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RU-486 Abortions at Home in Countries Where Abortion Is Illegal



Susan E. Wills - published on 08/31/14

Dumb plan or dumbest plan?

Sunday’s New York Times Magazine section has a seven-thousand-five-hundred-word paean to Rebecca Gomperts, a Dutch doctor who has dedicated the past 15 years of her life to promoting and facilitating illegal RU-486 abortions wherever in the world abortion remains illegal or restricted.

Entitled “The Post-Clinic Abortion” (and online, the more modest “The Dawn of the Post-Clinic Abortion”), Emily Bazelon begins by chronicling Dr. Gomperts’ media-splashy but highly ineffectual early efforts with Women on Waves and its floating mobile abortion clinic.

Each step in the saga of Women on Waves confirms the truth of Aleksandr Solzhenitsyn’s observation:

“ … violence does not live alone and is not capable of living alone: it is necessarily interwoven with falsehood. Between them lies the most intimate, the deepest of natural bonds. Violence finds its only refuge in falsehood.  … violence … cannot continue to exist without descending into a fog of lies, clothing them in sweet talk. … it demands from its subjects only an oath of allegiance to falsehood, only complicity in falsehood.”

To deliver on her promise of providing pills that kill and violently expel unborn children to women living in Ireland, Poland, Portugal, Spain and Morocco, Dr. Gomperts had to resort to multiple falsehoods. She had to build a mobile abortion clinic for the rented tugboat to comply with Dutch abortion law. To fund the building of the mobile clinic, she talked an artist friend into applying for a grant from the Dutch arts council for “a functional work of art” consisting of his design and construction of the mobile clinic. But having a container on the deck of the tugboat ran afoul of transport regulations, and they succeeded only by passing it off to authorities as a “functional work of art” named “A-portable.”

Gomperts also needed a license to perform abortions after 6.5 weeks’ pregnancy. She’d applied for one but had not received it when the time came for her widely publicized voyage to Dublin. She stated that some 200 Irish women were eager to board the tugboat, travel 12 miles offshore into international waters, take the pills and be delivered back to Dublin to wait for a “miscarriage.”

On arrival at a Dublin dock, Women on Waves was met by the press as well as protesters and, I suppose “eager women,” but there would be no abortion trips that day. Dutch authorities had notified the press that Gomperts did not have a license to provide abortions after 6.5 weeks and she was forced to backtrack, explaining that she wouldn’t be able to give out any abortion pills, but that this “is just the first of many trips we plan to make.” The London Telegraph reported on the fiasco with this headline: “Abortion Boat Admits Dublin Voyage was a Publicity Sham.” Another headline read: “Dutch activists renege on abortions promise.” The tugboat never returned to Ireland.

Two more years passed before Dr. Gomperts set sail for Poland. The 2-week voyage earned massive press coverage and may have resulted in exactly 10 RU-486 abortions (in international waters).

Authorities in Portugal and Morocco were able to prevent the tugboat from entering port. The voyage to Spain may have resulted in 7 or more abortions.

While there was little to show for the massive amounts of money thrown into these publicity ventures, Dr. Gomperts describes the whole Women on Waves campaign as a great success, crediting it with igniting movements for legal abortion in Portugal, Spain and Poland. An enduring legacy of sorts.

In 2006, Dr. Gomperts abandoned abortion advocacy by tugboat, giving up Women on Waves in favor of Women on Web, “a ‘telemedicine support service’ for women around the world who are seeking medical abortions.” The service provides women with instructions on where to make an online purchase of the RU-486 and misoprostol drug combination, and how to use it. They “screen” (via a short questionnaire) for ectopic pregnancy, gestational age (guesswork), and other possible contraindications. They tell women to seek medical attention if they believe something has gone wrong, because they (obviously) can’t judge from a distance if, for example, hemorrhaging is potentially fatal or if the woman may die of sepsis.

The biggest lies used by Women on Web to support the violent killing and expulsion of unborn children are in the area of safety and effectiveness. The FDA approved the two-drug RU-486/misoprostol combination for use only in the first 7 weeks of pregnancy because the effectiveness drops and the risks increase with every additional week thereafter. Some abortion providers in the U.S. offer RU-486/misoprostol off-label up to 10 weeks’ gestational age. Women on Web establishes a cut-off date (which, of course, they are unable to monitor) up to 12 weeks’ gestation. And that’s not the only questionable recommendation. Women on Web advises women to take both drugs by letting them dissolve under the tongue or between the cheek and gum rather than vaginally, so that no fragments of the pills could be found when the woman seeks medical attention for a “miscarriage.” This may reduce the risk of infection from insertion, but it also reduces effectiveness, increasing the likelihood of incomplete expulsion of baby and placenta. And that can lead to very grave, even fatal, infection.

