Louisiana laws will lead to life-threatening self-managed abortions


Courtesy of Isabelle Lian

Isabelle Lian, an intern at NCI and Planned Parenthood Gulf Coast, poses in front of a reproductive health research poster.

Isabelle Lian, Contributing Writer

Isabelle is a Newcomb College Institute Reproductive Rights & Reproductive Health intern and a Planned Parenthood Gulf Coast intern.

As abortion restrictions sweep across Louisiana, many are growing fearful that those seeking an abortion may now take matters into their own hands. These restrictions greatly decrease accessibility to medically safe abortions, putting individuals at risk of disability and death when making a choice about their own bodily autonomy. 

With the passage of a series of abortion bans in Louisiana this summer, care options are scarce for reproductive health organizations like Planned Parenthood Gulf Coast, which provided for 13,185 patients statewide from 2017-18 in family planning. In particular, the passage of the “heartbeat bill” this summer prohibits abortions once a “fetal heartbeat” is detected, which often is as early as six weeks into pregnancy.

The Louisiana House of Representatives has also passed an amendment stating that no provision in the constitution can be used to protect the right to abortion or require the funding of abortion. Several more passages add further limitations to the mix, making it more difficult for physicians to transparently provide care for current and potential patients. 

These restrictions will make self-managed abortion more common. Self-managed abortion is defined as an individual managing their own abortion without the guidance of a licensed medical professional. One is more likely to choose self-managed abortion should clinical care be unavailable, inaccessible or undesirable — all aspects that are shaped by multiple socioeconomic, cultural and political factors.

When abortions were illegal in the 1950s, self-managed abortions were estimated at 200,000 to 1.2 million per year. These abortions were often carried out in back alleys where the individual often endured danger and abuse.

Other at-home treatments included ingesting malaria medicines, smearing potassium permanganate in the vagina and inserting foreign objects such as coat hangers. These caused chemical burns, shock and infection, and remain some of the lasting scars of a time before Roe v. Wade. 

Today, the use of medication abortions is becoming increasingly common. While it has a higher success rate, many side effects — some of which are fatal — occur. In clinics, mifepristone and misoprostol are used together to manage abortions and have earned the moniker the “abortion pill.” Mifepristone blocks progesterone, the hormone required to preserve the uterine lining, while misoprostol aids in shedding to end the pregnancy. It is effective 96% of the time

Yet, for self-managed abortions mifepristone is much more heavily regulated and often times only misoprostol is accessible, with a lower success rate of 85%. Misoprostol itself is typically prescribed for stomach ulcers and miscarriages

Despite its status as an essential medicine by the World Health Organization, misoprostol is illegal to use without a prescription in the United States. It is still considered an over-the-counter drug in Mexico, however, under the name of Cyrux. Its $30 price tag makes it a much more affordable option than the abortion pill, which can fall around $500

Information about this drug is circulated throughout the internet. The WHO provides a general protocol to follow on its website, for pregnancies up to 12 weeks. 

Those with later-term pregnancies use forums as medical information to estimate proper dosages. These dosages depend on the stage of pregnancy, which often can be difficult information to obtain without medical guidance.

It is in these cases when exact details are scarce that misoprostol can be extremely harmful. The side effects include abdominal aches, intense pain, excessive bleeding and tearing of the uterus, with symptoms lasting longer the further along the pregnancy is. In cases of complications, it may be necessary to see a physician. 

Since these symptoms mirror miscarriage symptoms and there are no tests that can detect misoprostol in the system, it is in the best legal interest of the patient to withhold this information from the doctor. 

At least 20 arrests of women who have ended their pregnancies without clinical supervision have occurred. Now, many of the recent bills are taking a step further by criminalizing medical practitioners who assist women in clinical abortions, creating fear for all involved. 

Self-managed abortions are often a last-ditch effort or the only affordable option for many individuals. Their symptoms are painful and long-lasting, without a guarantee of success. 

Yet, with aggressive and harmful legislation closing in on reproductive health options and threatening medical practitioners in Louisiana, this will ultimately begin to limit the availability of clinical abortions and force individuals to make more risky choices. 

A version of this article originally appeared in Newcomb College Institute’s newsletter, ReproNews.

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