Like so many people who encountered the recent NPR piece on mothers suffering through miscarriage, my heart broke for the patients forced through the agony of waiting after using a less effective drug to end the pregnancy when there was a far quicker and more successful option available. However, that sorrow was overshadowed by the furious anger I felt for the doctors managing their care – because it is them, not the FDA – who are standing in the way of patients getting the mifepristone that would end their suffering faster.
As NPR reported, mifepristone is highly regulated, meaning a doctor does need to go through additional protocols in order to have it stocked in their office. But the actual requirements aren’t onerous at all, especially not for an OB-Gyn or other doctor doing pregnancy related or reproductive healthcare. All that is needed is for the provider to have a medical license, as well as the medical knowledge and ability to refer a miscarrying patient for a D&C should the medication fail.
Not even perform a D&C. Just refer.
Just like having Rhogam shots in the office to provide for a patient who is RH negative, or methotrexate if a patient has an ectopic pregnancy, mifepristone could easily be stocked in offices to have a supply on hand. The cost of mifepristone is the same as a Rhogam shot- nothing exorbitant! Unlike these other medications, though, mifepristone carries the stigma of being thought of as an “abortion drug,” and the added issue of drawing the attention of rabid anti-abortion activists who would rather watch women suffer and put their health in jeopardy through a drawn out miscarriage than risk the possibility that even one unwanted pregnancy might be ended with secretly in the process.
There is absolutely no reason for a hospital or doctor not to be stocking mifepristone other than complacency and cowardice in our profession. Mifepristone has been used to accelerate the process of pregnancy loss in non-viable pregnancies for two decades, with repeated studies showing that the process is both safer and more efficient. Yet every month I see patients coming in to have D&Cs after weeks of undergoing multiple rounds of misoprostol-only miscarriage management from doctors who simply don’t understand how the process works, or care enough about the physical and emotional well being of a patient who is suffering a drawn out loss of a wanted pregnancy. Patients who after waiting for a failing pregnancy to end eventually end up in a hospital surgical center with huge deductibles due for a D&C when she could have already been done and potentially trying once more to get pregnant again.
Make no mistake about it – doctors, led by abortion opponents, are letting miscarrying mothers suffer in order to punish abortion patients.
It doesn’t have to be this way. Doctors, whose first responsibility is to help their patients and provide the best care possible, could easily stock mifepristone and help any current and future mother undergoing a miscarriage – but only if they are brave enough to break the stigma around this safe, legal, efficient medication regime and stock it in their practices all across the nation. Instead, they’ve refused and tried to pin the blame on the FDA and NPR let them pass the buck.
The question is, are you going to let them pass the buck, too?
Dr. Gabrielle Goodrick 