Dr. David Berkans recalls how his classmates received abortion care when he attended Ohio State University in Columbus in the 1960s.
“There were a few corners down on Cleveland Avenue,” Berkans says. “You showed up there and a car came, you went in, you gave him money, he took you to have an abortion, you’re back.”
By the time he graduated from medical school in 1973, the US Supreme Court had issued its ruling Roe vs. WadeLegalizing abortion care at the national level. Berkans gave birth to children and terminated pregnancies, serving the patients of choice, no matter what their decision. Now, nearly 50 years later, when the court is set to reverse its landmark decision, Berkins is concerned about how the people of Ohio will receive abortion care in a ro-ro world.
“There are going to be some deaths related to this. There will be very serious consequences,” Berkans says.
Instead of getting in a car to drive people to a secret abortion site, Berkins says the new version of the back-alley abortion procedure will roll out online when patients are asked to terminate a pregnancy from out-of-state and black-market vendors. Will order pills. ,
“The Internet has changed everything,” says Berkans.
Most people who terminate a pregnancy do so with a range of prescribed pills — about 47 percent in Ohio, about 54 percent in the United States. This number has grown rapidly in recent years; In 2015, only four percent of abortion treatments in Ohio were performed using medication. The first pill usually prescribed is mifepristone (brand name Mifeprex), while the second pill, misoprostol (brand name Cytotec), is taken 24 to 48 hours later.
Berkans, who runs three abortion clinics — two in the Cleveland area, one in Toldeo — said that about 75% of the abortion care he provides is through the pill.
“Part of it is how we run our clinic. We try to get people very, very quickly,” Berkans says.
Berkans says that if patients are forced to find pills to terminate their own pregnancies online, that time will be compromised. The abortion pill is currently only an option during the first 10 weeks of pregnancy. After nine weeks and six days, Berkans says, patients are at risk for heavy cases of bleeding, cramping, and more complications that may require medical attention.
While pregnancy tests can detect pregnancy very early, Berkans says that most women don’t know they are pregnant until after their first missed period, which can be more than six weeks. If Ohio’s trigger ban is passed and abortion care is outlawed, it would force patients to wait for pills from the state or overseas to ship in time to take pills safely. . The Berkans don’t like those constraints.
“I think what’s going to happen is people will find out they’re pregnant, they’ll find these sites, they’ll order pills, the pills will come and it’s going to take a week or two to get the pills, so they’re already They’re just going to move on and it’s going to be a very high probability that they’re going to have problems. And there’s not going to be anyone to call for them,” Berkans says.
Patients who take the right abortion pills within the first ten weeks are likely to have a successful experience, says Berkans, but the uncertainty of how far along the pregnancy the meds can be combined with shipping delays still poses a risk. Is part of. Making sure you’re getting the right pills online is Berkens’ next fear.
“What you’re going to see is a lot of websites — some are going to be legit, some are not going to be legit,” Berkans says. “If you just go on the internet and look at ‘abortion,’ you get these crisis pregnancy centers, which have very professional and misleading websites meant to confuse women and prevent them from having abortions. I guarantee you these anti-choice people are going to put up websites like this, and if people find a drug it will probably be smarties [candy] or something else.”
Berkans says that even if a patient can’t get their hands on both misoprostol and mifepristone, misoprostol can work in some cases—but the two drugs together are most effective. If the supply of pills is limited, Berkans says, there will be higher rates of incomplete abortions, putting patients at greater risk for medical emergencies and — depending on the new laws that may come up — criminal charges.
“Infections, massive bleeding, that kind of stuff,” Berkans says. “There’s products left out there, and they’re going to bleed and need to go to the emergency room.”
an emergency room nurse spoke citybeat At a Planned Parenthood rally in Cincinnati in May. She did not want to reveal her name for fear of reprimand from her employer.
“We don’t get training for this at all,” says the nurse. “They are risking their bodies, risking their lives.”
She says current emergency room staff work almost entirely in a world where abortion care is accessible. Now, she says, she must prepare for patients who are administering drug abortions without a doctor’s assistance or receiving surgical abortions in a non-therapeutic environment.
“They won’t be able to provide information about what’s been done to them,” she says of the employees. “We’re talking permanent bodily harm. Infection. Death.”
Whether or not Ohioans will be able to legally order medical abortion pills through the mail remains a legal gray area in the row-cry world. Berkans says that because the state cannot prosecute out-of-state doctors, it is only a matter of time before lawmakers go after patients seeking to terminate their pregnancies.
“The opponents of choice always say that they are not after women. They call me a criminal,” says Berkans. “But my parking is full and I don’t advertise. People look for us. When there’s no physician in the state to prosecute because it’s all coming out of state, you know they’re going after women.
Fear of trouble with doctors or the law Berkins fears some patients will need help staying away from emergency rooms. He recommends those searching for abortion pills online try ordering from a website with a customer support phone number — some patients may call to speak with a doctor or nurse.
“I would look for a place that includes at least one therapist,” Berkans says. “If you have a problem, there’s a number to call and someone will answer who might be able to really help.”
Berkans emphasizes that MIsoprostol and mifepristone are highly safe and effective, but patients who are taking blood thinners or are anemic should be careful, as they can lose dangerous amounts of blood.
He points out that even if they are not pregnant, many people are getting abortion pills ahead of an upcoming US Supreme Court ruling, which is expected sometime in June.
“They have a long expiration period,” Berkans says. “Women are very smart people. They’re going to find a way out.”