Friday, March 29, 2024

RU-486 does not solve difficulty of abortion process

Last week, the Food and Drug Administration issued final approval for a drug called mifeprestone. The drug is known in France as RU-486 and is an abortifacient - a substance that causes the termination of a pregnancy.

By now, enough has been written about the drug to fill 100 opinion pages, and most of it has been angry and emotional. I can add nothing to the national debate that hasn’t already been said, but I can try to clear up some of the distortion about the drug and make clear what its approval might mean to Michigan and the MSU community. For the sake of clarity, I should mention that I do support the right of a woman to have an abortion. I will try my best to present the bare facts of the pill, but it is only right that I admit my bias.

In the course of a woman’s menstrual cycle, her uterus prepares itself for pregnancy. It grows a lining that will allow a fetus to implant securely and that will nurture the fetus once it has implanted. If the woman does not become pregnant, there is no fetus to supply, and the lining breaks down and is shed. When there is a fertilization, the fetus tells the body that it is pregnant through a hormone called progesterone. Progesterone makes sure that menstruation does not occur and keeps the uterine lining healthy so that the fetus can grow there.

Mifeprestone blocks the signaling hormone; it is technically called a progesterone-receptor antagonist. If the body does not receive progesterone’s message, it cannot preserve the uterine lining. Instead, it behaves as in a normal menstruation, and the lining is shed. Without the lining, or endometrium, the fetus cannot attach and grow. If the fetus has already implanted, it is shed along with the lining. In either case, the pregnancy is terminated.

Mifeprestone alone cannot complete the abortion procedure. It takes between two and three days to take effect, and even when it does take effect the abortion is not complete. While the drug may allow the detachment of the uterine lining and fetus, they are not expelled from the body. This is why a woman cannot get a prescription for mifeprestone, and this is why the pill is not a “quick and easy” abortion as some have claimed. The drug is administered in a physician’s office, and two days later the patient must return in order to take a second drug, misoprostol.

Misoprostol is a drug that causes the uterus to contract, as it does during childbirth. In fact, misoprostol is sometimes used to aid in difficult births. The contractions force the contents of the uterus - the lining and the fetus - out, and the abortion is complete. This also must be done in a doctor’s office. There is a third visit a few days later, when the woman’s health and reaction to the drugs can be judged.

Although there has been a lot of speculation that mifeprestone is an instant abortion that causes no discomfort or pain, that portrayal is simply not true. As described above, the abortion takes several days and visits to the doctor, and while the pain involved is not as intense as during a traditional invasive abortion, it is more prolonged. In France, where the drug has been legal for 15 years, only a third of all women seeking abortion carry it out by using it.

The safety of the drug is unquestioned. There is no evidence that it causes any kind of cancer or that it is more dangerous to the woman than either an invasive abortion or childbirth itself.

The social effects of mifeprestone are undoubtedly going to be widespread. While, as I have said, the drug does not provide for an easier or quicker abortion, it does allow more physicians to perform abortions. Invasive abortion must be taught, and fewer and fewer medical schools are willing to teach the procedure for reasons of safety and controversy. Mifeprestone can be administered by any physician, and its possible side effects can be dealt with by any doctor. With the approval of the drug, abortions are going to become more widely available. Currently, 86 percent of counties in the United States do not have a physician trained in abortion. Of all physicians, 54 percent have said they would be likely to administer the drug, and of those gynecologists who do not provide abortions, 45 percent have said they would be willing to do so. Mifeprestone will make safe abortions obtainable to millions of women who otherwise could not get them.

For the students of MSU, however, it will be disastrous. While both sides of the abortion debate distort the facts of mifeprestone in order to suit their arguments, nobody will do so more than the students of MSU, who will see the drug as one more reason that unprotected sex is acceptable.

There is an unspoken belief among students here - and people in general - that a sexually transmitted disease can be diagnosed inside a bar. It’s amazing; medicine uses microscopes, nutrient plates and Gram stains in order to determine infection, but a drunk Spartan can do it using nothing more than a couple of shots of Jagermeister. Using this brilliant scientific method, a girl is judged to be completely free of disease if she has clear skin, shiny hair and a good figure. A guy, on the other hand, is healthy if he’s clean-cut, has apples in his cheeks and a nice sweater on. There is a general idea of the look of an STD, and it includes pale, sagging skin, a sloppy and unfashionable appearance and possibly some open sores all over the face. As long as your partner is dressed nicely and looks clean, the belief is that you’re safe if you don’t bother to wear a condom.

The truth has an annoying tendency not to obey belief - disease can wear Abercrombie & Fitch and it knows how to gel its hair. That’s probably how it’s able to blend in at MSU, despite being present in ridiculously high numbers.

Last year, in Ingham County, there were 851 cases of chlamydia and 445 of gonorrhea. Both can be treated with antibiotics if detected, which is why they’re generally regarded as an inconvenience and the condom is left unused. Unfortunately, they’re usually not noticed, so the number of cases is representative of at least 1,000 people. In men, they may eventually cause prostatitis, which makes sitting on a bar stool a lot less fun. Most of those affected are women - and most of them won’t know they’ve been infected until they discover that they can’t ever have children because their fallopian tubes are twisted ropes of scars.

Unpleasant? Absolutely. Kind of gross? Definitely. Completely preventable? Yes. But antibiotics, miracles that they are, have reduced the threat of infection until it’s just not worth it to roll on the condom. And mifeprestone, despite being far from an easy solution, is going to lend itself to the same kind of idiotic reasoning. It’s going to be used as an excuse not to take a moment and let common sense have its say, and hundreds of MSU women are going to find out exactly how difficult the new abortion procedure is.

Rishi Kundi, State News graduate columnist, can be reached at kundiris@msu.edu.

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