Family Planning bare-foot health workers explain birth control pills |
REBECCA OAS
A
researcher dedicated to bringing risky medical abortion to developing countries
has set her sights on Bangladesh . Her new study demonstrates a plan to expand
access to abortion pills by using misleading language and an unusual set of
laws.
The
study proposes redefining “menstrual regulation” to include medical as well as
surgical methods.
Since
the 1970s, “menstrual regulation” took advantage of a legal loophole in Bangladesh , which
outlaws most abortions. After missing
her period, a woman could undergo a uterine evacuation, ostensibly to induce
her menstrual cycle. While the procedure
was technically identical to an early-term abortion using a manual vacuum
aspirator, it was not legally classified as an abortion unless a test confirmed
the pregnancy first.
“Abortion
remains a very sensitive topic in Bangladesh ,” wrote Julie DaVanzo
and Mizanur Rahman in an article on Matlab, a region that has been the focus
of several studies on abortion and family planning. “In fact, many of the restrictions for MR [menstrual
regulation], particularly its availability only before pregnancy is clinically
confirmed, are to reinforce the perception of MR as something other than
abortion.”
The new
study reaffirms that any such perception is merely semantic. The method being tested is identical to the
procedure for medical abortion, and the authors compare their results to those
obtained using “this regimen in other settings.” In the other settings, no euphemisms for
abortion were used.
Study
coauthor Dr. Beverly Winikoff is a longtime champion of medical abortion. Her
organization Gynuity led the effort to convince the World Health Organization
to classify drugs that can be used for abortion as “essential medicines.”
Collaborating
with Winikoff on the project were researchers from the International
Center for Diarrheal Disease Research
in Bangladesh . In addition to studying diarrheal disease, the
group focuses heavily on reproductive health. According to its website, “One of the greatest challenges in Bangladesh is
population control,” and their efforts to reduce births range from the
distribution of “behavioral change materials” to this recent study aimed at
increasing the acceptability of medical abortion by another name.
While
the study concluded that medical abortions would be feasible in Bangladesh, health
care providers in focus groups raised concerns about drug quality and medical
oversight given the lack of regulation of pharmacies and the widespread
availability of drugs without prescription. They also noted that the trial did not look at rural areas.
A doctor
who reviewed the study points out that of 651 study participants, 22 were lost
to follow-up after being given the drugs. “Are they dead?” asked Dr. Donna Harrison. “Who knows?”
Today, “menstrual regulation” remains largely unique to Bangladesh , a
product of the majority-Muslim nation’s willingness to turn a blind eye to
early abortion while appearing to enact tough restrictions on it overall.
Abortion promoters in the early 1970s saw its potential for gaining unwitting
acceptance of abortion methods. Gynecologist Geoffrey Davis posited in
1972 that the euphemism could have a worldwide impact.
“Perhaps one of the greatest contributions that somebody could
make to this is a new term that would do for abortion what “family planning”
did for “birth control,” Davis
wrote. “If we could call this something more acceptable than abortion, we
could get the public’s attitude changed a little faster.”
First appeared
in LifeNews.com, August 12, 2013
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