Some Experts Concerned That Women Still Are Undergoing Clandestine Abortions, ABC News Reports

26.08.2008      Despite Roe v. Wade and FDA's approval of the medication abortion drug mifepristone in 2000, some physicians recently have seen cases that have caused them to worry that the "phenomenon of underground abortions is still a reality," ABC News reports. Consequently, the groups Gynuity and Ibis Reproductive Health are launching a study in San Francisco, New York and Boston to determine how many women seek abortions outside standard medical settings and why.

According to ABC News, although 38 states have laws mandating that only physicians can perform abortions, there have been several anecdotal cases of women administering medication abortion drugs on their own in recent years. Misoprostol, the second drug in the two-drug medication abortion regimen that includes mifepristone, also was approved by FDA as an anti-ulcer drug to protect people taking high amounts of pain medication. Misoprostol's manufacturer, Pfizer, has opposed such off-label use, ABC News reports. Nevertheless, the drug has been used in areas where abortion remains illegal, especially in Latin America. Not only is the drug legal in such places, but it is relatively inexpensive compared with a surgical abortion, which can cost several hundred dollars, ABC News reports.

Daniel Grossman of Ibis Reproductive Health and St. Luke's Hospital in San Francisco who has worked in Mexico said that a bottle of misoprostol can be bought in Mexico for $125, although only eight pills, at $5 a pill, are needed to induce an abortion. Grossman said, "Sometimes, people talk about this as a passport to the ER. They take enough so it looks like they're having a miscarriage, and then they have an aspiration procedure."

According to ABC News, women also have begun to search the Internet for "emmenagogues" -- herbs that have abortifacient effects and that have been used for hundreds of years. Tieraona Low Dog -- a physician, herbal expert and former midwife -- said she sees more talk about abortion alternatives when the issue surfaces in politics and during election years. Although Low Dog added that she has never given women abortifacient herbs for safety reasons, she has seen women seeking these alternatives since she started as a midwife apprentice in New Mexico 25 years ago. Susun Weed, an herbal expert and author of "Wise Woman Herbal for the Childbearing Years," said some common herbs thought to induce an abortion early in pregnancy often are dangerous. "The most common way is that women take herbs that are poisonous and take enough to poison the baby but not themselves," Weed said, adding, "This is not easy to do. Unless the woman is sick enough to be throwing up and in serious pain, it's not going to work." Other herbs, such as blue cohosh, act in the same way as misoprostol by starting uterine contractions, according to ABC News.

Grossman said he expects the study will find a "common root" to clandestine abortions. "We want to find what some of the barriers [to reproductive health] are," Grossman said, adding, "I think that's really what the issue is all about" (Cox, ABC News, 8/22).

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