Abortifacients; Drugs & Herbal

 

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The book New Handbook for a Post-Roe America: The Complete Guide to Abortion Legality, Access, and Practical Support by Robin Marty has a chapter that basically goes over do-it-yourself abortion care.

The whole chapter which is 30 pages has been scanned into a pdf here.

 

Abortifacients

abortifacient, any drug or chemical preparation that induces abortion.

For centuries, herbal abortifacients have been made from infusions or oils of plants such as pennyroyal (Mentha pulegium), angelica (Angelica species), and tansy (Tanacetum vulgare). Such preparations are no more likely to terminate a pregnancy than they are to induce potentially lethal reactions such as vomitinghemorrhages, and convulsions in the women who take them. Truly effective abortifacients were not developed until the end of the 20th century, when the biochemical processes behind cell division and growth and the role of hormones in reproductive processes were understood. The most common agents of modern medical abortion include mifepristone (also known as RU-486), a steroid, and methotrexate, an antimetabolite; both are used during the early weeks of pregnancy in conjunction with the synthetic prostaglandin misoprostol.

Misoprostol, administered in prescribed doses either orally or as a vaginal suppository, causes the uterus to contract much as it would at the beginning of labour or during a miscarriage. Taken alone, it is rarely sufficient to expel the embryo and placenta from the uterus, but it is very effective as a sequel to treatment with mifepristone or methotrexate.

Mifepristone works by competing with progesterone for receptors on cells. By occupying receptor binding sites, it prevents the hormone from stimulating the inner lining of the uterus to prepare for implantation by a fertilized ovum. When administered early in pregnancy, mifepristone causes the breakdown of the uterine lining; a follow-up dose of misoprostol induces expulsion of the embryo and other uterine contents.

Methotrexate, administered by injection, blocks the rapid cell division characteristic of embryonic and placental growth. Once this growth is ended, administration of misoprostol completes the abortion.

Now that Roe is gone, state laws banning abortion outright or early in pregnancy are now constitutional. To find out the current status of abortion in your state, experts and advocates recommended several websites, including abortionfinder.orgabortionfunds.org, and ineedana.com, which should have up-to-date information about whether and when abortion is legal in your area and where to access care.

The Center for Reproductive Rights and the Guttmacher Institute also maintain maps and other webpages that track state legislation on abortion rights. You can also contact your local abortion clinic or abortion fund, which will have the best information about what kind of care is available.

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Medication abortion is a nonsurgical procedure that involves taking a combination of prescription medications called mifepristone and misoprostol to end a pregnancy of up to 11 weeks. Mifepristone blocks progesterone, the hormone needed for a pregnancy to continue, and then misoprostol causes the uterus to expel its contents.

The method has been widely tested, has a high success rate, and has resulted in very few incidents of hospitalization. The medications are approved by the FDA, which allows healthcare providers to administer the pills in person or send them to patients by mail, but several states have adopted laws restricting how the medications are dispensed (more on that later).

Plan C provides state-by-state information on how to access medication abortion — and the potential legal risks you may face — where you live. Organizations like Abortion on DemandAid Access, and Hey Jane provide the pills by mail. The Miscarriage and Abortion Hotline helps people navigate how to use the medications on their own. If/When/How’s Repro Legal Helpline, which can be reached by phone at 844-868-2812 or online via reprolegalhelpline.org, is also a resource for people seeking secure and confidential legal guidance on how to self-manage an abortion.

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The answer to this question is a bit more complicated, Diaz-Tello said. While only three states — Oklahoma, South Carolina, and Nevada — currently have laws criminalizing self-managed abortion, many more have adopted laws restricting access to medication abortion. According to the Guttmacher Institute, 19 states prohibit the use of telemedicine to prescribe medication abortion, and 32 states require clinicians who administer the pills to be physicians, rather than nurse practitioners or other licensed medical professionals.

One important thing to know is that healthcare providers wouldn’t be able to tell if you’re having a miscarriage or a medication-induced abortion when taking the pills orally, so experts said it’s not necessary to share that information with hospital staff in the event you needed to seek medical attention.

“There’s no difference between a prompted miscarriage and one that occurs spontaneously, and there’s no difference in the care that they would seek,” Diaz-Tello said. “The pills themselves are not clinically relevant.”

