I can see now why women die from the RU486 + Cytotec combo.

Just when one might think:
a) you've heard it all, or
b) we make this stuff up.

We received this email from a reader who wishes to remain anonymous:

Dear Emily & Annie:
I love your blog & greatly admire the work that you're doing.

I had an experience this week that made me puzzled & even a little angry. I miscarried at 8 1/2 weeks, and was seen by the midwife who works with my doctor. She confirmed by ultrasound that my baby had no heartbeat, then told me I had two options. The first was that she could prescribe something for me that would help the miscarriage along, and that I could go home and rest while it was happening. The other option was a D&C, but--

"We don't do those here [the hospital is a Catholic hospital], but we have someone we can refer you to. But you should know that some women who see him are like you, they had a miscarriage and are sad to lose their child. Others are there because they chose not to use birth control, and they are making that choice."

I started to cry and said that I couldn't go to a place like that, so we decided that I should go with the first option, get a prescription then go home. Because I'm traveling for work this week, she recommended that I make an appointment for a D&C anyway, just in case the miscarriage didn't complete at home. She then told me that if I didn't want to go to their doctor, I could "look up abortion in the yellow pages or call Planned Parenthood."

Anyway, I took the prescription, which was Cytotec (misoprostol) and 3 hours after taking it ended up in the emergency room of the public hospital near me after passing out from the pain and having my blood pressure drop to 80 over 40. It was discovered there that I had a uterine infection and I had a D&E the next morning.

I don't understand why a Catholic hospital wouldn't perform a D&C for a baby who is already dead? Especially if the alternative is to send women to an abortionist or Planned Parenthood--that position seems so hypocritical to me.

As an aside--somehow I got on Planned Parenthood's mailing list & despite repeated requests they will not remove my name. Have you heard of this happening? Any tips to get them to leave me alone, especially now?

Thanks so much for listening, and God bless you.

(this is okay to post w/o my name, if you want, but if it's outside the scope of your blog, i totally understand--it felt good just to write it down.)

My reply:

I don't know why a Catholic hospital wouldn't deal with this situation and instead refer you to PP. I can only guess an answer. Maybe it had to do with such a service not getting reimbursed by an insurance company? I know that sounds crass. I would think that they could do D&C but perhaps not on pregnant women, which technically they still considered you to be despite no heartbeat.

I wish they had told you about the side effects of Cytotec. First of all, it seems they erred in giving it to you, perhaps even doubly so, as you were past the "under 50 days" pregnant requirement for dispensing that in the first place. It isn't approved, to my knowledge, for anyone past that point as you were if you were 8.5 weeks.

Also: "On Aug. 23, 2000 Searle issued a letter to all Health Care Practitioners entitled 'Important Drug Warning Concerning Unapproved Use of Intravaginal or Oral MISOPROSTOL [CYTOTEC] in Pregnant Women for ... Abortion.' It states in part: 'Serious adverse events reported following off-label use of Cytotec in pregnant women include maternal and fetal death; uterine hyperstimulation, rupture or perforation requiring uterine surgical repair, hysterectomy [removal of uterus] or salpingo-oophorectomy [removal of ovaries and Fallopian tubes]; amniotic fluid embolism; severe vaginal bleeding, retained placenta, shock, fetal bradycardia and pelvic pain.'

I'm not sure if the following from iVillage.com is current, haven't time to check:

"Cytotec's only FDA-approved use is treating ulcers. In August 2000, Searle, Cytotec's manufacturer, sent physicians a letter reminding them that Cytotec was not approved for use as a cervical ripening agent and that it was contraindicated for use in pregnancy (14). The letter listed serious adverse effects associated with using Cytotec, including maternal or fetal death, uterine rupture, and severe vaginal bleeding and shock."

This site has more, and references the CDC warning.

Further info on the approved FDA dispensing procedures:
"The approved Mifeprex regimen for a medical abortion through 49 days’ pregnancy is:

Day One: Mifeprex Administration: 3 tablets of 200 mg of Mifeprex orally at once
Day Three: Misoprostol Administration: 2 tablets of 200 mcg of misoprostol orally at once.
Day 14: Post-Treatment: the patient must return to confirm that a complete termination has occurred. If not, surgical termination is recommended to manage medical abortion treatment failures.

The safety and effectiveness of other Mifeprex dosing regimens, including use of oral misoprostol tablets intravaginally, has not been established by the FDA."

This appears to be the label for the full "approved Mifeprex regimen". It sounds like you didn't get both drugs but still is valuable information to have.

How to get PP off your back: I'd call (and write) your state's attorney general and your prolife group. Tell them you've called and asked PP in writing to take you off the list (show them the letter), and you want the harassment to stop. Both those entities should make a case for you. If that fails, contact any attorney you are friendly with who'd be willing to write a simple letter (which you would write the draft for, they'll edit it to legalspeak), that they'd be willing to put on their letterhead, telling PP that they'd better cease and desist with the harassment of mailing you unwanted mail. If the attorney friend wants to charge more than say $50 or $100, then you could try contacting a prolife legal firm to do similarly, like one of the ones listed in our sister blog Abortion Pundit under "LEGAL FOLK" in the sidebar. They are usually so busy, they might not get to do it, but it could be good to at least talk with someone on the phone and get some advice.

I hope this helps. Do let us know how it all turns out. Prayers and hugs,
Annie

She wrote back:

Thank you so much for your kind words & medical data. I almost went into shock--it's a good thing I was not a teenage girl trying to have a secret abortion.

A good thing, indeed.

AN END NOTE: You and our readers also might want at least to know about this petition to the FDA to "[establish] ... much better regulation of" Cytotec. I don't believe I can sign it though, as it has language I can't accept: "the drug may well have a legitimate use ... in combination with RU-486 for abortion...We also recognize the right to early pregnancy termination."