Tuesday, October 04, 2005

Does Roe Even Matter?

With Ozzie's mom having been nominated to the Supreme Court, I've been thinking a bit about Roe v. Wade.

Does it really matter anymore?

I'm a man. And as such, I'm prone to stupidity when it comes to women's health issues. When I've heard about RU 486 in the news, I had assumed that this was a medication available that could prevent pregnancy after unprotected intercourse. This is not only incorrect, but a small part of the story.

It turns out that there are actually two medications at issue when it comes to preventing pregnancy. One medication prevents pregnancy after unprotected sex and is the so-called morning after pill:
Emergency contraception is taken after intercourse, but before a woman misses her period. So it is taken at a time when a woman doesn't know if she is pregnant or going to get pregnant. The pills are, at this moment, prescription pills, but they are actually the same formulations that are in normal contraceptive pills. There are two kinds. There is a combined contraceptive, which is Preven, and there is a levonorgestrel, or progestin-only contraceptive, which is called Plan B. Those are really the same as the pills in oral contraceptives. They are just your everyday contraceptives, but done in a different way so that women can take them after they have been exposed to potential pregnancy, but before they are pregnant.
The other medication causes an abortion after pregnancy and up to eight weeks later, the so-called "abortion pill":
The Abortion Pill (brand name Mifeprex) is a form of early abortion caused by the combination of two medications, mifepristone and misoprostol. Also known as RU486, mifepristone has been used safely in Europe for many years. The Abortion Pill is an early abortion option for women who are 8 weeks pregnant or less.
This site does a nice job of identifying the two and the differences. Maybe this is review for most, but I wasn't aware that there were actually two different drugs that have two distinct time frames, with one of them eliminating the need for surgical abortion. Then again, I've been "unable" to have children for around 25 years, so contraception hasn't exactly been on my radar screen.

I took a minute and did a little work trying to get these medications over the internet. Both medications are available in the United States via perscription from a physician. The morning after pill, or "Plan B" (I love that nickname) is currently under consideration for availability over-the-counter and has been the subject 0f much political wrangling and pressure on the FDA from interest groups on both sides of the issue. I was readily able to find internet sites that would sell the Plan B pills mail order.

So with the availability of medical abortion up to eight weeks of pregnancy, is surgical abortion even needed? Obviously there are cases where it is medically necessary for surgical abortion. And there may even be some unusual cases where an abortion is sought beyond the eight week time frame. But aren't these the exceptions?

It appears that the efficacy of each method is about the same, and that the risks are roughly equal.....low. The choice seems to have much more to do with personal factors rather than medical. But clearly, the ability to privately terminate a pregnancy in the first trimester is one that can be made in the comfort of one's own home.

So why is losing Roe v. Wade such a big deal?

I really think that technology is making it more and more irrelevent. Yes, those who are against abortion would, and will, continue to make the case against medical abortion and fight to outlaw the drugs. Thus far, they've been unsuccessful. And I suspect that the Supreme Court may be less likely to touch the issue of medical abortion due to the privacy issue being one-step removed from a surgical procedure. Also it seems to me that in a practical sense, the attempts to prevent medical abortions is a losing cause due to the ready availability of these drugs internationally via the internet.

I realize that the larger issue of privacy, choice, and civil rights are a major factor in the issue of Roe v. Wade. I just have to tell you, it gives me a little bit of solice to understand that if surgical abortion is made illegal, woman have viable alternatives to the old days of "coat-hanger" abortions. If a woman wants to abort even in the event of a repeal of Roe v. Wade, the options are much much better than they were thirty years ago.

And ironically, this argument may actually weaken the arguments by the pro-choice groups who want to preserve Roe.


At 6:02 PM, Blogger Lynne said...

Of course you are assuming a woman could get said medication from a pharmacist.
This is not always the case. They are shutting that door already.

At 7:44 PM, Blogger Greyhair said...

I'm assuming in the absolute worst case scenario, these medications could be gotten illicitly, particularly with the internet and other more enlightened countries.

Not an ideal situation, but better than it was 30 years ago.

BTW, I am definately pro-choice and will do all I can to see that Roe is upheld.


At 3:09 PM, Blogger Lynne said...

I am pro-choice too, especially since I had to make that decision as an 18 year old. It was hard but I decided that I could not care for a child and I decided to have the abortion. It was one week after my "first time" that I heard the words, "You're pregnant". My world collapsed.

In an odd turn, a second test confirmed that I was NOT, in fact, pregnant at all. (I've wondered since then if this clinic was trying to get some money out of a scared, naive teen). I still had to think through it all and it was not something I did lightly. I can't imagine not having the choice at all.


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