The choice to have an abortion is never an easy one. Unfortunately, many college women fall into the age group that has the highest abortion rate. A recent survey shows that women aged 20-24 have the highest percentage of abortions in America. While many know about surgical abortions, their knowledge of medical abortions may be scant.
Medical abortions are produced by a medication commonly known as RU486, or Mifepristone. The process of having a medical abortion begins with counseling, a physical exam, and a determination of the length of the pregnancy. At the first visit, an initial dose of mifepristone is taken orally. This drug inhibits endometrial development, and effectively prevents implantation of the embryo. Two days later, a prostaglandin called misoprostol is given. This drug causes the uterus to contract and expel the lining, and with it, the embryo. A third visit to the doctor verifies that the abortion is complete. In the event that it is not complete, a traditional surgical abortion is strongly recommended.
RU-486 was approved for abortion in the U.S. by the FDA, in September 2000. It is legal and available in all 50 states, Washington D.C., Guam, and Puerto Rico. Medical abortions as a percentage of all abortions in the U.S. have increased each year since approval.
RU-486 can only be used for very early abortions. After the 7th week of pregnancy, effectiveness drops below a level the FDA considers safe. 92% of women taking RU-486 will have a complete abortion. The other 8% will need a surgical procedure to end the pregnancy or to stop excessive bleeding. The side effects of a medical abortion include heavy bleeding, cramping, and nausea. Most of the time bleeding is not excessive, but it can last up to 30 days. Most side effects are not debilitating.
A woman who chooses to have a medical abortion using RU-486 must make three separate visits to the doctor’s office over a two-week period. Because the abortion pill is a multi-step process, some say that it can be more physically straining than a surgical abortion. In addition, doctors are quick to emphasize that RU-486 does not diminish the emotional pain that is often associated with the abortion process. Some say that the abortion pill can have a greater emotional impact than surgical abortion because it takes place over a period of two weeks, and the patient is awake and aware the entire time. Medical abortion may be more emotionally wrenching than a surgical abortion because the experience is similar to a miscarriage. Medical abortions may also be cost prohibitive for some women. The cost is usually about double that of a surgical abortion.
Women who choose to have a medical abortion do it for a variety of reasons. It is a less invasive procedure than surgery and involves no anesthesia. It is more private and can occur at home with a loved one near. Some women perceived medical abortion to be more like a natural miscarriage.
Advocates also hope that making abortion private will make it more difficult for anti-abortion protesters to target abortion providers. Anti-abortion protesters often target abortion clinics in hopes of convincing women not to abort. Some protesters try to deliver their message through harassment and intimidation of doctors and patients. Fewer doctors are willing to risk their lives to perform surgical abortions and many clinics have been forced to close. RU-486 would allow obstetrician-gynecologists the ability to provide abortions without being targeted because women seeking abortions will appear to be just like any other patient.
There are no abortion providers in 86% of counties in the United States. One in four women has to travel at least 50 miles for treatment. States like South Dakota and Mississippi have only one abortion clinic in the entire state. Illegal abortions still occur because of access problems. Medical abortions would help to combat this.
While few colleges provide abortions, those that do are choosing not to offer RU-486 to their students. Most have come to this decision because they are not equipped to handle complications that may arise. They also are not equipped to offer the information every woman needs to know before ending her pregnancy, such as the physical and psychological side effects that often accompany an abortion. By referring students to local abortion providers instead of performing the procedure on campus, colleges avoid unwelcome publicity and conflict. There is one exception to this. Yale has long been at the forefront in performing abortions on campus, both surgical and medical. They have chosen to offer a full range of services in their health center, including the termination of pregnancies.
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