However the U.S. Supreme Court rules in Dobbs v. Jackson Women’s Health Organization, current trends may result in more abortion complications, writes Ingrid Skop, M.D., in the summer issue of the Journal of American Physicians and Surgeons.
Chemical abortions, which now constitute 54 percent of all abortions, will likely increase further if Roe v. Wade is overturned and states pass laws making surgical abortion less accessible. Additionally, the FDA has lifted the in-person requirement for dispensing abortion pills, making unsupervised (“self-managed”) abortion available through telemedicine and on-line ordering.
Chemical abortion is more likely than surgical abortion to be complicated by hemorrhage or retention of fetal parts, Dr. Skop notes. In addition, mifepristone, the drug that blocks progesterone and thus causes fetal death, may itself increase infection and mental health issues.
Lack of in-person supervision may cause a number of avoidable problems. Dr. Skop lists: failure due to underestimation of gestational age; failure to diagnose an ectopic pregnancy; failure to give Rh D immunoglobulin to Rh-negative mothers; failure to recognize coercion; and poor quality of mail-order drugs.
Abortion complications are greatly under-reported in the U.S., Dr. Skop states. A study from Finland documented four times as many complications after chemical (20 percent) as surgical abortions (5.6 percent).
Failure to recognize complications in self-managed abortions is especially dangerous, as women are told to expect pain and bleeding as signs that “the pills are working.”
In striving to increase access to abortion, “safety” is apparently not a high priority in the industry, Dr. Skop suggests.
The Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties since 1943.
Read Article: https://jpands.org/vol27no2/skop.pdf