Here Comes Trouble: Stories from My Life

"Outstanding…Moore Triumphs! Publishers Weekly

Mike & Friends Blog

Dr. Jen Gunter

Dr. Jennifer Gunter is a nationally and internationally renowned obstetrician/gynecologist.

May 29th, 2012 7:14 AM

When safe abortion isn’t a choice

If she is brave enough, she will ask around. Someone will know someone who knows someone. Or something.

Someone’s grandma might know about the old days. Drinking turpentine or Clorox, which is what the poorest women often did. They also took massive doses of quinine. Equally dangerous and, like the household cleaners, not a particularly effective abortifacient. Although as faded memories become urban myths no one seems to remember that these methods don’t work and often kill, and so they remain in the lexicon of “options.”

An Internet search, if she has access and doesn’t have to worry about the prying eyes of parents or an abusive partner, might lead her to misoprostol. A friend from Latin America or Asia might be more familiar with this “option.” Assuming she gets the right dose of the real medication and not some sugar pill or poison passed off as the real thing, she might have a 30-40% chance of inducing her abortion early on. Ironically, it gets more effective as the pregnancy advances. Like most women she’ll take the pills by herself, cramping and bleeding on the toilet or squatting on the ground. No one to hold her hand. No one to wipe her brow. No one to recognize when she has a fever or has lost too much blood.

Many women find their way to people who offer certain “skills.” Procedures, if you can even call them that, offered in back rooms. Rooms that don’t have an autoclave to sterilize tools or even basic resuscitation equipment. Some rooms have the essence of respectability, many do not. Almost none are operated by anyone who has more than a cursory knowledge of the reproductive tract.

On kitchen tables these women lie. Some might be offered a Valium or a Vicodin. For a price. It might ease the pain a little. These medications may also makes them less likely to cry during the sexual assault that can be part of the deal. After all, who is going to complain about getting raped at their illegal abortion?

Maybe their vagina and cervix is cleaned before hand, but maybe not. An instrument is pushed through the cervix by hands that do not know how to atraumatically dilate the opening of the cervix. Too much force is dangerous. The practitioner may not know (or care) that the wall of a pregnant uterus is like butter and any instrument, no matter how soft, is like a knife.

If they can’t navigate the opening of the cervix, or if they haven’t even bothered to look, the instrument is just forced up until there is no more resistance or until the screaming stops. This blind stabbing often leads the instrument to puncture the top of the vagina, weaker than the cervix, traveling alongside the uterus where the major blood vessels are found.

Ultrasound machines are not used. They cost hundreds of thousands of dollars. Even if one were available, the chance that such a provider would know how to use one is slim. Gestational age is therefore a guess. Unfortunately, knowing about the long bones and skull is crucial in the 2nd trimester. An unskilled hand can easily push splinters or larger pieces through the uterus into waiting bowel and blood vessels.

If blood vessels are transgressed, the bleeding is catastrophic and requires emergency intervention. Many women don’t get to the hospital in time. Who is going to call the ambulance?

If fecal material announces a bowel perforation a caring provider might stop and say, “You need to get the hospital.” Most are not that caring. Better she stagger home and call.

Even when the procedure seems to go smoothly, the risk of infection is high. Pretreatment with antibiotics to lower the risk of infection, standard with a safe abortion, doesn’t happen. Products of conception left behind by untrained hands and unsterile equipment take their toll in 2-3 days. If the woman is not too ashamed or afraid to go to the hospital she will need advanced care. She may need her uterus re-evacuated to remove what was missed and is now the nidus of infection. As there are fewer and fewer providers skilled to perform abortions, there are fewer and fewer hands experienced enough to do this without the back wall of the uterus falling apart from the currettage. Many will now get hysterectomies.

A CT scan might show abscesses in the belly and a punctured bowel. In these dire circumstances surgery, a colostomy bag, and a prolonged hospital stay will be the result. Infection and blood loss may also cause the body to attack itself, losing the ability to clot. This is disseminated intravascular coagulation and even with prompt, expert, intensive care it is often fatal.

But if she is so alone, so alone that she can’t fathom asking anyone she might take a stick, or a coat hanger, or a knitting needle and stick it up her vagina. She won’t know about the cervical os, the opening of the cervix, or that she has no hope of finding it blindinly. She’ll push. It will hurt. A lot. But she’s desperate. She might stick it into her uterus, or right through the uterus into bowel. After two or three days of fevers and cramping and vomiting she might go to the hospital and hopefully the damage and infection will be confined to her uterus. She might also slice through blood vessels and bleed to death by herself on her bathroom floor.

It’s going to be challenged, of course, in the Supreme Court and all — but literally, we stopped abortion in the state of Mississippi, legally, without having to– Roe vs. Wade. So we’ve done that. I was proud of it. The governor signed it into law. And of course, there you have the other side. They’re like, ‘Well, the poor pitiful women that can’t afford to go out of state are just going to start doing them at home with a coat hanger.’ That’s what we’ve heard over and over and over.

“But hey, you have to have moral values. You have to start somewhere, and that’s what we’ve decided to do. This became law and the governor signed it, and I think for one time, we were first in the nation in the state of Mississippi.”

- Mississippi GOP state Rep. Bubba Carpenter

You must log in to comment.

You must be logged in to leave a comment. Log in | Register

If you have a moment today, I hope you can read the obituary for my father Francis (Frank) Moore, who died this past Saturday at the age of 92: Francis...

