance type rules, it's not women or legislators, it's the men who do the date raping.

Trib said...

I'm with you there. Rape is sickeningly under-reported. My paranoia just gets the better of me sometimes.

Jennifer said...

Dude, me too, me too.