Episode 38 The Next Defense: History of Medication Abortion

When we think of abortions today, we often think about surgical abortions when in fact, medication abortions have been commonplace for millenia. With the decision made in Dobbs v. Jackson, medication abortions in the United States are now at risk as legislators come for this next line of defense against unwanted pregnancies. In this episode, we explore how medical abortions work, their history and the state of access to them now. Then we look into where we’re heading with laws in various states regarding medication abortion and what folx on the ground are doing to maintain their right to choose. Join us for this can’t miss episode!

Feminist Corner:

What, if any, experience do you have with abortion pills in the clinical space? Have you had any conversations about abortion and how did they go?
What is one question you have about abortion access that you want to know the answer to?

Listen to the episode, discuss these questions with friends and family, let us know what you think!

Show Notes:

Part 1: What is Medication Abortion?

Abortion overall is the termination of pregnancy, which can be done either through a surgical procedure or by taking medications.
Medication abortion involves taking 2 pills, mifepristone and misoprostol
Mifepristone blocks the progesterone basically inducing a period and pushing the uterus to expel its content. About 24-48h later, the patient will take misoprostol which helps empty the uterus through bleeding and muscle contraction.
They can be taken immediately after someone finds out they’re pregnant and then up to 10 weeks of gestational age.
Note: medication abortion is different from Plan B which is emergency contraception that prevents or delays release of the egg.

Part 2: The History of Medication Abortion

In colonial America, abortion wasn’t just legal but it was a safe, condoned and practiced procedure. Abortions were allowed up until mothers felt “the quickening” which is when the baby’s first kick was felt between about 14 to 26 weeks.
Early medication abortions were completed with herbal remedies called abortifacients like tansy, safflower, mugwort, wormwood, pennyroyal, etc.
The Ancient Egyptians and Greeks wrote down and documented such herbs, however it was trusted midwives and nurses who often passed down this knowledge by word of mouth.
Created in the 1980s, mifepristone was developed by a French drug company.
France legalized the medication regimen in 1988, then other countries.
But in the US, the FDA banned importation of the meds for personal use until finally in 2000 they became available in a pregnancy up to 7 weeks.

Part 3: Medication Abortion as it stands today.

Research by a team from UCSF, Middlebury college and the Guttmacher Institute estimate that the number of legal abortions in the US will fall by at least 13% after the Dobbs v. Jackson supreme court ruling.
A study from early 2022 by the Guttmacher Institute, found that an estimated 54% of people chose medication abortion as their preferred abortion method in 2020. This is up from the 39% in 2017.
Telehealth is an option in 19 states, so a person can call a provider or by phone or text them and receive the pills by mail if they live in a state where abortion is legal.
But there are options for people who do live in states where you can’t access pills online because cross-border care across state lines. And this means of accessing care will only increase–though anti-abortion legislators and activists are trying to figure out a way to prohibit this.
Women have been finding some loopholes including forwarding abortion pills across state lines, etc. but ultimately, the biggest issue of all are the legal risks. Because even thought abortion pills are safe and effective, taking them in a state with an abortion ban is a risk.

Sources:

Baraniuk, C. (2022, May 25). The Story of Abortion Pills and How They Work. WIRED. https://www.wired.com/story/abortion-pills-how-they-work/

Brief History of the Abortion Pill in the U.S. (2000, September 28). WebMD. https://www.webmd.com/women/news/20000928/brief-history-of-abortion-pill-in-us

Christensen, J. C. (2022, June 27). What is medication abortion, and who has access to it? CNN. https://edition.cnn.com/2022/05/03/health/medication-abortion-mifepristone-access-wellness/index.html

Collins, L. (2022, July 5). The Complicated Life of the Abortion Pill. The New Yorker. https://www.newyorker.com/science/annals-of-medicine/emile-baulieu-the-complicated-life-of-the-abortion-pill

Donley, G., Rebouché, R., & Cohen, D. S. (2022, June 24). Opinion | How to Make Abortion Pills More Available Post-Roe. The New York Times. https://www.nytimes.com/2022/06/23/opinion/abortion-pills-online-roe-v-wade.html

la Foret, D. R. (2017). Alchemy of Herbs: Transform Everyday Ingredients into Foods and Remedies That Heal (1st Edition). Hay House Inc.

Little, B. (2017, June 23). The Science Behind the “Abortion Pill.” Smithsonian Magazine. https://www.smithsonianmag.com/health-medicine/science-behind-abortion-pill-180963762/#:%7E:text=In%20the%201980s%2C%20French%20researchers,and%20Sweden%20soon%20followed%20suit.

Medication Abortion. (2022, August 3). Guttmacher Institute. https://www.guttmacher.org/state-policy/explore/medication-abortion#

Miller, C. C., & Sanger-Katz, M. (2022a, May 4). What an America Without Roe Would Look Like. The New York Times. https://www.nytimes.com/2021/12/05/upshot/abortion-without-roe-wade.html

Miller, C. C., & Sanger-Katz, M. (2022b, June 27). What Happens if Roe v. Wade Is Overturned? The New York Times. https://www.nytimes.com/2022/06/20/upshot/abortion-united-states-roe-wade.html

NPR Cookie Consent and Choices. (2022, May 13). National Public Radio. https://choice.npr.org/index.html?origin=https://www.npr.org/2022/05/13/1098000879/abortion-pills-medication-abortion-roe-v-wade

Parramore, L. (n.d.). Abortion Drugs Fundamental to Ancient Economies, Argues Historian. Institute for New Economic Thinking. https://www.ineteconomics.org/perspectives/blog/abortion-drugs-fundamental-to-ancient-economies-argues-historian

Ralph, L., Foster, D. G., Raifman, S., Biggs, M. A., Samari, G., Upadhyay, U., Gerdts, C., & Grossman, D. (2020). Prevalence of Self-Managed Abortion Among Women of Reproductive Age in the United States. JAMA Network Open, 3(12), e2029245. https://doi.org/10.1001/jamanetworkopen.2020.29245

Roubein, R., & Beard, M. (2022, July 7). Women are using creative and risky tactics to get abortion pills. Washington Post. https://www.washingtonpost.com/politics/2022/07/07/women-are-using-creative-risky-tactics-get-abortion-pills/

Scarlet Letters: Getting the History of Abortion and Contraception Right. (2022, June 27). Center for American Progress. https://www.americanprogress.org/article/scarlet-letters-getting-the-history-of-abortion-and-contraception-right/

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