Last week, Glamour published two articles promoting DIY home abortions. Individually, the articles provide dangerous advice. Together, the guidance is toxic.
The first, “A New On-Line Service Aims to Help Women Self-Manage Abortions,” introduced Glamour readers to Women Help Women: “In April the organization launched the first-ever digital information service for medication abortion pills—Self-Managed Abortion: Safe and Supported, or SASS for short—that provides information and resources specifically about obtaining and using mifepristone and misoprostol, which the law usually requires are prescribed by a licensed health care professional.”
According to author Steph Herold, after women answer a series of questions, Women Help Women can refer them to nearby clinics for an abortion or to organizations for assistance with the cost. Women Help Women “can also provide instructions on how to self-manage an abortion if she has the abortion pills.”
“Self-manage” is the latest euphemism from pro-“choice” folks. Translation: A pregnant woman procures the abortion pill Mifeprex, then ingests it at home to abort her unborn baby.
To Get the Pills, Try the Black Market?
Glamour, however, leaves unanswered how women can acquire the abortion pill. Herold cagily hints at the answer—that they are obtained illegally—by noting that “self-managed abortions are legally risky in the United States. At least 17 women have been arrested for self-managing their own abortions in the last few years alone.” Women Help Women has no such restraint. It provides readers multiple suggestions for illegally obtaining the abortion pill, including Internet veterinary supply stores and over the counter in Mexico.
A similar organization, Women on Waves, which “helps women get access to a safe [sic] medical abortion,” provides even more direct advice, suggesting the mom-to-be visit a smaller pharmacy and “say that your grandmother has rheumatoid arthritis so severely that she is visiting and she forgot her medicines and is in pain, and that you do not have money to pay for a doctor to get the prescriptions for the tablets.” If unsuccessful “try another pharmacy, or send a male friend.” Women on Waves also shares that Mifeprex “can also be bought on the black market (places where you can also buy Marijuana).”
That’s right, America: Abortion-rights advocates have gone from warning of back-alley abortions to promoting black-market ones!
Eating Death Pills Is So Totally Safe, Girls
Beyond advocating criminal conduct and giving a verbal nod in the direction of Women Help Women’s web address, the Glamour article then dangerously portrays the abortion pill as unequivocally safe, first stating “having an abortion with pills is medically very safe.”
The article reiterates this point two more times, first by quoting Women Help Women’s Amsterdam-based executive director Kinga Jelinska, who told Glamour “I wish people knew how safe and effective abortion pills are.” The article ends by noting “that recent data suggest that medication abortion pills are perfectly safe to provide over the counter.” The only risk the article mentions? The legal risk!
Two days later, Glamour led its “health” section with “Research Confirms You Can Safely Induce Your Own Abortion.” This article highlights a just-published study of “the self-reported outcomes of 1,000 women in Ireland and Northern Ireland after they induced their own abortions with medication from the organization Women on Web (WoW).” In summarizing the study, Jennifer Gerson Uffalussy writes:
What they found was that 95 percent of these self-sourced and self-managed medical abortions were successful, meaning they didn’t require any surgical intervention afterward. Of the 1,000 women, 93 experienced a symptom that might have been indicative of a serious complication. The vast majority of these, 95 percent, sought care (the five who didn’t seek care also didn’t report experiencing any adverse outcome) — so, yes, women are smart, sentient beings who can follow directions, take medication as prescribed, and seek care when needed.
She then concludes: “Medical abortion has been shown before to be incredibly safe. According to Planned Parenthood, serious complications of the procedure are rare, and research indicates that it leads to serious side effects in fewer than one percent of cases.”
What’s an especially younger reader of Glamour to conclude after spying these two articles? That it’s completely safe to illegally purchase the abortion pill and terminate a pregnancy at home without seeking any medical evaluation or care. After all, according to Glamour, recent data suggests it’s “perfectly safe to provide over the counter.”
Doctor-Administered Mifeprex Includes Careful Guardrails
While it is true that serious side effects of Mifeprex (to the mother) are rare, they are so serious the manufacturer must provide the FDA’s strongest warning—a Black Box Warning. And the reason the number of (maternal) fatalities remains low is because the Food and Drug Administration approved Mifeprex for distribution through a restricted program called Mifeprex REMS, or Risk Evaluation and Mitigation Strategy.
According to the FDA, REMS seeks “to mitigate the risk of serious complications association with Mifeprex by requiring healthcare providers who prescribe Mifeprex to be certified in the Mifeprex REMS Program.” The program also requires health-care providers to only dispense Mifeprex in specific settings and to inform patients about the risks of serious complications.
To ensure that patients understand the risk of serious complications, the FDA mandates that doctors require patients to sign a “patient agreement form.” Among other things, in signing the form the patient confirms that her “healthcare provider has talked with me about the risks including heavy bleeding, infection, and ectopic pregnancy (a pregnancy outside the womb).”
