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Access to Abortion Hasn't Significantly Improved With Abortion Pill RU-486

By September 24, 2009

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Wouldn't you think that having an abortion pill available in the U.S. would improve women's access to abortion? It was widely hoped that when RU-486 won FDA approval in 2000, the abortion pill would be prescribed by physicians to women who sought to terminate their pregnancies  but lived in communities where abortion services weren't available. Unfortunately, that's not what has happened.

A study released earlier this month by the Guttmacher Institute reveals that 96% of RU-486 prescriptions are being written by practitioners in metropolitan areas. In fact, these prescriptions come from clinics and health care facilities where surgical abortion is already available.

Although it could be prescribed in any county in the U.S., prescriptions have been written in only 10% of U.S. counties. And access to doctors who are willing to do so is limited. There are 62 million females of childbearing age in this country, but more than half (58%) live in a county where there are no health care professionals who will prescribe RU-486.

The market is there. Just over 61% of abortions in the U.S. take place in the first 8 weeks of pregnancy, and the abortion pill is FDA-approved for the first 7 weeks following a woman's last period (and has been prescribed off-label up to 9 weeks after.) In 2005, 22% of abortions during the first 8 weeks of pregnancy were medical abortions. That number would grow if health care practitioners supported the use of RU-486 in larger numbers and in communities that are underserved by abortion services.

Wouldn't it make sense to encourage access to a medical abortion option instead of delaying women intent on terminating their pregnancy early on? Women who end up waiting to have an abortion say the delays are due to the complexity of making arrangements and the need to raise money to pay for the procedure. And like every other health care issue, cost is a factor.

According to Planned Parenthood, a medical abortion can cost between $350-650; a surgical abortion can cost between $350-900. Wouldn't it be sound fiscal policy to promote the cheaper option?

Cost containment, privacy, and provider safety are all undeniable benefits that RU-486 offers. In a post-George Tiller world, where an ugly precedent has been set by a lunatic anti-abortionist willing to murder a doctor committed to legal and safe abortion, it becomes even more urgent that other doctors not shy away from prescribing a medication that can make an enormous difference in women's lives.

Unplanned pregnancies happen. Abortion is legal and has been for more than 36 years. Look at how skillfully the NRA invokes its members' rights to bear arms. Why aren't we invoking our rights to reproductive choice as guaranteed by the Supreme Court's ruling in Roe v. Wade? It's the law of the land.

And it's a law that the vast majority believe in. It's true. Though not widely disseminated by the media, the fact is that in two Gallup polls conducted earlier this year, 78% of respondents felt that abortion should be legal under any (21%) or certain (57%) circumstances.

Yet so many pro-choice doctors are so afraid to support the legal right of a woman to choose. That's because a loud, hysterical, and vocal minority shouts down a quieter majority that  understands there are circumstances that warrant the termination of a pregnancy. It is never a decision undertaken lightly, but it is a woman's right to choose. So why doesn't the medical community do all it can to use the tools at its disposal (such as RU-586) and improve women's access to reproductive health care, instead of restricting us at every turn?

Related article:
You Have a Choice - Medical and Surgical Abortion Options including RU-486


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