Some women just know they want an abortion
June 9, 2021 10:32 AM   Subscribe

Ms. Magazine interviews Dr. Jamie Phifer, founder of Abortion on Demand: Abortion on Demand Offers Telemedicine Abortion in 20+ States and Counting: “I Didn’t Know I Could Do This!”
posted by Mchelly (16 comments total) 24 users marked this as a favorite
Baker: Have you heard of any clinics being negatively impacted by telemedicine start ups?

Phifer: I just got off the phone with a brick-and-mortar practice that was forced to triple their marketing budget to stay afloat due to aggressive marketing by a telehealth start up in their state. I’m getting very worried online mifepristone start-ups will force closure of the only sites available to vulnerable and late gestation patients. I’m hoping AOD’s donations can help clinics like theirs survive this rapid change.

Man it sucks that this is even a consideration that has to be made. Turning a necessary medical procedure into a commodity in a marketplace where resources have to be wasted competing with other providers is perverse.

And to be clear, this is not AOD's, it is the government's.
posted by Reyturner at 10:53 AM on June 9 [2 favorites]

I absolutely don't want to derail a thread on this important topic, just want to issue a small reminder that people who are not women have abortions too
posted by an octopus IRL at 11:13 AM on June 9 [27 favorites]

I'm really glad to see innovation happening in this space - I think there would be more if it weren't so politically charged, thus hard to get investment. (I used to work with a small company that provides something similar)

This is especially great because it fills a huge gap in abortion services. Full-service abortion clinics have to have a lot of structures in place to provide second-trimester abortions (or abortions slightly later in the first trimester), including safety measures for clients (because of terrorists and harassers) and medically unnecessary but legally required equipment. This means that it can sometimes be hard to get a quick appointment, or you might have to spend hours in a clinic just to swallow one pill and get another pill to take home. This is NOT the fault of those clinics, but it can make it harder than it should be for people seeking medical abortions.

Services like this are a bit controversial in the provider community, though, because the later abortions are more expensive/difficult to provide, and are often needed by people in more dire circumstances (have health problems, couldn't scrape together the money early on for a medical abortion, in abusive relationships, etc.). So there's some worry that by peeling off the easier-to-provide earlier abortions, it will leave full-service providers and their clients high and dry. This is not anyone's fault and it really just points to how threadbare and underfunded reproductive healthcare is in this country.
posted by lunasol at 11:27 AM on June 9 [11 favorites]

Thank you for posting - this drew my attention to Abortion Care Network, an umbrella org for independent clinics, and I just set up a recurring donation. I really feel her point about the need for both on-demand mail services and in-person clinics.
posted by Lawn Beaver at 11:28 AM on June 9 [9 favorites]

To me, this seems both great and horrible. A relative took an abortion pill and had a very bad hemorrhage. I went with them to the hospital and they got great care and information here in Denmark. I can see how this can go very badly in a situation where someone has no or mediocre healthcare in the US.
posted by mumimor at 1:24 PM on June 9

mumimor, while I'm glad your relative got great care in Denmark when necessary, in a thread about medical abortion access I want to say that very bad hemorrhage from it is rare. (Lousy healthcare in the US? Business as usual.)
posted by Iris Gambol at 2:49 PM on June 9 [15 favorites]

posted by The Underpants Monster at 6:31 PM on June 9

> This is not anyone's fault

The fuck it isn't. This is situation is the fault of anyone who's opposed public healthcare in the US. It's the fault of anyone who's opposed abortion, anyone who thinks abortion is a healthcare procedure magically separate from the rest of healthcare. It's the fault of anybody who doesn't believe in a better social safety net, anyone who thinks the lazy poors possibly getting something they didn't "earn" to be a travesty.

It's the fault of anybody who's promoted abstinence-only sex education, as if that were remotely useful, and not a colossal waste of everyone's time. It's the fault of anyone who's refused to wear a mask in the past year. Prolonging the pandemic hasn't helped the economy. It's the fault of anyone who profits off the existing for-profit US healthcare random collection of clinics. (It's too haphazard for it to be called a proper system.)

