Why hasn’t RU-486 changed the game?
A new study by the Guttmacher Institute provides some clues
A 1999 New York Times magazine cover story by Margaret Talbot called mifepristone (RU-486) “the little white bombshell,” speculating that the pill used for first-trimester non-surgical abortion could blow the pro/con abortion debate to smithereens and leave entirely new terrain in its place. Mifepristone’s promise to make abortion available as early as 5 weeks, shift a significant proportion of procedures from embattled clinics to private doctors’ offices (sorry, protesters) and increase the overall number of abortion providers convinced Talbot — and the feminists who fought for its approval by the FDA — that medical abortion could “reconfigure the politics and perception of abortion in this country more definitively than any piece of legislation has in the quarter century since Roe v. Wade.”
Ten years later, here we are. Dr. George Tiller is dead; Randall Terry, apparently, is still relevant. Has mifepristone changed anything at all?
Yes and no, according to new research by the Guttmacher Institute. Yes (as also described here earlier), RU-486 has — at very least — become an “integral” part of the abortion landscape. The number of mifepristone providers increased from 208 in 2000 to 902 in 2007; its availability may have contributed to a trend toward abortion at its earliest — and, relatively speaking, least controversial — opportunity. At very least, under some circumstances (though medical abortion is not for everyone), women’s options have expanded.
But what mifepristone hasn’t changed is possibly the most important aspect of legal abortion: access to the procedure in the first place. “Expectations that approval of mifepristone would result in a wider range of providers offering abortion have not yet been met, and mifepristone has not brought a major improvement in the geographic availability of abortion,” reads the study. “Most mifepristone abortions were performed at or near facilities that also provided surgical abortion. Only five mifepristone-only providers of 10 or more abortions were located farther than 50 miles from any surgical provider of 400 or more abortions.” In other words, it was largely those who already provided abortion who added mifepristone to their practice, not new doctors getting into the game.
“One-third of women live in a county without an abortion provider. We’ve had a missed opportunity here to facilitate access for these women,” Lawrence Finer, Ph.D., director of domestic research for Guttmacher and a co-author of the study, told Broadsheet.
But why? Well, it’s not like mifepristone “just didn’t catch on.” All that was a lot to ask of one little pill. For one thing, a doctor can’t just add mifepristone to a practice like a chef adds in-season fruit to a menu; there are training and liability issues to consider — not to mention lingering stigma and yes, fear. And mifepristone made its debut at a time when — broadly speaking — the anti-abortion movement had just begun to take some of its business from the sidewalks to state courts and legislatures, where specious and cruel laws could restrict abortion more effectively than signs and rosaries . That’s another barrier to offering mifepristone, notes Finer: in many states, adding abortion services means complying with all manner of elaborate structural requirements (as in the case of Mississippi’s clinic, singular). “And in a lot of those cases the focus of those regulations is to make it harder to do abortions [of any kind],” says Finer.
There was also speculation, way back when, that the possibility of ultra-early termination could help shift public perception. “Abortions in the earliest weeks of pregnancy are not only safer, cheaper and less emotionally wrenching for the women who undergo them, they are also more politically tenable,” noted Talbot, who cannot be blamed for failing to foresee that in some influential circles — talk about early — contraception was on its way to becoming politically untenable.
So no, at least compared to predictions, mifepristone has not substantially changed the game. And for that, in large part, we can blame the very opponents we’d hoped to have stymied.
What can be done? Says Finer: “Well, this study is a quantitative assessment of what’s going on. Maybe it’s time for something qualitative: talk to the OBs, the family practice doctors, ask them whether they’re interested in providing it and if not, why not — and then based on those conversations we could have some insights on how to overcome that barrier.”
So the headline here is not “Mifepristone: FAIL.” Rather, this research should serve as a reminder that when it comes to abortion, there’s “the debate,” and there’s the reality. The debate shifts here, and the terrain shifts there, but the bitter pill is this: despite certain victories — and during theoretical, ill-informed, even specious wars of words — so many women, right now, remain able to exercise their legal right to abortion only with unacceptable difficulty, or not at all.
