By Randall K. O’Bannon, Ph.D., NRL Director of Education & Research
Editor’s note. In Part One, Dr. O’Bannon provided the background to the very unfortunate reality that Doctors Without Borders is involved with a new website giving women instructions on how to use abortion drugs. It is called howtouseabortionpill.org.
Doctors Without Borders (the acronym in French is MSF) says they have “teamed up” with HowToUseAbortionPill.org “to create a free, open-source, evidence based online course on medication abortion, or abortion with pills” by means of “five animated videos.” In prior posts, Dr. O’Bannon analyzed the first two videos here and here.
VIDEO #3 How to do Chemical Abortions
The third video, “Medication Abortion before 13 Weeks” is supposed to walk the “humanitarian aid worker” through the chemical abortion process. To state the obvious, this is also a “how to” for anyone who can get their hands on the abortion drugs.
It shares two “options” – one using the combination of mifepristone and misoprostol, the other using misoprostol alone. MSF grants that the combination of the two different types of pills is the most effective, but suggests that misoprostol used alone is as well.
Misoprostol, however, is “available in many places” because it has other medically justified non-abortion uses. By contrast mifepristone is primarily used as an abortifacient and thus is not available by prescription in countries where abortion is not legal.
Most of the third video is devoted to giving basic instructions on the dosage, the timing, and administration of the pills. MSF tells women what to expect after taking each of the pills and suggests what to do if the pills don’t work, albeit with all the customary assurances that the pills are usually “safe and effective.”
What should women expect? Bleeding that is “heavier than a menstrual period and often accompanied by blood clots,” with even more bleeding if their pregnancy is farther along.
Cramping, which they say may be “mild to very strong,” ensues after the misoprostol is taken and may continue for days. Women are told to take pain medication soon after the first dose of misoprostol; they are told “not to wait until the pain is unbearable before taking painkillers.”
(Note: These are not special cases, but what women are told they can expect in the common course of a chemical abortion.)
She can also look forward to fever, chills, dizziness, headache, nausea, vomiting, and diarrhea– “all common side effects of misoprostol.”
MSF tells workers that women who are farther along, say, at nine weeks gestation (the baby would be seven weeks old), “might see an embryo.” Their advice for women at this morally profound and psychologically sensitive moment? “Women can choose not to look at the pad, wrap it up, and dispose of it as they would during a menstrual period.”
MSF assures video viewers that, for most women, the abortion and side effects are over within 24 hours of taking the misoprostol. However it cautions that the entire process may not be complete for a couple of weeks.
MSF repeatedly tries to emphasize that these abortions are safe and that major complications are rare. But it does tell women who experience a fever for more than 24 hours or continue to have heavy bleeding or cramping for a week to see a “health care worker.” (The term “doctor” is avoided because abortion advocates want to be able to have nurses and lower level practitioners manage these cases.)
In cases of extreme bleeding, severe abdominal pain, unusual or bad smelling vaginal discharge, MSF suggest that a woman seek emergency care right away because they admit this complication may be life-threatening.
It is unclear what this is supposed to mean for women who received these pills from humanitarian workers who MSF envisions “helping” women in remote villages far from any trained doctor or functional medical facility.
In some cases, “women may require hospitalization, additional surgical intervention, blood transfusion, or other advanced care.” But of course, they add that, even then, she does not need to tell those treating her that she has had an abortion.
Rather than a “how to” video on chemical abortion, this sounds more like a recipe for a medical crisis.
Part Four will run on Monday, February 24.