However, when taken intravaginally, the pills can leave residue, said Dr. Ghazaleh Moayedi, an obstetrics and gynecologist who provides abortion care in Texas. Moayedi said it feels wrong to tell people to only use medication abortion orally, noting that taking it intravaginally can reduce some of the side effects of the drugs, like diarrhea, and can be good for people with certain medical conditions. Still, she agreed that people who are accessing pills “in a clandestine fashion” should take them orally for that reason.

The Repro Legal Helpline also recommends using a VPN to hide your internet search activity and encrypted messaging services like Signal to protect your private conversations. When people are prosecuted for self-managing an abortion, law enforcement can gain access to their phones and computers and use information gleaned from those devices.

“This isn’t something that’s unique to prosecutions related to self-managed abortion,” Diaz-Tello said. “This sort of law enforcement intrusion into people’s private data has been relatively commonplace.”

One suggestion being passed around is hoarding the pills:

It’s an idea that has merit: Mifepristone has a shelf life of about five years, misoprostol about two, and both drugs work better the earlier in a pregnancy you take them. In states that are ramping up abortion restrictions, there’s often a race against the clock to access care. In Texas, for example, if you don’t realize until eight weeks in that you’re pregnant — which could be only a couple of weeks after a missed period — you would have already passed the state’s new legal deadline for obtaining abortion pills. But if you had already stored them in your home, or your friend or neighbor had, then you’d be able to take them.

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Rebecca Gomperts, the Dutch physician who in 2018 founded Aid Access to deliver abortion pills to US patients, has been one of the most vocal advocates for advance provision, and began offering it as an option to people in all 50 states last fall. Costs for the pills range from $110 to $150, with a sliding scale for those who lack funds. Recently, in Politico, Gomperts encouraged doctors to begin prescribing mifepristone and misoprostol to those who are not pregnant, so they have the medication available if they need it later.

“Abortion pills are something that, actually, you cannot die from,” she said. “There’s no way that you can overdose on it. And what we know from research is that you don’t need to do an ultrasound for a medical abortion.”

The idea of getting medication in advance of need is nothing new. Doctors also used to commonly prescribe emergency contraception to women before it became available over the counter.

Right now large mainstream abortion rights groups are mostly staying quiet on advance provision, leaving lesser-known organizations like Aid Access and Plan C to try to get out the word. (NARAL and Guttmacher declined to comment, and Planned Parenthood did not return requests for comment.)

Aid Access and Forward Midwifery are among the few groups currently offering US patients the option to order pills in advance, though Elisa Wells, co-director of Plan C, said she knows others are considering it. “I was just having a conversation with a provider in Montana,” she told me. “We believe it will become more common. Sometimes we call it the ‘just in case’ plan, because unplanned pregnancy is so common.”

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When it comes to safely ending pregnancies, medication abortion is over 95 percent successful, according to Guttmacher. Less than 0.4 percent of patients require hospitalization. The National Academies of Sciences, Engineering, and Medicine has also affirmed medication abortion as a safe method to terminate pregnancy, one with very low risk of complications.

Research published earlier this year in the medical journal Lancet found self-managed abortions specifically to be very effective, and with high rates of patient satisfaction.

Gomperts also urges more attention on misoprostol-only abortions, which are common internationally. The drug can be easier for women to access since misoprostol is less tightly regulated; it’s used for other ailments including stomach ulcers and managing miscarriages, and is sold over the counter in many countries.

While medication abortion is a safe option for almost everyone with an early pregnancy, the pills are not recommended for people who take blood thinners, who have bleeding disorders, or who are at high risk of ectopic pregnancies. (Ultrasounds are recommended for those in this latter category.)

Still, one upside of advance provision — and medication abortion generally — is the greater number of people who could potentially provide the pills, including primary care doctors. Another upside is that it could be easier to share pills with those who need the medication quickly but lack access to it. Research suggests the drugs are best taken within the first 10 to 12 weeks of a pregnancy.

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“We have ibuprofen in case of a headache, cough syrup in case of a cold, and Plan B in case of a broken condom,” said Bracey Sherman of We Testify. “It’s already normal for other health care and we should normalize it for abortion.”

Wells, from Plan C, said the historical restrictions placed on abortion have likely made some groups and individuals more reticent to talk about advance provision. “I think there’s probably a lot of fear about not wanting to break any rules,” she said.

Another factor limiting discussion, Wells suggested, is the way abortion has been heavily medicalized in the US, to the point where people believe the drugs have to be or are best administered by a medical professional. Attitudes are different internationally, she said.

“We have become so invested in saying that we need to have safe abortions and that doctors and clinicians and the clinics can provide that,” Wells said. “Clinicians have done a wonderful job, and we have to have all these different types of care options available, but [self-managed abortions] can be a bit of a threatening message to that whole system.”

