Friday, 20 October 2017

Website counsels women taking abortion pills without prescription – CBS News


In response to increasingly restrictive laws on abortion in many states and fears of a further crackdown under the Trump administration, an international advocacy group is now offering online advice and counseling on how women can use abortion-inducing drugs on their own, outside of a medical setting.

The pills — mifepristone (Mifeprex) and misoprostol — require a prescription in the United States and the U.S. Food and Drug Administration says they should only be used under medical supervision.

But with states like Texas, Florida, Utah and others attempting to impose more hurdles to abortion access — and a president who has said he supports overturning Roe v. Wade — such a project signals that some women may be considering taking matters into their own hands, either by ordering the pills online or crossing international borders to get them.

The project, launched by Women Help Women, does not offer women in the U.S. access to abortion pills (though it does so in other countries where they are legally sold without a prescription). Rather, it provides information and email guidance from a counselor through a secure web portal.

The group’s U.S. spokeswoman Susan Yanow said the idea to set this project in motion came after Donald Trump was elected president.

“In November, we were quite alarmed, as many people were, at the new administration and we quickly realized that it was a unique threat to the reproductive rights to the women in this country,” she told CBS News.

While instructions for how to use the pills can be easily found online, Women Help Women is unique in that it connects its users with a counselor for step-by-step advice in real time.

The service is sure to add fuel to the controversy surrounding abortion, particularly regarding those that are medication-induced.

According to the Guttmacher Institute, which studies reproductive health issues, medication-induced abortions accounted for 31 percent of all non-hospital abortions in 2014, and 45 percent of abortions before nine weeks’ gestation.

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File photo from 2005 of a nurse holding RU486 pill at the family planning department of Hopital Broussais in France.

Manoocher Deghati / AFP/Getty Images

The pills, often taken together, can be used to safely end a pregnancy through 70 days gestation, or 70 days or less since the first day of a woman’s last menstrual period, the FDA says.

Anti-abortion activists argue that using the pills without a prescription is unsafe.

“[The drugs] are dangerous, and have been deadly for some women,” said Kristi Hamrick, spokeswoman for Americans United for Life. “Such dangerous chemical abortion drugs when used later in pregnancy or when given to a woman who is experiencing an ectopic pregnancy, harm women. Side effects have included severe bleeding, infection and death.”

According to the FDA, in some instances, the pills can lead to very heavy vaginal bleeding that will need to be stopped by a surgical procedure, often performed in a doctor’s office. 

The agency has received several reports of serious adverse effects in women who took Mifeprex, including one case of ectopic pregnancy resulting in death, and several cases of sepsis, including some that were fatal. However, the FDA says it is unknown at this time whether the use of Mifeprex and misoprostol actually caused any of these complications.

Katherine D. Pocius, MD, MPH, is the medical director of family planning at Massachusetts General Hospital, and says that medication abortion is “incredibly safe.”

“The fact that sites like this exists speaks to the need in our country that even though abortion is legal and covered by many insurances there are women who have many issues with access, which is appalling but true,” she told CBS News.

Still, she has concerns when it comes to using the pills without medical supervision.

“Seeing a doctor will ensure women know exactly how far along they are in their pregnancy, which is something you can’t always tell based off periods,” Pocius said. “So if you’re either much farther along than what is recommended with medication abortion that can be an issue or if you have an ectopic pregnancy – meaning one that’s not in your uterus but in your tubes – medication abortion won’t end an ectopic pregnancy and if you miss that it could potentially be life-threatening.”

Pocius also cautions against purchasing pills online. “Any time you’re obtaining something illegally, there’s really no way to know what you’re really getting,” she said.

The Women Help Women initiative also highlights potential legal ramifications for women who use the pills without a prescription.

“In the U.S., abortion is legal in every state, and every state has at least one clinic that provides abortion care,” the organization states. “However, in many states the law requires that abortion pills be given by licensed health care clinicians, and a woman may be arrested for using abortion pills that were not obtained through a clinician.”

The organization’s site Abortionpillinfo.org allows users to log into a portal and send a secure message to a counselor overseas. “There will be no evidence on the woman’s phone or computer that she has contacted the site,” Yanow said. “The message back will be a secure link, which will disappear after seven days.”

Most of the counselors — based on four continents and providing email counseling in six languages, 365 days a year — have as many as 10 years experience in abortion counseling, specifically in supporting women who are self-inducing, the organization says. They are also supported by two Ob-Gyn physicians who are experienced abortion providers, as well as by scientific advisors who are experts on medication abortion and research.

In case of complications, women will be told to seek medical attention and reminded that symptoms and treatment for complications of a miscarriage are similar to those for complications of medical abortion.

The site includes a disclaimer that its contents are for “informational purposes only” and are “not a substitute for advice from a medical provider.”



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