Pro-life physicians on mail-order chemical abortion: “reckless”

The Food and Drug Administration (FDA) has okayed the mail-order dispensation of an abortion-inducing drug. The American Association of Pro-life Obstetricians and Gynecologists (AAPLOG) sees no reason to celebrate. The following statement, including the heading, was published in the AAPLOG email newsletter.

Chemical abortion scores in court

Women’s health is going up against chemical abortion in courts this week. Health is taking a hit.

Courts to abortion providers: we’ve got your back 

Iowa’s Sue Thayer, former PP manager, is reporting today that an Iowa judge just granted an emergency stay on a new Iowa law that would have required a physician to be present with a woman on whom an abortion is being performed. The law, which would have blocked “telemed” chemical abortions, was to have gone into effect tomorrow. The case is Planned Parenthood of the Heartland, Inc. v. Iowa Board of Medicine. (“Heartland,” indeed. Orwell, call your office.)

Yesterday, the U.S. Supreme Court refused to hear a challenge to a lower-court ruling that overturned an Oklahoma law regulating the use of chemical abortion. The law would have required that abortion providers adhere to FDA protocol limiting chemical abortion, using drugs rather than surgery, to 49 days of pregnancy. The case is Cline v. Oklahoma Coalition for Reproductive Justice. 

Meanwhile, in Texas …

The new four-part Texas law made famous by a state senator’s effort to filibuster it to death is being challenged piecemeal. So far, the U.S. Fifth Circuit Court of Appeals has allowed the law to go into effect. (See Planned Parenthood of Greater Texas Surgical Health Services v. Abbott.)

The most immediate effect of the Texas law seems to have been triggered by the law’s requirement that a physician performing abortions have admitting privileges at a hospital within 30 miles of the abortion facility. Over a dozen abortion facilities have reportedly closed down as a result of that provision. Abby Johnson, another ex-PP-manager, calls this a “Texas Size Victory.”

New Hampshire implications

Challenges to the manner of use of chemical abortion in New Hampshire have been administrative and judicial so far, not legislative.

As reported here in early September, pro-life physicians and civil liberties attorneys have urged the New Hampshire Boards of Medicine and Nursing to investigate Planned Parenthood’s advertising of chemical abortions through 63 days of pregnancy instead of the FDA protocol’s 49 days. As attorney Michael Norton from Alliance Defending Freedom said at that time,

No matter where people stand on abortion, everyone should agree that Planned Parenthood must abide by established FDA protocols for using a potentially dangerous drug. This includes requiring a licensed professional to personally meet with women and examining them before prescribing abortion-inducing drugs which pose serious health risks, and limiting the length of time it can be used…. [It is] important to hold healthcare providers to appropriate standards of care for women in New Hampshire in connection with the provision of drugs which result in abortions.

The October 29, 2013 edition of the New Hampshire Union Leader carried a front-page article reporting that New Hampshire Right to Life and two individual citizens from Cheshire County have gone to court over chemical abortions administered by Planned Parenthood of Northern New England. At issue: the 49-day limit, the right of PPNNE to prescribe any drug whatsoever in the absence of a state contract, and the practice of distributing the drug for at-home use rather than for administration in a physician’s office.

New Hampshire is in a different judicial circuit than Oklahoma, and so ruling on that state’s chemical-abortion law is not binding here. It does not augur well, though, when the U.S. Supreme Court lets a lower court throw out the Oklahoma law. This will no doubt have a chilling effect on efforts to regulate chemical abortions and monitor their effects on women’s health.

Chemical abortion: the wave of the future?

While I’ve been concerned that the lessons of Gosnell are already being forgotten in some quarters, late-term abortion restrictions are gaining ground in several states. If there’s one thing the Gosnell trial will be remembered for, it’ll be the images of those babies he tried to abort and then “snipped.” They looked just like … babies.

Chemical abortion, on the other hand, is much neater. The preborn children look less like children. The mother can’t feel the baby yet, as early in pregnancy as abortion drugs are supposed to be administered. The pills can be sent home with the mother, even in defiance of the law. Telemed abortions, in which a provider teleconferences with a mother before remotely unlocking a drawer to give the mother access to abortion pills, requires much less overhead than a surgical abortion facility. The drugs are relatively cheap. The mother bleeds and sheds her child into pads or her toilet at home, keeping the abortion-drug provider from having to deal with medical “waste.”

