Proponents weigh in on how to guide those who get abortion pills: Shots

Julie Edwards, a patient advocacy program manager at Planned Parenthood of Tennessee and North Mississippi, had had an abortion herself as a teenager and said they will be more common and can be safe.

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Julie Edwards, a patient advocacy program manager at Planned Parenthood of Tennessee and North Mississippi, had had an abortion herself as a teenager and said they will be more common and can be safe.

Rachel Lacovone/WPLN

At a meeting in Nashville, Planned Parenthood organizer Julie Edwards looked at some depictions of “abortion in an alleyway” on placards, including bloodied hangers. But, Edwards told the crowd, driven onto the streets by the U.S. Supreme Court’s decision on abortion rights, it’s not like it used to be. Roe v. Wade

Nearly ten years ago, Edwards was a teenager, receiving medication from some older friends. Edwards said this could be the new norm in states that ban abortion, such as Tennessee.

“I’m standing in front of you, I’ve had an abortion myself and have been given abortion pills from people in my community. And I’m safe,” Edwards said, cheering. “We all need to keep each other’s secrets, hold hands, keep each other safe.”

Medications are now available for first-trimester abortions. And it has become the main way abortion is induced.

The regimen includes two prescription drugs that have since entered the market: roe was decided in 1973. Mifepristone is taken first. It is the abortion drug which is quite expensive and highly regulated. A day or two later, the patient takes misoprostol, which is much more widely available and can work on its own to induce abortion. The drug was developed in the 1970s to treat ulcers, but has several other off-label uses in addition to abortions, such as relieving arthritis. It’s even prescribed for animals, so veterinary stores have the medication. Misoprostol is even sold without a prescription in Mexico.

“It’s really based on what someone can get. And in the self-administered context, the only way to get mifepristone plus misoprostol is over the internet, so it takes a while to wait for the delivery,” said Susan Yanow, spokesperson for Women Help Women , a nonprofit organization on four continents working to increase access to abortion.

The international organization ships both drugs around the world, but not to the US because the laws vary so much from state to state. Social media sites like Facebook and Instagram have already started removing posts offering to send these drugs by mail. Many states that now prohibit abortion have recently tightened their laws on mail-order abortion drugs.

“We still have the right to share information,” Yanow said. “People are using the Internet. People are using their phones. People will find ways to get these pills.”

Using Abortion Pills Safely

But it’s more than just finding the drugs, which is why Yanow’s organization has a detailed guide on how to use them safely. And she, like others, trains local reproductive rights groups.

Lynsey Bourke of Self-Guided Abortion, based in Montana, began producing video tutorials late last year and posting them to YouTube explaining how to use misoprostol on its own and offering ways to make the process more sacred by making an altar. building, burning incense and lighting candles. † She even gives yoga instructions after the abortion.

Multiple rounds are needed with misoprostol alone. Nausea is common. And the drug causes cramping and bleeding that can be alarming to those unprepared.

Even some OB-GYNs are quietly in favor of self-managed abortion.

“I’m more concerned about people who can’t get to one of these sources and are so desperate that they take matters into their own hands,” says Dr. Nikki Zite, an OB-GYN at the University of Tennessee Medical Center in Knoxville.

She said clinical counseling before taking the pill combination is ideal. For example, some patients are anemic and may bleed enough to require emergency care. And some just don’t do well with pain and a lot of blood.

“Not every patient is a good candidate to miscarry at home,” she said.

But right now Zite can’t afford to give that advice. In Tennessee, she would face a felony and jail time under a six-week ban now in effect and a blanket abortion ban that goes into effect in August. And it’s unclear how far the police want to reach.

References to coat hangers have been used to protest the decision to drop Roe v. Wade† Abortion rights activists say “self-managed abortions” are much safer today because of drugs — but women still need counseling.

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References to coat hangers have been used to protest the decision to drop Roe v. Wade† Abortion rights activists say “self-managed abortions” are much safer today because of drugs — but women still need counseling.

Caroline Eggers/WPLN

Tennessee laws specifically exempt the pregnant person from prosecution. But a motivated prosecutor could find ways to press charges related to a self-imposed abortion, said Nashville criminal defense attorney David Raybin.

“I mean, that’s fraught with danger,” Raybin said. “I would strongly advise against a woman using such underground methods without quotes to get such drugs.”

He said it’s best to get a legal abortion in another state. But abortion rights activists in Tennessee say they know travel will be difficult for many. And even for those who can, a self-managed abortion may be more convenient. To some extent, reproductive rights groups are willing to help navigate the legal gray area.

Assessing the risk

Healthy and Free Tennessee, an organization committed to sexual health and reproductive freedom, has been organizing several training sessions through Women Help Women in recent weeks. Policy Director Nina Gurak said their biggest concern isn’t the health complications — it’s the legal risk.

“We recommend that if someone performs an abortion themselves, they have a supporter or friend. That supporter or friend may be at higher legal risk than the person arranging an abortion,” she said. “And then you have to decide for yourself – is that something I’m comfortable with? Is that something I’m not comfortable with?”

Organizations in states with an abortion ban have their own risk assessment. They are confident that the First Amendment protects the sharing of medical information approved by the World Health Organization.

But abortion rights advocates are torn between raising awareness and being targeted by anti-abortion lawmakers — who are no longer constrained by Roe v. Wade

“We are certainly concerned about the increasing criminalization of abortion or self-administered abortion and abortion pills,” Gurak said. “We also want to balance that with the need for communities to have the information they need to make their own decisions.”