Everyone has heard of the Sears Catalog. It was most likely a staple in every American home in the 1950’s, but Sears did not span the nation from the beginning. Originally, the brand operated primarily in exclusive store locations. Those in rural areas were forced to drive into the city to shop, that is until the start of the Sears Catalog. The company’s sales increased fivefold in the first year alone—it was a raging success. Soon, farmers were having packages dropped on their doorstep and the delivery system has not stopped evolving since.
It seems that everyone is now doing delivery—even abortion pills can be brought to you in the comfort of your home. It’s called telemedicine, and women can now have their abortion in the comfort of their own home without the oversight of a medically qualified physician. A medication first provided under strict physician surveillance is now being prescribed over computers and telephones for autonomous use. For the abortion industry, this is a victory. The feat is touted as an expansion of access and autonomy, but in the statement, they forget the other tenets of non-maleficence (do no harm) and beneficence (active good). It also distracts from the true intentions of reducing medical abortion protocol.
For example, when Sears created their famous catalog and initiated home delivery, it was not with the modest intentions of making farmer’s lives easier. They wanted more money and increased sales, and delivery was the perfect route to expand. Medical abortion has taken the same approach, and from a business perspective, it should be applauded. However, from the standpoint of safety and good, it directly contradicts medical ethics and its supposed “respect” for women.
The move to expand medical abortion access targets rural communities. This seems like a novel idea with heroic intentions. But the original protocols for medically induced abortions are being disregarded without any substantial medical research. It has even been stated by the Royal Australian and New Zealand College of Obstetricians and Gynecologists that “medical termination should not be performed in an isolated or an inaccessible setting which lacks ready access to suitable emergency care from administration of mifepristone until termination of pregnancy is complete.” This is due to the complications requiring surgical interventions that accompany medical abortions: 19.3 percent at <9 weeks, 15.5 percent at 11–12 weeks and 44.8 percent at >13 weeks. The health risks for infection only increase in rural areas, as seen in a Nepal study where 52 percent of women had high-grade complications and 11 percent died. A Latin America study also revealed that pain is a large part of the process with “seven out of 10 women requiring analgesics,” due to “severe pain and prolonged bleeding.” However, despite the dangers of induced abortions in rural areas, telemedicine and telehealth continue to encourage the “self-procedure.”
While medical abortions may seem to be only a fraction of abortion statistics, the movement has been grossly underestimated. According to the Guttmacher Institute, medication abortions accounted for 31 percent of all nonhospital abortions in 2014, and for 45 percent of abortions before nine weeks’ gestation. Within that 31 percent, patients 20-24 years of age constitute 34 percent, patients 24-29 constitute 27 percent, and adolescents constitute 12 percent. More recently, the United Kingdom Department of Health noted that in 2016, 72 percent of abortions under 10 weeks were medical abortions.
The reality is that this move for radical access and autonomy is not medical care, it is business exploitation, which will only result in more complications. Every medical procedure and prescribed medication have specific protocols for a reason. Access may seem ideal, but operations are not performed in living rooms for the sake of convenience. Autonomy may sound noble, but this does not mean patients perform the operations themselves. If we truly cared about the well-being of women, we would not ignore protocol for the sake of business.