Apr 22nd
6:33 PM
Read More

My father, Francis (Frank) Moore, passed away this morning a few months shy if his 93rd birthday. He was a great dad I am blessed to have had him in my life. I...

Apr 20th
2:58 AM
Read More

Time to put the cuffs on Chris Christie -- not for the bridge scandal, but for this: Chris Christie's $300m pension proposal broke state anti-corruption...

Apr 18th
7:31 PM
Read More

George W. Bush Debuts New Paintings Of Dogs, Friends, Ghost Of Iraqi Child That Follows Him... President Bush has a new hobby -- painting! --...

Apr 17th
7:28 PM
Read More

Big new story from David Sirota and Pando on top Christie adviser and appearance of corruption at New Jersey's pension fund: REVEALED: Gov....

Apr 17th
12:41 PM
Read More

FBI Uncovers Al-Qaeda Plot To Just Sit Back And Enjoy Collapse Of United States WASHINGTON—The FBI announced today that it has uncovered a...

Apr 15th
3:28 PM
Read More

Revealed: Rahm Emanuel's top donor bought stock in Marriott just before it was awarded huge contract As schools are closed and pensions cut,...

Apr 9th
2:00 PM
Read More

I'll be at First Time Fest today in New York City at the screening of my first film, Roger & Me. Loews Village 7 at 12:30 pm. Come see it on the big...

Apr 5th
9:48 AM
Read More

Revealed: Rahm Emanuel cuts public pensions, diverts money to benefit campaign donors If you've read the financial news out of Chicago the last...

Apr 4th
2:19 PM
Read More

Please take a moment today to think of Casey Austin Sheehan, son of Cindy and Patrick, who was murdered by U.S. foreign policy in Sadr City, Baghdad ten years...

Apr 4th
2:00 PM
Read More

ICYMI - I've joined this "thunderclap" to support the Connecticut legislators who voted yes on last year's Act Concerning Gun Violence...

Apr 3rd
7:38 PM
Read More

I've joined this "thunderclap" to support the Connecticut legislators who voted yes on last year's Act Concerning Gun Violence Prevention...

Apr 2nd
8:27 PM
Read More

I am opposed to the death penalty, but to every rule there is usually an exception, and in this case I hope the criminals at General Motors will be arrested...

Apr 1st
3:55 PM
Read More

How Long Some in the US Will Survive Under New Health Law Donna Smith Those who must access care to live and can afford it are not...

Mar 31st
10:13 PM
Read More

Last night, The Good Wife on the East Coast started 40 minutes late due to the overrun of the NCAA basketball game. If you had your DVR set for the show, you...

Mar 24th
5:41 PM
Read More

Watching films today, looking for the ones I'm going to pick for my film festival this summer. I (and a whole bunch of others!) have this thing we put on...

Mar 23rd
4:48 PM
Read More

When the U.S. Health Care System Keeps Killing, Who Cares Enough to Fight? Donna Smith We have largely forgotten that people are at...

Mar 21st
5:56 PM
Read More

Tell the White House not to give up on Dr. Vivek Murthy's nomination as Surgeon General despite the ferocious opposition from the NRA: Don't give...

Mar 21st
5:38 PM
Read More

This criminal would never see a jail cell, nor would his cronies. In fact, they'd later be rewarded with re-election: Presidential Address on War with...

Mar 19th
9:40 PM
Read More

The crime of the century -- our invasion & slaughter in Iraq -- started 11 years ago tonite in this 7pm (ET) hour, March 19th, 2003: CNN Coverage of...

Mar 19th
9:08 PM
Read More

Washington’s Back-to-the-Future Military Policies in Africa Nick Turse Nick Turse is an award-winning journalist, historian,...

Mar 17th
4:59 PM
Read More

"I think democracy is the most revolutionary thing in the world." -- Tony Benn, 1925-2014 Tony Benn in 'Sicko'

Mar 14th
10:07 AM
Read More

RIP Tony Benn, one of the UK's greatest leaders: Tony Benn, veteran Labour politician, dies aged 88 Former cabinet minister died at...

Mar 14th
9:53 AM
Read More

Please read this important story from K. Ford K.: Am I the Face of the New American Middle Class? I began to feel I had slipped so low...

Mar 13th
2:24 PM
Read More

Yesterday Dianne Feinstein revealed that the CIA has been spying on the Senate Intelligence Committee. This is all about the report the committee has produced...

Mar 12th
6:48 PM
Read More

Health Care for All Colorado has brought Mercy Killers, a show written and performed by Michael Milligan about our murderous for-profit healthcare system, to...

Mar 10th
1:08 PM
Read More

Health Care Dramas that Sting and Why We Have to Watch Donna Smith The realities Milligan has written into the show cut deep into...

Mar 10th
1:02 PM
Read More

Did you know the Lehrer Newshour on PBS has been produced for 20 years by a company owned by conservative cable billionaire John Malone? Me neither. After...

Mar 7th
8:39 PM
Read More

Mr. Obama, if int’l law is so damn crucial . . . | The Russian intervention deserves criticism. But let’s be clear. The...

Mar 6th
1:21 PM
Read More

Subscribe to Mike's Blog RSS

Click here to suggest an article

Mike's Blog

See More Blogs

Vew the archives

View older articles