Studies continue to show that RU-486 abortions pose serious risks. A 2009 Finnish study (“Immediate complications after medical compared with surgical termination of pregnancy” by M. Niinimäki et al.) compared the outcomes of over 45,000 women who had either RU-486 or surgical abortions between 2000 and 2006. Adverse events occurred among 20% of women who were given RU-486, a rate almost 4 times higher than those who had surgical abortions. Hemorrhage occurred among 15.6 % of women who took RU-486 vs. 2.1% of those having a surgical abortion. Incomplete abortion (which can result in fatal infection) was also four times higher in the RU-486 group: 6.7% vs. 1.6%. These figures must be understood in the context of the strict guidelines and excellent medical care available in Finland. RU-486 abortions "at home" are permitted under medical supervision only up to 9 weeks’ gestation. Between 9 and 12 weeks gestation, anyone given RU-486 is required to stay in the hospital to be monitored for serious side effects for three days. But Dr. Gomperts thinks it’s sound medical practice for women at 12 weeks (and later because she cannot control the usage) in developing countries and others where abortion is illegal, to abort alone at home with no medical supervision, trusting that someone can get her to an ER before she bleeds to death or succumbs to sepsis. 

A 2011 study in China (“Medical versus Surgical Abortion Methods for Pregnancy in China: A Cost-Minimization Analysis”) by Wei Xia et al. found that RU-486 abortion ended up being more costly than surgical abortion due to various complications, such as persistent bleeding and failure to abort, that required surgical intervention.

Here’s something else that Dr. Gomperts is not telling the women she’s helping to undergo an RU-486 abortion.


Melinda Tankard Reist, writing in The Age (Australia) quotes the experiences of several women:

" ‘Rose,’ 27, from South Australia, wrote, ‘’It was three days of nausea, high temperature, sweating, cramping, lots of blood, distress and swirling emotions. I would never ever go through that again.’’ Rose bled for another three weeks.

“An unnamed 25-year-old American woman described her experience after taking RU486 at six weeks. ‘I was in excruciating physical pain for at least 12 hours straight and I was bleeding through my pants, but I was in so much pain I couldn’t even clean myself,” she says. ”I vomited continuously … I couldn’t speak, eat, drink, sit up, and had difficulty breathing … I thought I was going to die …’ “

At least 14 women in the U.S. did, in fact, die from RU-486 abortions and many more have done so in other countries. An ER doctor named Mark Louviere in Waterloo, IA wrote of his experience with RU-486: Two weeks after her RU-486 abortion, ”a woman arrived at the ER ‘in obvious shock’ having ‘lost between one-half to two-thirds of her blood volume. … It was my clinical opinion that she would die soon. … Without even doing the routine preparation we normally do for surgery, I realized that I had to take her immediately to surgery to save her life.’ “

In a World Health Organization (WHO) study, 30% of women who had incomplete RU-486 abortions developed pelvic/genital tract infections because one effect of the drug combination is to suppress immune system response. In fact, the WHO study calls for women to receive antibiotics for six weeks following an RU-486 abortion. ("Pregnancy Termination with Mifepristone and Gemeprost: A Multicenter Comparison Between Repeated Doses and a Single Dose of Mifepristone," Fertility and Sterility, 56:1, 1990, at 40.) 

An audit of 7,000 RU-486 abortions performed in South Australia in 2009 revealed that 5.7% of women had to be admitted to the hospital for complications.

In light of the risks associated with RU-486 abortions even when they occur in countries with advanced healthcare systems and where abortion is legal, it is detrimental to women’s health to facilitate the use of RU-486 in countries where abortion is illegal, where access to emergency care may be limited at best. And reading some of the painful stories of women “served” by Women on Web which they’ve posted on their site (including one’s photo of her dead child) makes one wonder why they stay in business.

Susan E. Wills
is Spirituality Editor of Aleteia’s English-language edition.
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