RU Ashamed?

By Claire Barnett, AlterNet. Posted December 2, 2004.

On Nov. 19, the Seattle Post-Intelligencer editorial board commented on the new "black box" warning labels placed on Mifeprex (also known as "the abortion pill" or RU-486), stating, "The FDA must avoid shaping its future handling of RU-486 to fit political whims."

Since its approval in the United States in 2000, Mifeprex has been used by 360,000 women and indirectly linked to the deaths of three. Recently, the government issued a statement assuring the public that Mifeprex will remain on the market. As we look closer at the anti-choice movement's cry to ban this safe drug and all abortions, we must also look deeper at the social context in which these women are living and navigating their choices.

As a doctor who performs abortions, I am committed to helping women and to providing the safest health care possible. I am deeply affected by any woman's death and certainly these three deaths are a tragedy. It is my job to do whatever is possible to prevent further deaths or serious complications. It is also my duty to practice evidence-based medicine to ensure that society has access to medicines and procedures that are proven to be safe and effective.

So what are the risks of taking the early abortion pill? There is a large body of scientific research as well as a history of use by millions of women worldwide since 1988 that proves Mifeprex is extremely safe. According to recent information provided by the FDA, the adverse event rate for Mifeprex is a remarkably low 0.02 percent and the death rate is 0.008 percent. Evidence shows us that legal abortion is one of the safest medical procedures performed. There can be no argument that it is infinitely safer than illegal abortion.

It is clear to me that the stigmatization of abortion markedly affects the safety of abortion care. It does so both by isolating the woman and by limiting the amount of training physicians receive to care for any unusual outcomes they may encounter. The political climate around abortion and the lack of adequate training for doctors in this specialty of women's health is appalling.

Often, women come seeking abortion care completely alone. They do not feel safe to disclose their decision to those around them, so in the rare instances when problems do arise, they are often trying to navigate them alone. As a provider of compassionate, respectful abortion care, I am concerned with bringing the abortion experience out of the closet and into public discourse where women and their experiences belong. Almost half of all women in this country have an abortion at some point in their lives. Why are we as a society forcing our sisters, our friends, our mothers and our daughters to experience this in an isolating and stigmatized way?

Blaming a drug for society's inability to truly discuss the deeper issues women face is an equation for disaster. Mifeprex was not the culprit in these women's deaths but lack of communication may very well have been. Stigmatization of abortion gets in the way of safety by isolating the experience and cutting off a woman's ability to talk about what is happening with her and her body.

We must allow women to discuss their abortions and their abortion experiences in an open, supportive and non-judgmental way. This is the key to ensuring that abortion remains a safe and viable alternative for women faced with an unwanted pregnancy. Banning the abortion pill will not help women. That would only reduce the safe options available to women as well as make abortion more difficult to obtain. The true answer lies within all of us to discuss abortion openly and honestly.

Claire Barnett, M.D., is the medical director of Aradia Women's Health Center in Seattle. This article was first published by the Seattle Post-Intelligencer.

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