Recent Resources for Feminists
US: Death risk from RU-486-based abortion appears approx 10 times that from surgical abortion Print E-mail

Refer Feminist Research 1991:

   

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Thursday May 11, 2006

Scientists Will Gather to Discuss Safety of Abortion Pill

By GARDINER HARRIS

Worried about a bacterial infection that led to the deaths of at least five women who took the abortion pill RU-486, scientists from the nation's leading public health agencies will gather in Atlanta today for the first meeting in 10 years on the drug's safety.
 

Dr. James McGregor of the University of Southern California [J. Emilio Flores for The New York Times]
 

Dr. Vanessa Cullins, a Planned Parenthood vice president [Marilynn K. Yee/The New York Times]

Scientists from the Food and Drug Administration, the Centers for Disease Control and Prevention, and the National Institutes of Health will consider whether the means of administering abortion drugs make pregnant women more susceptible to the bacterium Clostridium sordellii.

They will also discuss whether the deaths may signal the emergence of a new and more virulent strain of the bacterium that poses a threat to pregnant women generally, not just those who use RU-486.

The five deaths were confirmed as resulting from infection by Clostridium sordellii, which can induce toxic shock. The cause of a sixth death has not been announced, although the same bacterium is suspected.

Clostridium sordellii infections are rare, but pregnancy appears to increase the risks, said Dr. David E. Soper, vice chairman of the obstetrics and gynecology department at the Medical University of South Carolina.

Abortion experts have been at a loss to explain why four of the deaths occurred in California. Initially, the F.D.A. investigated whether the pills used in California might have been contaminated, but an agency official said tests had found no evidence of contamination.

Another theory concerned the role a dry climate might play in encouraging the growth of Clostridium sordellii, which lives in soil.

Some experts believe that pregnant women who take RU-486 with another drug, misoprostol, are more vulnerable to infection. RU-486 by itself ends early pregnancies, but the pill is routinely given along with misoprostol, which causes uterine contractions that expel the dead fetus.

After examining many studies, the F.D.A. in 2000 approved a protocol that requires women to take misoprostol orally. But abortion providers have instead instructed women to insert misoprostol vaginally.

Some scientists say the vaginal insertion may introduce bacteria along with the drug.

"The tablets are small, and women don't necessarily know where their vagina begins and ends," said Dr. Phillip G. Stubblefield, a professor of obstetrics and gynecology at Boston University.

If women are not careful, Dr. Stubblefield said, they can easily drag the tablet across the perineum, between the rectum and vagina, and contaminate the vagina with the bacteria.

Other experts dismissed the contamination idea. "I'm still using the vaginal route," said Dr. Mitchell Creinin, director of family planning at the University of Pittsburgh.

In 2004, the F.D.A. put strong warnings regarding the risks of infection on RU-486 labels.

There has been no hint that the F.D.A. is considering further restrictions on the use of the drug.

Abortion rights advocates are also concerned over the F.D.A.'s indefinite delay in deciding whether to approve over-the-counter sales of Plan B, an emergency contraceptive that has a use different from that of RU-486. Most agency observers blame politics for the delay.

After the deaths, the National Abortion Federation's insurer insisted that its clinics use the F.D.A. protocol when providing abortion drugs or face the loss of their medical malpractice insurance.

In the United States, some abortion doctors have decided against using RU-486 altogether. Among them is Dr. Peter Bours of Portland, Ore., a member of the federation.

"I'm not sure I want to be in a shared insurance group policy with people doing medical procedures because you share that risk," Dr. Bours said.

Until March, Planned Parenthood, the nation's largest abortion provider, continued to instruct its doctors to give misoprostol vaginally, said Dr. Vanessa Cullins, vice president for medical affairs. But with the sixth death, in March, the organization now uses an oral protocol.

The deaths linked to RU-486 have created an unusual split in the small world of abortion providers, a growing number of whom say that they will not dispense the drug. The risk of death with pill-based abortions now appears to be about 10 times that of surgical abortions.

Dr. James McGregor, a visiting professor of obstetrics and gynecology at the University of Southern California, said RU-486 might make women more susceptible to Clostridium sordellii in part because the drug may inhibit mechanisms that moderate immunity. In cases of toxic shock, the body's immune response becomes lethal.

"The body ends up attacking itself," and RU-486 may encourage this attack, Dr. McGregor said.

Dr. Soper, of South Carolina, said that once a Clostridium sordellii infection took hold, there was little hope.

"I'll never forget when I was a fellow in San Diego, and I had this post-partum patient literally die before my eyes," Dr. Soper said.

After the patient gave birth, she told her husband that she felt extremely tired. He took her back to the hospital, and she died quickly, Dr. Soper said.

The oral administration of misoprostol is more common in Europe, but vaginal use there has been growing.

Ann Furedi, chief executive of the British Pregnancy Advisory Service, which provides 25 percent of all abortions in Britain, said her agency relied on vaginal drug insertion.

Clinics in Sweden and Hong Kong do the same, and vaginal use is growing in France, according to Gynuity Health Projects, a New York group that supports the use of RU-486 around the world.