HERBAL Options

Ben Franklin included an abortion recipe in his book The American Instructor that taught everything from math to letter to taking care of horses:

But Franklin’s choice to get Tennent’s pamphlet into the hands of readers all over the colonies meant that anyone learning to read, write, and calculate with his book would also have access to the leading available treatment for ending a pregnancy. Tennent’s handbook prescribes angelica, an herb known to be an effective abortifacient in the early stages of pregnancy for thousands of years, and which was frequently recommended across early modern herbal books.* Moreover, the recipe refers to several herbal abortifacients known at the time:

For this Misfortune, you must purge with Highland Flagg, (commonly called Bellyach Root) a Week before you expect to be out of Order; and repeat the same two Days after; the next Morning drink a Quarter of Pint of Pennyroyal Water, or Decoction, with 12 Drops of Spirits of Harts-horn, and as much again at Night, when you go to Bed. Continue this 9 Days running; and after resting 3 Days, go on with it for 9 more.

The entry combines attention to potent herbs with careful accounting of dosage to treat the “misfortune.” Here the entry recommends acting early before someone might “expect to be out of order” with their next period. This is consistent with the timing for maximum efficacy for angelica, aka “Bellyach Root,” a plant member of the carrot family. Likewise, pennyroyal was known even to the ancient Greeks as a form of birth control; “Harts-horn,” or century plant, was also commonly recommended at the time as part of concoctions for abortions and expelling afterbirth. The entry concludes by advising that the patients “shou’d be cautious of taking Opiates too often, or Jesuits-Bark”—a remedy for malaria sometimes mistakenly thought to be an abortifacient—and just in case anyone was not clear on what caused this malady, “nor must they long for pretty Fellows, or any other Trash whatsoever.” So: avoid sex.

The recipe details, moreover, assume that these “unmarry’d Women” had the kind of knowledge of arithmetic that the book’s earlier instructional sections had taught. The recipe insists on careful attention to measurement and counting. And it asks the preparer to work with repeated multiples of three. Franklin had a track record of promoting female education, and of arithmetic for them in particular. He advocates for it in his early, anonymous “Silence Dogood” articles, and in his Autobiography singles out a Dutch printer’s widow who saved the family business thanks to her education. There, Franklin makes an explicit call “recommending that branch of education for our young females.” He likely hoped that his American Instructor would reach audiences that included women and girls; and based on his choice of which medical book to reprint, he may also have understood that the Dutch widow would have needed to know how to end an unwanted pregnancy just as much as she would need to know how to balance an account book.

In a 1760 edition of The American Instructor held by the American Antiquarian Society, a reader has pulled out the page that included the abortion recipe, either to save it from or to save it for prying eyes. Another copy, held at the Huntington Library in San Marino, California, shows that the Gilbert family treasured the book so much that they used it as kind of a family Bible starting in 1755, with Thomas Gilbert entering the names and birthdates of his children into it, even including the five-day duration of Rachel Gilbert’s labor with their daughter Sarah. Births, abortions, arithmetic—all of them were wrapped up together and taken for granted in this colonial American book, which thanks to Franklin circulated far and wide and for generations, including among enslaved Americans.

Snopes investigated it:

While “suppression of the courses” can apply to any medical condition that results in the suspension of one’s menstrual cycle, the entry specifically refers to “unmarried women.” Described as a “misfortune” it recommends a number of known abortifacents from that time, like pennyroyal water and bellyache root, also known as angelica. 

According to the article, “Persephone’s Seeds: Abortifacients and Contraceptives in Ancient Greek Medicine and Their Recent Scientific Appraisal,” published in the Pharmacy in History journal by the University of Wisconsin Press: “There is evidence that pennyroyal […] and other medicinal plants were used in Ancient Greece as anti-fertility agents […] These anti-fertility agents, which were administered orally or as vaginal suppositories, may have functioned as early term abortifacents and contraceptives in women.”  

The ninth edition entry, reprinted in Slate, also recommends the use of “Harts-horn.” Harts-horn, according to Merriam-Webster, is an “American pasqueflower.”  According to “Edible and Medicinal Plants of the West” by herbalist Gregory L. Tilford, pasqueflowers were used by Native Americans to induce abortions, or speed up childbirth.  

The entry concludes with warning patients off “taking Opiates too often, or Jesuits-Bark” and “nor must they long for pretty Fellows, or any other Trash whatsoever” a statement that indicates they should not have sex. 

