Written by Toni K. Thayer for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.
The legal landscape for abortion is changing rapidly in Ohio, as it is in many states. Our governor recently signed into law a measure requiring as-yet-unspecified “viability testing” on women seeking abortions past 20 weeks. At least half a dozen other restrictive measures were recently passed or are on the horizon, including the “Heartbeat Bill,” which seeks to outlaw abortions as early as 6 weeks (before many women know they are pregnant). It’s unclear what this will all mean for clinics and for women. At my clinic, Preterm, the largest independent abortion provider in the state, women are calling us daily asking if abortion is still legal.
At the same time, Ohio clinics and our patients are now dealing with the effects of a restrictive law passed several years ago. Caught up in court challenges until last spring, this law dictates the way medication abortions—induced by a combination of mifepristone (mife), also known as RU-486, and misoprostol (miso)—must be performed in Ohio. It requires doctors to use an outdated FDA regimen, established during trials in the 1990s, instead of a lower-dose evidence-based regimen that has been used safely and effectively all over the U.S. for more than a decade.
Essentially, the FDA regimen
shortens the time a medication abortion can be used from 63 days to 48 (or from 9 weeks of pregnancy to just under 7), triples the amount of mife used (and at $90 a pill that adds up!), and increases the required number of clinic visits from three to four, so that a doctor can watch the patient swallow the miso at the clinic rather than allowing her to dissolve it inside her cheek at home.
Our First Case
The first medication abortion patient we saw at Preterm after the new regulations went into effect was exactly one day over the new legal limit for taking the combo of pills that is used to end an early pregnancy without surgical intervention. Denise had estimated that she was within the stipulated 48 days, but her ultrasound measured her at 49 days. “It took a lot of work for her to even get here,” explained Director of Counseling Samara Knox, “and she was really devastated when we told her she was too far.”
Denise had had a difficult time with her abortion decision. She was sure she could not keep the pregnancy, but she wrestled with the stigma, shame, and fear that so often surround abortion in our culture.