R U 486 or R U anti-choice? The Abortion Pill: A Gynaecological Revolution
Since I’ve been in Poona on holiday I haven’t picked up a newspaper or watched the news on TV even once! So at a recent dinner with some family friends I was quite ashamed at how little I suddenly knew about world affairs. I decided I desperately needed to update myself.
And I discovered the Abortion Pill!
Now the abortion pill is not, as some people mistakenly presume, the same as the morning-after pill. The morning-after pill is merely an emergency contraceptive. It is a drug that acts both to prevent ovulation or fertilization and possibly post-fertilization implantation of the embryo.
RU 486 is the abortion pill. RU stands for Roussel-Uclaf (the initials of the pharmaceutical company) and 486 is a lab serial number. I know, really imaginative right?
So anyway, what surprised me is that this pill is available in India! I had never heard about it. Abortions have been legal in India since they passed the Medical Termination of Pregnancy Act in 1971. That I knew. Of course there are only some circumstances under which a woman may have an abortion – rape, incest, risk to the life of the woman or her child, and surprisingly – in a situation where “pregnancy occurs as a result of failure of any device or method used by any married woman or her husband for the purpose of limiting the number of children, the anguish caused by such unwanted pregnancy may be resumed to constitute a grave injury to the mental health of the pregnant woman.” Ha! Pretty progressive I thought.
Anyway, this new pharmaceutical method is called ‘medical abortion’, as opposed to ‘surgical abortion’.
A medical abortion involves a combination of two drugs – Mifepristone and Misoprostol. First you’re given Mifepristone, which blocks the hormone progesterone levels that are needed to maintain a successful pregnancy and causes the uterine lining to begin to shed, the cervix gets softened and bleeding (an indication of abortion) may occur. Then, a couple of days later, Misoprostol, which causes uterine contractions (cramps) to expel the contents of the uterus from the body. According to the WHO, this method has a 95% success rate.
Mifepristone is used only for abortions, so it’s not available all over the world, but Misoprostol is also used in the treatment and/or prevention of gastric ulcers and to induce labour. So it’s much more easily and widely accessible! Apparently, if you take just Misoprostol though, the effectiveness drops to just 80-85%.
Still, isn’t that better and safer that any other option a woman may turn to?
A medical abortion basically causes a miscarriage – and you can’t tell it apart from a natural miscarriage. That’s important for women in countries where they might get thrown in jail if they seek help in a hospital after a messed-up abortion. Apparently it’s no riskier than a natural miscarriage, and there’s no known harm to a woman who turns out not to have been pregnant after all. One serious downside is that Misoprostol is suspected of causing birth defects, perhaps 1 percent of the time, but only if it fails and the pregnancy continues to term.
And when I first read about this, I thought ‘WOW!’ Really, how awesome. It’s not invasive, it’s cheaper. It’s nowhere near as dangerous as going to some back alley quack that might make things much worse! It also gives the woman a lot more control than if she were to have a surgical abortion.
Abortions are illegal in Sri Lanka, except when they are performed to save the life of the woman. Arguments against the decriminalization of abortion are aplenty, the commonest one being, if you allow abortions, women will get pregnant indiscriminately just because they know they have a way out and that more people will have casual sex. A lot of groups put abortion on par with murder.
But here’s the real shocker. There are about 750 to 1000 abortions in Sri Lanka every day. 86% to 96% of abortion seekers are married. And the commonest reason given for seeking abortion was that it was too soon after their previous delivery.
More shocking – most people are using abortion as a method of contraception. Sounds completely mad doesn’t it? Mad yes, but not really surprising. It is in keeping with the lack of knowledge on reproductive and sexual health, lack of knowledge on family planning methodologies, access to such services, lack of negotiation skills within men dominated sexual relationships, alcoholism, rape and socio cultural influence.
In the face of all this information there are still some people who believe that laws against abortion will stop abortion. The only thing that laws against abortion do, is make abortions dangerous, turn women into criminals, produce thousands of disadvantaged children and create a wide disrespect for the law.
People make mistakes and sometimes they forget to use contraception or use it wrong. Motherhood cannot be a punishment for human error!!
Brazil and some other countries have tried to tighten access to Misoprostol because of its use for abortion. But curbing access to Misoprostol would mean that more women would die of hemorrhages.
We see thousands of women willingly risk their lives to end an unwanted pregnancy, because the alternative would be to live with the stigma of rape, incest, bastard children or simply poverty.
So now who’s the murderer?
grassrooted 
