Behind the Abortion Industry Push for Chemical Abortions: Reason #3 of 5

By Randall K. O’Bannon, Ph.D., NRL-ETF Director of Education & Research

Editor’s note. Last Wednesday Dr. Randall K. O’Bannon provided NRL News Today readers with a succinct explanation of the “5 Reasons behind the Abortion Industry Push for Chemical Abortions.” As promised, last Thursday, Dr. O’Bannon began fleshing out the five reasons, one per day. Chemical abortions are a crucially important “growth center” for the Abortion Industry.

ru_486aReason # 3. Finding New Allies, Expanding to New Areas

Though they imagine themselves as heroes, when they are honest, abortionist acknowledge their doubts and admit that they are not well respected in the medical profession. 

Colorado Abortionist Warren Hearn told the New York Times in 1990 that abortionists “are treated as a pariah by the medical community… At best, we are tolerated.” Another doctor who performed 32,000 abortions before quitting told the Times that “other doctors treated us as second-class M.D.’s (New York Times, 1/8/90).

In the same article, a female abortionist talked about having to emotionally prepare herself each time, often enduring a sleepless night before an abortion. “It’s a very tough thing for a gynecologist to do” she said.  The emotions that it arouses are so strong, she told the Times, that doctors “don’t talk to each other about it.”

She admitted to losing control one time, collapsing on the floor while performing an abortion, shortly after her own miscarriage following seven years trying to conceive.

Given such attitudes and internal conflicts, it is not surprising that the industry has had a hard time recruiting new abortionists. Signs are that, despite their best efforts, things are getting more difficult for the industry.

Only 14% of Ob-Gyns in a survey published in 2011 said they performed abortions.  This was down from 22% in the 2008 survey. (Reuters Health, 9/1/11).  It was 33% in 1995 and 42% in 1983 (Washington Post, 9/23/95). 

The abortion industry has fought back. In 1995, under pressure from the abortion lobby, the American Council of Graduate Medical Education, the group that handles accreditation for U.S. medical schools, voted for a rule making abortion training a mandatory part of residency training.  The impact of that rule was blunted by an “opt out” provision for students and by an amendment passed by Congress which specified that lack of abortion training would not be recognized as an obstacle to accreditation, but the point was made: the industry needed more abortionists.

Though the public cause has been muted, fearing backlash (see “Pro-choice timidity in fighting shortage of abortion providers,” Remapping the Debate, 3/13/13), the industry has still been active. It has established 58 “Kenneth J. Ryan Residency Training Programs in Abortion and Family Planning” around the country, funded special fellowships in “family planning” that include abortion training. They have also pushed to have nurses (and others) authorized to perform abortion (see “Takeaways from the UCSF Abortion “Turnaway” Study, Part 4,” NRL News Today, 1/8/13, “UCSF: A Study in High-Powered Abortion Advocacy,” NRL News Today, 5/28/10, and “Pro-abortion California Governor signs law allowing some non-physicians to perform first-trimester abortions,” NRL News Today, 9/25/12; see also Washington Post, 9/1/09, NY Times, 7/18/10).

Doctors have continued to resist, some for moral reasons, others for practical ones. But one of the explicit aims of those who pushed to bring RU-486 to America was to recruit new allies, to make doctors feel like they were somehow less direct agents of the killing, to make abortion something that could be more cheaply and discreetly added to a doctor’s practice. The two-drug chemical abortion regimen is key to these efforts. 

Though phrased in terms of “increased access,” the clear aim is to increase the numbers of doctors and locations offering abortion.  Margaret Catley-Carlson, president of the Population Council, the group that sponsored the official marketing application for the abortion pill in the U.S., said at the press conference announcing U.S. trials of RU-486 that these abortions would “eventually increase women’s access to abortion services.” 

Promoters of an alternative chemical abortion regimen used as a stop gap before RU-486 and misoprostol obtained FDA approval in 2000 said it more directly:

“Perhaps the greatest advantage of medical abortion is that it can take abortion out of the clinics and distribute it among many physicians’ offices, particularly in many areas of our country that do not have abortion services.”

Eleanor Smeal, head of the Fund for the Feminist Majority, a major fundraiser for U.S. trials of RU-486, told the San Francisco Examiner, “More doctors will be willing to write a prescription… It’s easy to administer, and they don’t have to do an invasive procedure” (SF Examiner 8/3/94).  Carol Jouzaitis, reporter for the Chicago Tribune, wrote that the most ardent supporters of RU-486 envisioned it as a way to “make the procedure as accessible as the nearest doctor’s office” (Chicago Tribune, 10/2/94)

Despite initial expressions of interest, however, once government approval came, few doctors ordered and offered the pills when they found out what was involved.  Costs of the pills ($90 per pill for the recommended three pill dose of RU-486) were an issue, as were the three expected visits over a two week period.  Few wanted to be responsible for answering the phone should a woman call in the middle of the night with an emergency (“RU486: Not Selling,” NRL News, May 2001)

Some of these were addressed by the abortion industry’s pushing an alternative off label protocol that cut the number of office visits and reduced the number of RU-486 pills used (see Reason # 4 on Tuesday). 

A handful of doctors have indeed joined the ranks of abortionists since RU-486’s introduction.  The Guttmacher Institute says that while the number of abortionists dropped 2% (32)—from 1,819 in 2000 to 1,787 in 2005– their data indicate it would have dropped by 8% (about 145) if not for the doctors adding abortion to their practices.

Where growth seems to have taken off, though, was not so much at the offices of private practice Ob-Gyns, general practitioners, or pediatricians, but at smaller “family planning” clinics which previously were neither equipped nor staffed to offer surgical abortion.

Nearly half of the seventeen locations participating in the 1994-1995 U.S. trials of RU-486 were Planned Parenthood clinics.  Within a few years approval, in its 2003-2004 Annual Report, Planned Parenthood was noting that nearly two-thirds of its 123 U.S. affiliates had a center offering RU-486 abortions. PPFA also indicated that there were at least 49 of its clinics offering chemical abortions that had not previously offered abortions before. 

By 2010, more than a third of its clinics offered chemical abortions, including about 122 that offered only chemical and not surgical.

Planned Parenthood giant Midwest affiliate, Planned Parenthood of the Heartland, took the expansion to its horrible, but logical extreme, offering “web-cam” abortions at sixteen of its smaller, often rural Iowa affiliates. 

In webcam abortions, women teleconference with an abortionist back in Des Moines via the internet. He looks at the woman’s records and conducts an “interview.”  If satisfied, he clicks his mouse, triggering the release of a drawer at the woman’s location, in which the abortion drugs are found.  She is never actually physically examined by the doctor and simply calls a hotline – or maybe travels miles to the closest ER – if she has problems.

It is a situation fraught with risk, but others in the industry have expressed interest in trying something similar with their own affiliate networks.

So while the medical profession hasn’t welcomed chemical abortion with open arms, the new product has enabled the abortion industry to expand its reach into many new communities.

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