Absolutely offer tele-medicine to everyone but especially women (PMDD anyone?), but we ended up here because healthcare CAN NOT be run as a for-profit system accessible to only those who can pay. The past year speaks that in volumes, never mind the history of abortion in the US, though how we get from here to there is beyond me.
posted by fragmede at 9:46 AM on June 10 [15 favorites]

and I'm sorry, but telling an anecdote spreading rumors about how my cousin's co-worker's brother took the abortion pill and it caused life-threatening hemorrhaging is irresponsible in this day and age. It's not impossible, but it IS rare, but if reading the anecdote results in a single unwanted zygote being brought to term and living the life of an unwanted child, because the travesty of abortion access, healthcare, and education in this country, I'm not so sure that child's going to have a life that's setup for success.

Some women just know they want an abortion, but others are emotionally immature teenage girls who don't know left from right. I was once an emotionally immature child so there's no judgement here, but if we're going to take such a hard stance against "just asking questions", re-framing those questions as a short 'just-so' anecdote doesn't change what looks like an underlying agenda.

posted by fragmede at 9:59 AM on June 10 [7 favorites]

I don't want to go into a fight about how to solve US healthcare. I think everyone on MetaFilter agrees that it is a scandal. But I take offense to my personal story about a close relative being described as an anecdote. I am protecting my young relative by not giving further details because this is the internet.

That said, my point was and is that I find it tragic and bordering on criminal that American women are forced to use online services for something that can potentially be dangerous. It is not coat-hanger dangerous, but it is not as safe as having your procedure monitored at all hours by caring and understanding ob-gyns. My relative used the abortion pills at home, but was told when she received them at the clinic that she should not hesitate one minute to call the hospital if she experienced any problems, and she trusted their advice because she knew she could, that they were alerted and ready to receive her if there was a problem, and she knew it would cost her nothing to go there. Women need proper care, at all ages and for all social groups and races, in all countries.

In my opinion, it is indeed laudable that someone is providing a service that is otherwise not easy to access many places in the US. But I think that one can approve of the people who do this, and at the same time be angry at the societal framework that makes it necessary.
posted by mumimor at 2:37 PM on June 10 [6 favorites]

If someone has no access to healthcare, pregnancy itself can be life-threatening, even in the first trimester.

I don't have any objection to sharing a personal experience but it's easy to fall into a trap of thinking only about the risks of doing a particular thing while ignoring the risks of doing nothing (vaccines come to mind as another example).
posted by randomnity at 3:11 PM on June 10 [6 favorites]

I don't have any objection to sharing a personal experience but it's easy to fall into a trap of thinking only about the risks of doing a particular thing while ignoring the risks of doing nothing

The Guttenberg Foundation released a study not long ago that concluded that carrying a pregnancy to term was 14x more dangerous than getting an abortion.
posted by suelac at 4:15 PM on June 10 [6 favorites]

This is one of the few good pieces of news on women's healthcare. Thanks so much for posting - I don't think this is widely known and I've shared it with some of the young(er) people in my life in hopes that they share it widely. This could be a life saving resource for some people.
posted by bluesky43 at 7:11 PM on June 10 [2 favorites]

I think you're referring to the Guttmacher Institute - Reuters summary, pubmed.

More about the Guttmacher Institute. Probably deserves its own fpp.

If you're wondering who does the good, hard, tedious research about the before and after of choice and impacts of no choice, it's generally them.
posted by abulafa at 7:31 PM on June 10 [5 favorites]

This is not anyone's fault

The fuck it isn't. This is situation is the fault of anyone who's opposed public healthcare in the US.

Well, yes. But I was specifically talking about the landscape of abortion providers. It’s not any of their fault. I thought it was clear from the rest of my long comment that this is what I was talking about, apologies if it wasn’t.
posted by lunasol at 9:37 PM on June 10

> This is not anyone's fault

The article does a pretty good job, I think, of outlining whose fault it is, without giving the enemies of women's health a roadmap to shut this down.

If you read the article, you can know how easy this would be to shut down by whom.

After having read the article, I came away with the feeling that these people are very smart and dedicated, and I'm happy and grateful for their advocacy in our dumb country.

I only wish they would talk about access to care for those of us in jurisdictions under siege. Red states are just voter suppression states. Making you think that we are "red states" is a part of the strategy to shut down women nationally. It's still easy to cross a state border into Georgia. Just think if we had a funded train system in the USA!

Healthcare can be easy!
posted by eustatic at 9:48 AM on June 12 [2 favorites]

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