The patient also verifies that she has the medication guide and will take it with her if she needs care at an emergency room “so that they will understand that I am having a medical abortion with Mifeprex.” The FDA also informs emergency room physicians of the protocol for treating women suffering from complications after taking Mifeprex.
Women who follow Glamour’s lead and obtain Mifeprex illegally won’t have the benefit of these precautions, a medical consultation, or examination, or a doctor walking them through the risks and warning signs of serious complications.
Women Help Women does provide warnings on its webpage about complications, but the FDA believed that to properly mitigate the risk of serious injury or death, a medical professional needed to verbally review the risk factors with the patient. While the FDA directs women to provide emergency room personnel with the Mifeprex medication guide, Women Help Women tells women to lie to their ER doctor and claim they are having a miscarriage. So much for Glamour’s claim that “women are smart, sentient beings who can follow directions [and] take medication as prescribed.”
The Data Only Relates to Abortions Under Medical Care
What about those studies Glamour highlighted? Well, Glamour misinterpreted, misrepresented, or blindly ignored several significant facts. For instance, the study the fashion magazine claims “suggest[s] that medication abortion pills are perfectly safe to provide over the counter,” if read in full, concludes several “evidence gaps” necessitate additional research before over-the-counter sale would be appropriate.
That same article also raised several red flags on the “extremely safe” narrative. For instance, the study stressed that “[c]omplications will also be more common if medical termination regimens are used (off-label) at gestational ages beyond 10 weeks.” The study also reported that many women self-assessing the gestational age of their unborn babies are at least that far along. In one study, 33 percent of the women followed up on believed they were candidates to use the abortion pill, including 10 percent who were 13 weeks or further along in their pregnancies. Another study showed that when women used the “eligibility checklist” from Women on Web, nearly 30 percent wrongly concluded that it was safe for them to use Mifeprex.
Glamour also dangerously cribs from the study it relies upon in “Research Confirms You Can Safely Induce Your Own Abortion.” Contrary to Glamour’s portrayal, the patients included in the study did not “self-source” or “self-manage” their abortions. The women did not purchase Mifeprex online, from a veterinarian, or on the black market. Instead they received the abortion pill from Women on Web following a consultation with a doctor.
Further, nearly 60 percent of the women in that study had an ultrasound before proceeding with the chemical abortion. Not only does the ultrasound confirm the baby’s gestational age, it will reveal if the woman has an ectopic pregnancy—one where the embryo attaches outside the uterus. Ectopic pregnancies present serious risks to the mother and, because the signs of an abortion with Mifeprex mirror complications from an ectopic pregnancy, using Mifeprex in that situation is extremely dangerous.
Women obtaining Mifeprex at abortion clinics in the United States typically receive an ultrasound to determine both the baby’s gestational age and to ensure the pregnancy is not ectopic. Similarly, the majority of the women included in the studies Glamour touted likewise underwent ultrasounds before ingesting Mifeprex. The clinical trials submitted to the FDA in support of the Mifeprex application for approval also included only women who had undergone an ultrasound. Glamour mentions none of this, and Women Help Women merely directs women not to use Mifeprex if, among other things, they are having an ectopic pregnancy. But there is no way to know this without an ultrasound—until it is too late.
The Implications Are Horrendous
Glamour has done its readers a grave and dangerous disservice. They have encouraged pregnant women (or worse yet, disgruntled fathers–to-be) to illegally procure a dangerous drug while implying medical oversight is not needed. This is even more disconcerting given that in recent years Glamour has shifted its target to younger women, specifically the college set.
Further, even 20 years ago, more than 20 percent of 12- to 15-year-old girls said they read Glamour regularly. These young girls will be even more lacking in the ability to “self-manage” an abortion, withstand any pressure placed on them to abort, and later navigate the emotional and psychological ramifications of an abortion.
In fact, American Family Physicians highlighted that “[s]ocial or psychological contraindications to medical abortion are more common than medical contraindications.” Even ardent supporters of chemical abortion recognized the importance of properly assessing the gestational age because of “social” risks: “Termination later in pregnancy also carries increasing medical risks and, potentially, legal and social risks, depending on the setting.”
Abortion Translator Activated: Women who have miscalculated their unborn child’s gestational age and proceed to abort a 12-week-old fetus might not be prepared to view the human remains of their child.
Glamour bills itself as “one of the biggest fashion and beauty magazine brands, reaching an all-time high of one out of eight American women, with 10 million print readers and 15 million unique users online.” While the magazine might be a great source for beauty and fashion tips, women (and girls) should not rely on Glamour for pointers about “reproductive health.”
As for abortion-rights advocates: “Safe, legal and rare” is so ‘90s. Today’s tagline: Unsafe, illegal, DIY.