Cytotec: Rebirth of the “Coat Hanger” Abortion?

This feature was originally published for WOMAN.ca, an online lifestyle magazine for women. 

CYTOTEC

For movie-goers who watched Revolutionary Road or For Colored Girls this past film season, two scenes are likely seared in your mind’s eye: first, there’s Kate Winslet’s coat-hanger abortion as April Wheeler in the final scenes of Revolutionary Road and the even more horrifying back-alley abortion scene in Tyler Perry’s For Colored Girls. 

Revolutionary Road Abortion 1

Revolutionary Road Abortion 2

Both films call attention to the painful and life-threatening harms women inflict on their bodies in order to rid themselves of an unwanted pregnancy. What’s more, both films demonstrate how issues surrounding reproductive rights play out in the everyday lives of women—both in the 1950s and today.

When discussing abortion issues, I ground myself in these scenes to avoid becoming theoretically wrapped in in “abortion” as an abstract concept, and in order to tie myself to the real woman who still remains hidden behind political discourses of women’s reproductive rights.

When people ask me whether or not I believe in abortion, I’m confused: it’s like they’re asking me whether or not I believe in French cinema or stand-up comedy: abortion, like these other examples, exists in our worlds and take place whether or not we believe in it. Abortion, unlike Santa Claus, isn’t contingent on my beliefs, I make this distinction because whether or not we (politically and legally) recognize abortion as an issue that needs addressing, it’s a serious reality effecting the lives of girls and women.

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Now, to ask my stance on abortion, that’s a different (and better) question, and one I’m happy to answer: I’m pro choice. I’ve never been in the position to have to make that choice, but I’m comforted to know I live in a country where I have a say over my body and my reproductive capacities. Despite my liberal attitudes towards women’s reproductive rights, the thought of a do-it-yourself abortion pill chills my bones, inducing the same reaction as watching Winslet’s bloody coat hanger scene.

Cytotec, often referred to by its chemical name misoprostol, is an oral tablet that contains anywhere from 100-200 mcg’s of misoprostol. When swallowed, Cytotec initiates a cervical compression that terminates pregnancy. Although the drug was originally manufactured to reduce ulcers, it has quickly seeped onto the black market in Europe and North America as a quick-and-easy DIY abortion pill.

According to health columnist Ian Hodder, Cytotec has already become known as “the underground abortion pill” in Latin America, where abortions are illegal. As Dr. Emily Godfrey, family medicine professor at University of Illinois, explains, women who take Cytotec “are not necessarily completing [the abortion] on their own, but they’re initiating the process.” Godfrey, a member of the Association of Reproductive Health Professionals, says that women take Cytotec, then “show up to emergency rooms, are told they are having a spontaneous miscarriage, and are offered a completion.”

Chemically, Cytotec isn’t that much different than Plan B, the over-the-counter morning after pill, but unlike Plan B, which prevents fertilization if taken within the first 72 hours after having sex, Cytotec can be used at any stage of gestation.

On the one hand, the off-label abortion pill makes termination of pregnancies simple and easily accessible; compared to surgical abortions, medical abortions are less invasive, cost less, and are less complicated to administer. Further, medical abortions leave no visible scarring on a woman’s body. On the other hand, the pill has once again made abortion a do-it yourself service, removing reproductive rights from political conversations and public institutions.

Unlike clinically supervised abortions, the DIY abortion pill risks bleeding, and in some cases, the drug can cause stroke and even death. According to Mark Bower, a lawyer who specializes in health and birth-related cases, Cytotec isn’t safe. Bower is collecting information on instances where Cytotec was used to induce labor, and making a case against using the drug in the reproductive realm. Bower argues that Cytotec has not been tested for reproductive uses. The drug can cause “abnormally strong uterine contractions (hyperstimulation or tetany) so strong that the uterus ruptures, resulting in severe injury or death of the mother. […] It can cause such heavy bleeding that to save the mother’s life, her uterus must be removed (hysterectomy), leaving her incapable of bearing another child, and disrupting her natural hormones.”

Other research also suggests Cytotec is used to induce labor in the final trimester of a woman’s pregnancy, which is clear evidence that medical practitioners have yet to understand the full scope of this drug: should it be used for abortions, or should it be used to induce labor? What’s clear is this: if Cytotec is being used as an off-label abortion pill—and it is— then abortion issues are once again being forced into the private sector, hidden from public discourses and institutions that treat reproductive rights. While Cytotec may be easier/cleaner/ more affordable/more accessible/ safer (?) than surgical abortions, we need to think about how the widespread mis/use of this pill pushes abortion from the political sector and into bathrooms and back alleyways —and how different is this than the harmful coat-hanger methods that prevailed in the 1950s?

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