Jesuit’s bark, also known to us as quinine, was an important anti-malarial drug. According to Molly Farrell, an associate professor of English and the history of science who first reported on Franklin’s abortion entry in Slate, it was also “mistakenly thought to be an abortifacient.” 

The abortion recipe may or may not have actually been effective, given that it was prescribing herbs and ancient remedies far removed from our modern scientific methods for carrying out abortions. Modern scientists and experts agree that herbal abortions just don’t have the same efficacy as medical abortions, and should not be relied on. The use of pennyroyal to induce an abortion came up in a contemporary case from the 1990s, when a young woman named Kris Humphrey died as a result of ingesting the herb, not knowing that she had an ectopic pregnancy.

So to translate the recipe to modern times:

For this Misfortune, you must purge with Highland Flagg, (commonly called Bellyach Root) a Week before you expect to be out of Order; and repeat the same two Days after; the next Morning drink a Quarter of Pint of Pennyroyal Water, or Decoction, with 12 Drops of Spirits of Harts-horn, and as much again at Night, when you go to Bed. Continue this 9 Days running; and after resting 3 Days, go on with it for 9 more.

Highland Flagg (Bellyach Root) aka Angelica (Angelica archangelica) a week before you think you missed your period and then again 2 days later?

Side effects: 

Pregnant women should not use angelica. Angelica may cause the uterus or womb to contract, which could threaten the pregnancy.

Then the next morning drink a quarter of a pint (4 ounces) of Pennyroyal Water (tea) with 12 drops of Harts-Horn aka American pasqueflower (Anemone nuttalliana / Pulsatilla nuttalliana) then again at night.

Pennyroyal scientifically known as Mentha pulegium is a common plant in the mint family, Lamiaceae, that is commonly found in North America, the Middle East, and Europe. Some of the other common names include pennyrile, squaw mint, mosquito plant, and pudding grass. When the leaves are crushed, they release a powerful aromatic scent that is reminiscent of spearmint. Pennyroyal does have toxic properties, and should not be directly consumed, particularly in the form of its essential oil. In some cases, ingestion of the oil has resulted in death, and there is no known treatment for pennyroyal toxicity. [1]

While this herb was once used for rudimentary abortions, due to its menstruation-stimulating ability, the dose required for an abortion is close to the lethal limit and is no longer considered safe. There are some antioxidant, antimicrobial, and anti-inflammatory properties of this herb, including notable levels of alpha-terpineol and pulegone, but it is still considered a dangerous substance. Only use extremely mild doses and be sure to speak with a trained herbalist or medical professional first.

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Side Effects:

As mentioned, the side effects of consuming pennyroyal in any form can be dangerous, so extreme caution must be taken. Some of the side effects include the following: [6]

  • Liver damage

  • Kidney damage

  • Stomach pain

  • Nausea

  • Vomiting

  • Fever

  • Restlessness

  • Dizziness

  • Vision

  • Hearing problems

  • High blood pressure

  • Abortion

  • Lung failure

  • Brain damage

  • Complications of pregnancy

  • Breastfeeding

  • Liver disease

 

This herb should not be used by children in any form. Consuming as little as 5 grams of this herb can be lethal.

There is a limited amount of research on a safe dosage, and most medical experts recommend avoiding pennyroyal altogether. However, brewing a mild tea with these dried leaves can be a better way to benefit, without suffering serious side effects. A tincture with pennyroyal oil can be applied to the skin, but pay attention to any allergic reactions, as it may demonstrate a high sensitivity to the herb, putting you at a higher risk if you continue using it. [7]

Pasqueflower (Pulsatilla

Pulsatilla is a toxic plant. Misuse can lead to diarrhea, vomiting and convulsions,[9] hypotension, and coma.[10] It has been used as a medicine by Native Americans for centuries. Blackfoot Indians used it to induce abortions and childbirth. Pulsatilla should not be taken during pregnancy nor during lactation.[11]

Extracts of Pulsatilla have been used to treat reproductive problems such as premenstrual syndrome and epididymitis.[11] Additional applications of plant extracts include uses as a sedative and for treating coughs.[11] It is also used in the field of homeopathy.[11]

And drink this for 9 days, a break of 3 days, and then another 9 days.

I think I would rather try Plan C or go camping.

Do not despair. If Latin America can get abortion rights then we can regain our rights!

Get trained, get organized; go on Mobilize and find like minded people who are ready to get shit done.