skip to main content
skip to newscasts

Tuesday, February 27, 2024

Public News Service Logo
facebook instagram linkedin reddit youtube twitter
view newscast page
play newscast audioPlay

ND makes the grade in a national report evaluating public school support; SCOTUS justices express free speech concerns about GOP-backed social media laws; NH "kids on campus" program boosts retention; proposed law bans hemp sales to Hoosiers younger than 21.

view newscast page
play newscast audioPlay

The Supreme Court hears arguments on whether social media can restrict content. Biden advisors point to anti-democracy speeches at CPAC, and the President heads to the US-Mexico border appealing to voters on immigration and border issues.

view newscast page
play newscast audioPlay

David meets Goliath in Idaho pesticide conflict, to win over Gen Z voters, candidates are encouraged to support renewable energy and rural America needs help from Congress to continue affordable internet programs.

TX Court Ruling with Nationwide Implications for Abortion Expected Soon

play audio
Play

Tuesday, February 21, 2023   

By Carrie Baker for Ms. Magazine.
Broadcast version by Roz Brown for Texas News Service reporting for the Ms. Magazine-Public News Service Collaboration


Over half of clinician-supervised abortions in the U.S. in 2020 were done with a combination of two medications: mifepristone and misoprostol. A Trump-appointed judge in Texas will soon decide a lawsuit brought by anti-abortion extremists asking him to force mifepristone off the market in all 50 states. If he does, as anticipated, reproductive rights advocates are ready to offer a safe and effective alternative to end pregnancy through three months: a higher dosage of misoprostol taken alone.


Misoprostol is a widely available ulcer medication that can induce a miscarriage by causing contractions of the uterus to expel a pregnancy. In the 1980s, Brazilian women began using misoprostol to end their pregnancies because abortion was unavailable through the medical system. Self-managed abortion with misoprostol resulted in precipitous declines in infection, hemorrhaging and death from unsafe abortion.


Today in countries where abortion is legally restricted, misoprostol is often used alone for self-managed abortion because it is inexpensive and widely available, often over the counter, unlike mifepristone.


Many studies from around the world have found that self-managed abortion with misoprostol alone is 93 to 99 percent effective and very safe. Because of the widespread availability of mifepristone in the United States, the use of the misoprostol alone for abortion had not been studied here, until recently.


On Feb. 6, researchers at the University of Texas at Austin published peer-reviewed research on the use of misoprostol alone for abortion. The research found that misoprostol alone was over 88 percent effective, with few incidents of serious adverse events or signs of potential abortion complications.


"This is the first U.S.-based study on misoprostol alone for self-managed abortion and it's coming at this critical time where we don't know what's going to happen with access to mifepristone," said the study's lead author, Dana M. Johnson, a Ph.D. candidate in public policy and demography at the University of Texas at Austin and a senior associate research scientist at Ibis Reproductive Health. "Our contribution with this study is to add to the broad evidence base we have from the international space on how safe and effective misoprostol is."


The research was based on data from the Vienna-based telemedicine abortion provider Aid Access, which provides telemedicine abortion services with pills in all 50 states in the U.S. Due to pandemic-related challenges shipping mifepristone, Aid Access prescribed misoprostol alone to over one thousand U.S.-based patients in June of 2020. Aid Access physicians either mailed misoprostol directly to patients or sent prescriptions to local pharmacies for pick-up.


"We took a very conservative approach by including just the people who had a totally confirmed, complete abortion at four weeks and didn't get a surgical intervention," said Johnson. "That is why our finding is 88 percent effectiveness, which is much lower than the SAFE Study from Ibis, which showed 98 percent effectiveness."


Published in November of 2021, the SAFE Study-which stands for Studying Accompaniment Feasibility and Effectiveness-showed that 98.8 percent of those who used the misoprostol-alone regimen had a complete abortion without surgical intervention. "SMA with misoprostol only is highly effective, and warrants renewed attention," it concludes, calling it "no longer a second-tier method, but one that offers similar effectiveness, and often greater accessibility, than the mifepristone and misoprostol regimen."


While this research shows misoprostol alone is a little less effective than the combination of mifepristone and misoprostol, extra doses of misoprostol can increase efficacy.


"We did take this conservative approach, but our findings were really, really good. There were very few people who had a serious adverse event. There were very few people who had any kind of treatment for that or a symptom of a potential complication," added Johnson.


