Wednesday 20 March 2019

Is handing women a packet of illegal pills the best we can do?

Opting for telemedicine to end an unwanted pregnancy could be playing Russian roulette. Stock picture
Opting for telemedicine to end an unwanted pregnancy could be playing Russian roulette. Stock picture
Fiona Ness

Fiona Ness

Before I'd even finished reading yesterday's newspaper headline, the flashbacks had begun.

'Home abortions' using pills and online support are 'safe and effective' the headline read.

'Home abortions' - the words making my stomach lurch right back to September 2012, when I was given abortifacients by a hospital consultant, to take at home to induce a 'missed miscarriage'. They were a safe and effective option to make my body pass the baby, I was told. "But if you have any excess bleeding, call us."

Today, a study of 1,000 women in Ireland has concluded that an online home abortion service had outcomes that were "safe and effective". These "home abortions" involved women taking abortifacient medication sourced from the Women on Web online group.

The new findings come from a study undertaken by the University of Texas. Researchers there analysed questionnaire responses to a telemedicine clinic by 1,000 women in the Republic and the North. The women had used the drugs mifepristone and misoprostol to end an early pregnancy four weeks earlier. Almost all of the interventions were "successful".

Read More: Customs has already seized 158 abortion pills this year

Seven women had to have blood transfusions and 26 had to be administered antibiotics. A small number, by anyone's standards. Find yourself with an unwanted pregnancy in Ireland and whether desperate, or simply mildly put out by the event, you would definitely take your chances with this.

"How much blood is too much?" I asked my husband the night I took the abortion pills and bled out over the bathroom floor. Earlier this year, writing in the Irish Independent's series on miscarriage, stillbirth and neonatal death, I detailed how I took myself off to hospital in a taxi, sitting on a towel to soak up the blood, while my husband remained at home with our sleeping children. I couldn't even contemplate grieving the loss of a baby. I was terrified.

I still live in terror of what might have been, if I hadn't acted in getting myself to A&E, if I hadn't already been a patient at the hospital I subsequently attended, if I hadn't had a cloak of respectability about me when I called the midwife to say I was coming in.

The pills had been given to me by an Irish hospital consultant to enable my body to release a baby who had already died. I'm not sure I would have been so keen to rush to hospital had I procured the pills online to commit an illegal act.

However, many years of a Repeal the Eighth movement later, I don't feel we've moved on hugely in how society en masse judges women who have abortions. Which brings me to a new terror: the thought of women in Ireland rushing towards an abortion service that conducts free medical consultations and posts out eligible women the pills. Why am I terrified of this? Well, because there was nothing in my medical history to indicate I was not an eligible woman - but still, there I was, bleeding to death in the back of a taxi.

To opt for telemedicine to end an unwanted pregnancy could be to play Russian roulette with your life, in the hope that you'll know how much bleeding is too much, that you will have the courage to present to A&E, and will meet a sympathetic doctor who doesn't make a judgment call on your actions, and who will work swiftly to save your life. Is self-sourced medical abortion really where we're at? Is this the best we can do for women in crisis situations? Handing them a packet of pills, clapping them on the back and saying get on with it?

"Women of all social classes in a legally restricted yet high resource setting have equitable access to a reasonable alternative: medical abortion guided by physicians through telemedicine," the study's researchers wrote.

In the absence of safe and equitable abortion care, it's definitely something. It's also terrifying.

Irish Independent

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