What Can We Learn from Abortion Access?

category: Women

Published August 24, 2009 @ 08:34AM PT

A few weeks ago, I talked about the multiple meanings of access to health care, focusing on the fact that access is always more complex than you expect. A recent report on abortion access in the US brought that home to me.

The Alan Guttmacher Institute reports that mifepristone for medication abortion was expected to widely expand abortion access in the United States. That promise has not come true. Instead, new research found that "most medication abortions were performed at or near facilities that also provided surgical abortions." In other words, ten years after the abortion pill became available, access to abortion is still linked to being near a medical facility that provides abortions.

What happened? The article doesn't speculate on why mifepristone hasn't improved access to abortion, but I have a theory. I think they misunderstood exactly what the barrier to abortion access was.

The barrier wasn't providers who were capable of providing abortions. Just about every obstetrician is capable of performing an abortion. A vacuum-aspiration abortion is a very easy procedure to perform - one of the easiest. A dilation and curettage isn't much more difficult, and it is called for in situations unrelated to abortion, such as when removing fibroids from the uterus.

The true barrier to abortion access is providers who are willing to perform an abortion. Some providers are morally opposed to abortion provision. Others are unwilling to risk the threats and violence that go along with being an abortion provider. And doctors who are unwilling to provide surgical abortions are also unwilling to prescribe an abortion pill.

So, ten years after the abortion pill was introduced, American women who have access to a health care provider who does abortions can choose between a surgical abortion and a medication abortion. And women who don't have access to that kind of provider are still screwed.

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Comments (1)

The anti-choice harassers and terrorists have no hesitation to threatening providers of medicinal abortion. As long as law enforcement, federal marshalls and Homeland Security (it was ok to harass Grandmothers For Peace, but anti-choice terrorists are no big deal!) refuse to adequately do their jobs, access will continue to decline. Access should be expanded, including late-term abortions. Abortion should also be included in health-care reform. Rev. Bookburn - Radio Volta

Posted by Rev Bookburn on 08/24/2009 @ 02:49PM PT
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Author

Alanna Shaikh has spent the last ten years immersed in global health; she has worked for NGOs, companies, universities, and the US government on projects that ranged from preventing antibacterial resistance to improving maternal and child health.