NEW YORK, August 9 (C-FAM) A researcher dedicated to bringing risky medical abortion to developing countries has set her sights on Bangladesh. Her new study demonstrates a plan to expand access to abortion pills by using misleading language and an unusual set of laws.
The study proposes redefining “menstrual regulation” to include medical as well as surgical methods.
Since the 1970s, “menstrual regulation” took advantage of a legal loophole in Bangladesh, which outlaws most abortions. After missing her period, a woman could undergo a uterine evacuation, ostensibly to induce her menstrual cycle. While the procedure was technically identical to an early-term abortion using a manual vacuum aspirator, it was not legally classified as an abortion unless a test confirmed the pregnancy first.
“Abortion remains a very sensitive topic in Bangladesh,” wrote Julie DaVanzo and Mizanur Rahmanin in an article on Matlab, a region that has been the focus of several studies on abortion and family planning. “In fact, many of the restrictions for MR [menstrual regulation], particularly its availability only before pregnancy is clinically confirmed, are to reinforce the perception of MR as something other than abortion.”
The new study reaffirms that any such perception is merely semantic. The method being tested is identical to the procedure for medical abortion, and the authors compare their results to those obtained using “this regimen in other settings.” In the other settings, no euphemisms for abortion were used.
Study coauthor Dr. Beverly Winikoff is a longtime champion of medical abortion. Her organization Gynuity led the effort to convince the World Health Organization to classify drugs that can be used for abortion as “essential medicines.”
Collaborating with Winikoff on the project were researchers from the International Center for Diarrheal Disease Research in Bangladesh. In addition to studying diarrheal disease, the group focuses heavily on reproductive health. According to its website, “One of the greatest challenges in Bangladesh is population control,” and their efforts to reduce births range from the distribution of “behavioral change materials” to this recent study aimed at increasing the acceptability of medical abortion by another name.
While the study concluded that medical abortions would be feasible in Bangladesh, health care providers in focus groups raised concerns about drug quality and medical oversight given the lack of regulation of pharmacies and the widespread availability of drugs without prescription. They also noted that the trial did not look at rural areas.
A doctor who reviewed the study points out that of 651 study participants, 22 were lost to follow-up after being given the drugs. “Are they dead?” asked Dr. Donna Harrison. “Who knows?”
Today, “menstrual regulation” remains largely unique to Bangladesh, a product of the majority-Muslim nation’s willingness to turn a blind eye to early abortion while appearing to enact tough restrictions on it overall. Abortion promoters in the early 1970s saw its potential for gaining unwitting acceptance of abortion methods. Gynecologist Geoffrey Davis posited in 1972 that the euphemism could have a worldwide impact.
“Perhaps one of the greatest contributions that somebody could make to this is a new term that would do for abortion what “family planning” did for “birth control,” Davis wrote. “If we could call this something more acceptable than abortion, we could get the public’s attitude changed a little faster.”