Now there’s a business model. No wonder abortion advocates go to court to fight regulations on chemical abortions.

(Fact: one of the nurse practitioners on staff at the abortion-providing Lovering Center in Greenland, New Hampshire did her Ph.D. dissertation on “Women’s Experience with Decision-making with Medication Abortion.”)

Medication/chemical; potato/potahto. Ironically, women’s experience with the outcome of “medication abortion” is something neither academic medicine nor public health can pin down, at least not in New Hampshire. No one collects reliable statistics on how many women choose drug-induced abortion or how many women experience poor outcomes as a result. The number of chemically-induced attempted abortions that “fail” and are then followed up with surgical abortion is a mystery as well. Abortion providers lobby against stats bills, and call opponents “anti-choice” for wanting data.

How is that not putting politics ahead of women’s health?

Pro-life doctors, ADF call on NH to investigate PPNNE’s use of chemical abortion drugs

Does Planned Parenthood of Northern New England prescribe chemical-abortion drugs in a manner inconsistent with Food and Drug Administration protocol?

The American Association of Pro-Life Obstetricians and Gynecologists thinks an investigation is in order. Joined by the Alliance Defense Fund, AAPLOG sent a letter on September 4 to the New Hampshire Board of Medicine and the New Hampshire Board of Nursing. ADF issued a press release summarizing the letter and the reasons behind it.

If I may be flippant for a moment, here’s my paraphrase of the AAPLOG/ADF letter to the Boards, which I have read (all 20 pages): abortion’s legal, and we all know it. Even so, would PP mind terminating pregnancies in a way that damages women as little as possible? It looks terribly like money is trumping health here.

Who kicked up this fuss, anyway? Michael Tierney, New Hampshire attorney and former Executive Council candidate. He knows that the FDA protocol for the use of chemical abortion is to use it no later in pregnancy than 49 days after a woman’s last menstrual period. He also knows that the Planned Parenthood of Northern New England web site indicates that women shouldn’t use this method after more than 63 days. (I accessed the web page today, 9/6/13, to confirm that PP is still using that language.) Tierney brought this to the attention of the New Hampshire Board of Pharmacy. He then called on AAPLOG and ADF (with which he is an allied attorney) to contact the boards of medicine and nursing to urge an investigation.

Tierney’s concern: “Planned Parenthood’s main concern should be the health and safety of women, not its bottom line.”

Health before profits: what a concept. Unfortunately, with the wall of secrecy around the abortion industry – a wall that too many New Hampshire legislators and the current governor fight to preserve – no one in this state has any proof that women are safe when they go for an abortion. Of course, that means that no one has objective data in this state to prove that women are harmed in this state, either. That’s the way New Hampshire abortion providers like it. I’ve heard their testimony in Concord year after year. Morbidity and mortality following a “medical” procedure is a public health issue, unless that “medical” procedure is abortion. I use quotation marks because a small part of me still wants to think of medicine as a healing art, despite all current evidence that it has been reduced to a technical skill. Abortion has nothing to do with healing.

“Gynotician” is the latest epithet PP has coined to throw at lawmakers who dare to demand that abortionists be forced to account for women’s health. Imagine the nerve of some people, wanting objective information about how abortions are done and what happens to a woman’s health after abortion. PP knows that New Hampshire will never pass a stats collection law while there are legislators who dislike being called names. The abortion industry is not self-policing. Ask Kermit Gosnell.

Thank God that there are people in New Hampshire like Michael Tierney willing to force the question. Doctors at AAPLOG are willing to speak out about how medicine is practiced by abortion providers (an increasing number of whom are not M.D.s). Does PP have a catchy name for boards of pharmacy, medicine, and nursing that choose to investigate how PP prescribes drugs? We might find out yet.

A bit about the American of Pro-Life Obstetricians and Gynecologists: AAPLOG is a recognized professional interest group within the larger American College of Obstetrics and Gynecology. It was founded a few decades ago by a gynecologist who was alarmed by ACOG’s willingness to espouse abortion-on-demand. That gynecologist was Matthew Bulfin, M.D. of Fort Lauderdale, Florida. He was my mother’s doctor.