Johnson is now conducting follow-up interviews with the research participants to understand their experiences of using misoprostol alone, which can be more difficult than the combination of mifepristone and misoprostol because the misoprostol-alone regimen calls for multiple doses of the medication, as opposed to one dose if combined with mifepristone. Those who use misoprostol alone may experience stronger cramping. Side effects from misoprostol can include nausea, fever, chills, vomiting and diarrhea, which can be more severe when taking misoprostol alone because of the higher dosage.


Johnson is finding in her research that women's experiences of using misoprostol are shaped by their mindset and how prepared they felt. Many found information on Reddit.com. The abortion Subreddit is curated by OARS (Online Abortion Resource Squad) with trained, expert volunteers who "ensure that every Reddit post asking for abortion-related help gets a quality, accurate, compassionate answer and referral to resources."


"People asked a lot of questions and that brought a sense of comfort because if you know that you can prep your hot water bottle or your ibuprofen or your chamomile tea, you're going into it with a little bit more of a mindset that you can manage this pain," said Johnson.


Research from other countries has shown that patients can have positive abortion experiences with misoprostol alone when they have access to the information they need, feel prepared for what they will experience and are supported through the process.


If the Texas court imposes a nationwide ban on mifepristone, women and pregnant people can still access the highly effective and medically safe method to end an early pregnancy with misoprostol alone. And unlike mifepristone, misoprostol is inexpensive and widely available by prescription for different indications in pharmacies throughout the U.S.


While the FDA has not labeled misoprostol for abortion, U.S.-based providers can prescribe the medication off label for this use to patients in states where abortion remains legal. Many telemedicine abortion providers have already pledged to offer misoprostol off label to their patients if mifepristone is removed from the market, including Abortion on Demand, Aid Access, carafem, Choix, Forward Midwifery, Hey Jane and Just the Pill. Planned Parenthood has also said they will offer this service.


National Abortion Federation's clinical practice guidelines suggest offering misoprostol alone where mifepristone combination is not accessible. The World Health Organization also has guidelines for misoprostol alone as a safe and effective options for abortion care. According to these guidelines, women in the first 12 weeks of pregnancy dissolve four 200 mg of misoprostol between their gum and cheek, three times at three-hour intervals.


"With clinical options for abortion severely limited post-Dobbs, these guidelines are important in affirming self-managed abortion as a safe and essential practice that can be empowering for those seeking to end a pregnancy," concluded the U.T. Austin study authors. "There is potential for its use in the U.S. as a method of ensuring reproductive autonomy, especially for populations who have been systematically cut off from safe, affordable and non-coercive reproductive healthcare services."



Carrie Baker wrote this article for Ms. Magazine.

Disclosure: Ms. Magazine contributes to our fund for reporting. If you would like to help support news in the public interest, click here.


get more stories like this via email
more stories
A new report shows that people who complete Prop 47-funded programs like those offered at Safe Harbor Recovery Center in Los Angeles are much less likely to be reincarcerated. (Safe Harbor)

Social Issues

play sound

Programs intended to reduce the chances that someone will end up back behind bars are working, according to a new analysis of California state data…


Social Issues

play sound

Arizona is gearing up for its presidential preference election that takes place in less than a month, and registered Democrats and Republicans were …

play sound

You might say "every day is 'bring your child to college day'" at New Hampshire's Manchester Community College. On-campus childcare programs are …


Social Issues

play sound

The number of Black mothers in Ohio who die during or following pregnancy continues to climb and health advocates said they hope to shine a light on t…

Legislative supporters say had South Dakota taken part in a new federally funded summer meal program for low-income families, an estimated 54,000 children around the state would have benefited. (Adobe Stock)

Social Issues

play sound

It's been an uphill battle for childhood nutrition advocates to advance meal access policies in the South Dakota Legislature. However, organizers say …

Environment

play sound

A cooperative effort has seeded more than 26,000 acres in eastern Nevada. It's all in an effort to increase desirable grasses, forbs and shrubs while …

Social Issues

play sound

Texas postal customers, especially in rural areas, are experiencing delays in mail delivery, and some letter carriers feel it could get worse…

 

Phone: 303.448.9105 Toll Free: 888.891.9416 Fax: 208.247.1830 Your trusted member- and audience-supported news source since 1996 Copyright 2021