Epilogue: Doctors Without (Moral) Boundaries

The End Result of a Long Campaign to Push Chemical Abortion 

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

Editor’s note. Last week Dr. O’Bannon authored a five-part analysis of the five videos mentioned in his opening paragraph—here, here, here, here, and here.

Whether knowingly or not, it is clear that whatever noble or charitable impulses Médecins Sans Frontières (MSF), known as Doctors without Borders in English, may have had, they have been compromised by a concentrated campaign by abortion advocates to create the illusion of a worldwide need and demand for Do-It-Yourself (DIY) chemical abortions. Sadly, MSF’s joining the campaign with their latest 5-part video series is a sign that campaign is working.

MSF did not originate this DIY abortion campaign.  However, their new video training series is the culmination of decades of deadly research, lobbying government agencies, media manipulation, and political pressure by abortion pill activists.

Here’s how it all started.

Decades ago, abortion advocates recognized a problem: there simply weren’t enough trained abortionists. Not only was there a shortage, these abortionists weren’t distributed widely enough to cover every area of the world.  

Vast areas of the U.S. were what pro-abortionists dubbed “abortion deserts”—areas with no identified “abortion provider.”  And there were whole countries, particularly in the developing world, that had no abortionists at all (or at least none performing abortions legally).

Development of a drug or pill in place of surgical abortions was supposed to remedy that. Not merely offering a novel way of aborting, they theorized, chemical abortion would enable abortion advocates to take abortion to people and places where there were no traditional abortion clinics or surgical facilities. 

And, most important, this would allow them a way to contravene and undermine the laws of any state or country that tried to protect unborn life.

It was, like the chemical abortion process they championed, a campaign that would involve many steps.

At first, it meant doing studies, selling the public on the fantasy of “safe,” “simple,” “easy abortion.” They quickly moved on to securing the drug’s approval somewhere. That began with France and China in the late 1980s, Britain and Sweden in the early 1990s, and eventually America in September of 2000. Most of the rest of the modern world soon followed.

Abortion pill advocates originally worked with abortionists already doing surgical abortions to learn and add the chemical method to their clinical practices.  Then, touting their supposed safety record (ignoring several deaths and many injuries), they sought to expand the pool of prescribers to include pediatricians, general practitioners, and other Ob-Gyns not currently performing abortions.

That was just the beginning. Initially, they accepted modest limitations, including how far into pregnancy it could be used, how it could be distributed (directly to certified doctors rather than through pharmacies), and who (those same doctors) could prescribe it and supervise its use. 

Soon, however, they produced studies arguing that these could be managed by nurses and certified nurse midwives, and physician assistants.  Their complication rates were actually worse than for women who went to medical doctors for their abortions, but that didn’t matter to abortion pill advocates.

Then came the webcam or telemedical version, where a woman didn’t actually go to the abortion facility, but merely to a storefront clinic. There she talked to an abortionist over a computer video connection.  If satisfied with her answers (and it wouldn’t take much, one ventures to guess), he clicked a button releasing a drawer with the drugs for the woman to take– the mifepristone there at the clinic, the misoprostol later at home.

The only medically trained person the woman may have actually seen in person in this set up might have been a certified medical assistant with a couple of semesters training from a community college. He may have taken her blood pressure and checked her temperature.

It was only a short step from there to the suggestion than these pills could be ordered over the internet after a short “consultation.” And so, in short order, large studies were produced covering several states where women could contact doctors and order their pills online and then receive their pills in the mail in a couple of days.

All this went far beyond what the FDA had originally authorized when it first approved mifepristone in September of 2000.  At that time, the pills were supposed to be given directly to the woman, under a physician’s supervision, limited to those no more than 49 days pregnant. 

There were to be three visits: the first to take three pills of  mifepristone; the second to administer two pills of the misoprostol; and the third to do a follow up to confirm the abortion. Distribution of the pills was handled directly from the supplier to the doctor, bypassing pharmacy and consumers. 

From the very beginning, abortion advocates fiercely resisted each element of the FDA protocol. They wanted to reduce doses of the expensive mifepristone, cut the number of visits, allow women to take the misoprostol at home, extend the gestational cutoff, and allow lower level clinicians to prescribe and administer the pills. 

In March of 2016, under the Obama administration, the FDA gave in to these demands, but advocates were still unhappy. They wanted to end the controlled distribution of the drug so that they could eliminate office visits entirely and sell the drugs directly to women over the internet.

They floated stories, dutifully reported by the press, of women picking up abortion drugs from the black market or using herbal concoctions to self abort. This simultaneously promoted the idea of “do-it-yourself” abortions and thumbed their noses at government efforts to limit chemical abortions. 

Rogue websites sprung up giving women instructions on how to obtain and use abortion drugs. Many followed the lead of “abortion ship” pioneer Rebecca Gomperts, who made it her personal mission to import abortion pills into countries where abortion was illegal and to promote DIY abortion in areas where abortion was legal but abortionists were few.

Academic abortion activists and researchers conducted and published studies at each point along the way. As we reported, they claimed, often with highly questionable data, that each modification of the protocol to loosen control and broaden access to the pills was fully safe and effective. That all this happened while nearly two dozen women were dying and thousands more were suffering complications (many of them very serious) mattered not to these people.

Rather than using that data to counsel caution, they’ve doubled down, now suggesting that these could be used much later in pregnancy, even in the second or third trimester. 

The data that abortion pill advocates have cranked out — on women’s self-abortion attempts, safety estimates of webcam and mail order abortions (based on the reports of only those women willing to admit to having chemical abortions), high numbers of abortions and abortion related maternal mortality in countries where there were no hard official statistics, etc. — all joined together to make the case that Doctors without Borders now makes in these videos. 

And that is that (1) women supposedly are desperate for abortion; (2)  chemical abortion offers them a way to safely and easily abort their babies; (3) these are abortions that amateurs (or even the women themselves) can handle with just minimal instruction, the sort of thing one can pick up in a short video just a couple of minutes long.

This string of falsehoods, particularly the lie about the alleged safety of chemical abortions  means two things to those who know the truth. In lieu of the life-saving prenatal care that desperate women really need, more babies are dying and more women’s lives are being put at risk.

That’s not humanitarian. That’s not even humane.