Award-winning journalist Lynn Harris is author of the comic novel "Death by Chick Lit" and co-creator of BreakupGirl.net. She also writes for the New York Times, Glamour, and many others. More Lynn Harris.
What happened to Broadsheet?
A farewell (of sorts) to Salon's feminist blog
Read about it here.
Did the recession prevent teen motherhood?
Some thank the economy for a decline in teenagers giving birth, but contraception is the likelier savior
Teen births hit a record low last year, according to a CDC report released Tuesday, and the narrative quickly taking hold in the media is that we have the recession to thank. It’s a surprising idea, that teenagers are keeping it in their pants because a baby isn’t a prudent choice in the current economic environment. Foresight isn’t what we expect from those creatures of impulse — and, indeed, when is a baby a practical economic choice for a teen? It also struck me that the teen birth rate isn’t the same as the teen pregnancy rate, if you catch my drift (my drift being … abortion). I took my questions to a couple of experts in hopes of some clarity.
Continue Reading Close
Tracy Clark-Flory is a staff writer at Salon. Follow @tracyclarkflory on Twitter. More Tracy Clark-Flory.
Olbermann still doesn’t get it
The MSNBC host is back on Twitter with a response to his critics -- but he ignores their key complaint
Update: Olbermann has responded on Twitter by blocking me and tweeting, “Your article embarrasses you and your site.”
Back from his self-imposed Twitter timeout, Keith Olbermann is lashing out at his feminist critics. As Sady Doyle explained last week in Salon, the online protest was started in response to Michael Moore’s mischaracterization of the allegations against Julian Assange. Olbermann became a target after retweeting a link from Bianca Jagger that incorrectly claimed “the term ‘rape’ in Sweden includes consensual sex without a condom,” and that named Assange’s accuser (which is generally a journalistic no-no). Overwhelmed by the Twitter campaign, which was waged with the hashtag “mooreandme,” Olbermann quit the microblogging site in a huff. This afternoon, after a few days of calm reflection, he tweeted a link to his thoughts on the matter:
Continue Reading Close
Tracy Clark-Flory is a staff writer at Salon. Follow @tracyclarkflory on Twitter. More Tracy Clark-Flory.
Save the children from Hooters?
NOW calls on the breast-obsessed chain to stop serving kids
The National Organization for Women is protesting Hooters. I know: Yawn. Next I’ll be interrupting major sporting events with breaking news that Gloria Steinem isn’t a fan of the “Girls Gone Wild” franchise. But, seriously, the argument at play here is more interesting than it at first seems. It isn’t the breast-obsessed chain’s existence that is being challenged, but rather the fact that Hooters serves children. Clearly, there is abundant evidence that Hooters is guilty of poor taste (see: restaurant name) — but should the chain be forced to card customers at the door and turn away anyone younger than 18? Several California chapters of NOW have filed official complaints alleging just that.
Continue Reading Close
Tracy Clark-Flory is a staff writer at Salon. Follow @tracyclarkflory on Twitter. More Tracy Clark-Flory.
Why do serial killers target sex workers?
The question is raised after four female bodies are found on a Long Island beach
Authorities search in the brush by the side of the road at Cedar Beach, near Babylon, N.Y., Tuesday, Dec. 14, 2010. Police looking for a missing prostitute on Long Island's Fire Island have discovered three bodies and a set of skeletal remains near Oak Beach since Saturday. Investigators are considering the possibility that a serial killer may have dumped four bodies along the same quarter-mile stretch of beachside road, a police chief said Tuesday. (AP Photo/Seth Wenig)(Credit: AP) As New York confronts the possibility that there’s a serial killer on the loose, many have taken note that this case looks a lot like what we see in the movies: The victims are all women, and at least one is suspected to be a sex worker. When it comes to serial murder, it turns out fiction really does reflect reality. A report was released last month finding that 70 percent of known victims of serial killers are women (consider that only 22 percent of homicide victims in general are female); and it turns out sex workers are 18 times more likely than “normal” women to be murdered. Why might this be? Well, in the words of the Green River Killer, who targeted prostitutes:
Continue Reading Close
Tracy Clark-Flory is a staff writer at Salon. Follow @tracyclarkflory on Twitter. More Tracy Clark-Flory.
Page 1 of 1031 in Broadsheet