In the debate over RU-486 versus a surgical abortion, women have diverging opinions. A 43-year-old New York mother of two who said that she had had "every kind of abortion," told her abortion provider during a counseling session recently that she would consider only a pill-based procedure.

"I do not like doctors and hospitals," said the woman, who did not wish her name to be used for privacy reasons. "Both of my children were born at home without anything. And that's how I want to have my abortion: in home, in my privacy, at my own pace and without somebody's other agenda over me."

Reached at home after taking both abortion drugs, the woman said she felt fine. After going to the bank, the pharmacy and the deli, she planned to nap much of the day, she said.

Anne Hawkins, 36, also of New York, said she, too, had had both pill-based and surgical abortions. But taking RU-486, she said, "was the worst experience, the most physically and emotionally painful thing, that I've ever been through."

Ms. Hawkins had another abortion in March, and she chose surgery.

"It was 10 minutes, max, and then it was over," Ms. Hawkins said of the surgical procedure. "The pill for me was the experience of having a baby. Contractions for 10 hours, sweating, screaming, being by myself. It was emotionally scarring and physically horrible."

Zeina [Not the courageous film-maker's real name]: Iraq: The Women's Story Print E-mail
 UK -- Monday 8th May, 20:00 hrs

Iraq: The Women's Story

 

The invasion of Iraq heralded promises of freedom from tyranny and equal rights for the women of Iraq. But three years on, the reality of everyday life for women inside Iraq is a different story. To make this film, two Iraqi women risk their lives to spend three months travelling all over the country with a camera to record the lives and experiences of women they meet. Dispatches: Iraq: The Women's Story provides a compelling account of a life inside Iraq that is rarely seen on news bulletins: stories of ordinary women whose struggle to survive has only worsened since the war.
Franny Armstrong: Drowned Out Print E-mail

 

Spammer Films

Click above banner, and scroll down to lower RHS "Of course we feel like crying WATCH" to view DROWNED OUT,  75 mins, 2002. UK/ India, Dir: Franny Armstrong

Shot over three years by Director Franny Armstrong (McLibel), Drowned Out tells the true story of one family's inspired stand against the destruction of their land, homes and culture. The 75 minute no-budget, no-electricity, no-Hindi documentary has been seen by more than 14 million people.

Three choices. Move to the slums in the city, relocate to a barren resettlement site with no drinking water or stay at home and drown.


The people of Jalsindhi in central India must make a decision fast. In the next few weeks their village will disappear underwater as the giant Narmada Dam fills.

Bestselling author Arundhati Roy joins the fight against the dam and asks the difficult questions. Will the water go to poor farmers or to rich industrialists? What happened to the 16 million people displaced by fifty years of dam building? Why should I care?

Drowned Out follows the Jalsindhi villagers through hunger strikes, rallies, police brutality and a six year Supreme Court case. It stays with them as the dam fills and the river starts to rise.  
 
"At once angry, compassionate, disturbing and yet empowering, it makes for urgent and necessary viewing" - TIME OUT

"Heartbreaking" - SAN FRANCISCO CHRONICLE

"Documentaries rarely, if ever, come better than this" - BERMUDA ROYAL GAZETTE

"Masterfully crafted" - ONEWORLD AWARDS JURY

"Quiet, fierce, beautiful" - NEW INTERNATIONALIST

"A real eye opener ... powerfully intimate" - FILM JOURNAL INTERNATIONAL

"A film of enormous heart, grit and insight, that is both taut political essay and enormously moving plea" - SAN FRANCISCO FILM FESTIVAL JURY

Muriel Spark: Feminist author, February 1 1918 - April 14 2006 Print E-mail

Sunday, April 16, 2006


Dame Muriel Spark at the Edinburgh International Book Festival 2004. Picture: Bill Henry via The Scotsman [scroll down for article]

Author Muriel Spark dies in Italy

Rome, Reuters: Nominated twice for the prestigious Booker Prize - in 1968 for Public Image and in 1981 for Loitering with Intent - Ms Spark won the Bram Stoker prize in 1987 for her biography of Mary Shelley.
 
Scottish-born novelist Muriel Spark, 88, died in Italy on Friday. She will be buried in Tuscany, an Italian official said.

Describing Ms Spark as an open person, Mayor Massimiliano Dindalini said, “She was both fascinating and down-to-earth at the same time. Her loss will be very difficult to overcome.”

Though Ms Spark wrote 24 novels, three biographies and several short stories, she is best known for The Prime of Miss Jean Brodie, a novel about a young teacher stirring thoughts of emancipation at an Edinburgh girls’ school before the second world war. The book was made into a critically-acclaimed film starring Maggie Smith in 1969.

Ms Spark died on Friday in Florence after battling health problems since last year. She was born in February 1918 in Edinburgh to a Jewish father and Anglican mother.

She married in 1937 and moved to Southern Rhodesia - now Zimbabwe - but the marriage did not last. During World War Two, she worked for the Foreign Office on anti-Nazi propaganda.

A self-styled “experimentalist”, Ms Spark was hailed as being far ahead of her times, both in her style of writing and the subjects she chose. She used sharp satire to expose the pettiness and vanity pervading all facets of life and death.

Her last novel, The Finishing School , was published in 2004.

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RU486 Wake-up call: Medical admission that Mifeprex FAR riskier than surgical abortion Print E-mail

Refer Feminist Research 1991:


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Sunday April 1 2006


HEALTH  [Read MORE]

Some Doctors Voice Worry Over Abortion Pills' Safety

By GARDINER HARRIS

Abortion rights advocates once hoped that RU-486 would prove at least as safe as surgical abortions and largely end the abortion wars by making access widely available and very private.

But in the wake of reports in March that two more women had died after taking abortion pills, some doctors say they are increasingly uneasy about prescribing them.

"None of these women should be dying; it's shocking," said Dr. Peter Bours, an abortion provider in Portland, Ore., who is rethinking whether to offer pill-based, or medical, abortions.

Dr. Warren Hern, a provider in Denver, said the latest reports demonstrated that abortions by RU-486, or Mifeprex, were far riskier than surgical ones. "I think surgery should be the procedure of choice," Dr. Hern said. Pills, he said, "are a lousy way to perform an abortion."

When followed up by another drug, misoprostol, Mifeprex induces a miscarriage that generally occurs within two weeks. To some women, this process seems more natural than surgery, and the expulsion of the fetus often takes place at home, which some also prefer.

But the number of women who have died in the United States after taking Mifeprex has now reached six, according to reports received by the Food and Drug Administration; another has died in Canada.

The drug has been used in more than 560,000 abortions in this country, so the reported risk of death is a bit more than one in 100,000. Some deaths may have gone unreported, meaning the real risk may be even higher.

By contrast, the reported risk of death associated with surgical abortion is one in a million, according to studies ­ one-tenth as high.

Quite apart from death, women who undergo medical abortions suffer an increase in complications, some doctors say. A 1999 study of 377 women found that those who took the pills suffered significantly higher levels of pain, nausea, vomiting and worrisome bleeding than those who underwent surgical abortions.

Pill-based abortions are also 5 to 10 times as likely to fail as surgical ones, and those that do fail require a follow-up surgical procedure in women whose pregnancies by then may have advanced significantly. Generally, the later a woman undergoes an abortion, the greater the risks.

The causes of the two most recent deaths are unknown, but all five previous fatalities resulted from infections with an unusually virulent bacterium called Clostridium sordellii.

F.D.A. officials said that there was neither a definitive link between the infections and RU-486 nor any concrete evidence that the drug increased the risk of infection beyond that found in women who underwent surgical abortions, suffered natural miscarriages or gave birth.

Dr. Cynthia Summers, a spokeswoman for Mifeprex's manufacturer, Danco Laboratories, said a comparison of the risks of medical and surgical abortion was unfair because, she said, reports of problems with surgical procedures were poorly collected.

And Dr. Vanessa Cullins, vice president for medical affairs at the Planned Parenthood Federation of America, the nation's largest abortion provider, said, "Both surgical and medication abortion are extremely safe and effective procedures."

The two kinds of abortion "have comparable risks with the exception of what we have recently seen as it relates to septic fatalities," Dr. Cullins said.

Experts debate whether the method of administration has played a role in the deaths. When the F.D.A. approved Mifeprex in 2000, officials instructed doctors to give it and misoprostol orally. But Planned Parenthood and other abortion providers soon started instructing women to insert misoprostol vaginally at home two to three days after taking Mifeprex. This method allowed women to take lower doses of misoprostol and meant fewer office visits for abortion providers.

All five women who died of infections had inserted misoprostol vaginally, Dr. Cullins said. In France, where no deaths have been reported, the oral method of administration is still standard. Planned Parenthood announced on March 17 that it would go back to giving misoprostol orally.

Opponents of abortion have long argued that RU-486 is not safe and should be withdrawn. Some abortion rights advocates now concede that their counterparts are somewhat right.

"The complications associated with RU-486 far exceed the complications of surgical abortion," said Dr. Damon Stutes, a provider in Reno, Nev., who refuses to offer pill-based abortions. Dr. Stutes, whose clinic has been bombed, said he was uneasy about agreeing with abortion opponents on anything.

"But the truth is the truth," he said.

Still, Dr. Stutes and some other physicians interviewed did not call for Mifeprex's removal from the market, since the drug may be the only option available to women in some rural areas. But women who have a choice should be steered toward surgical abortions, these doctors said.

"One needs to tell patients that the medical procedure, even though it seems more natural, may be more likely to result in death," said Dr. Phillip G. Stubblefield, a professor of obstetrics and gynecology at Boston University.

Dr. Stubblefield speculated that women who had inserted misoprostol vaginally might have accidentally dragged the pill across the skin near the anus, inserting bacteria that then flourished. But Dr. Mitchell Creinin, director of the division of gynecologic specialties at the University of Pittsburgh, said the method of drug administration had nothing to do with the deaths. Miscarriages, both induced and natural, can lead to infections, he said.
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