This isolation of abortion is based on the model for reproductive care first established by Sanger at the start of the twentieth century, when almost all birth control was illegal, and it was crucial to gather the few doctors willing to circumvent the law in one clinic. Today, abortion is isolated in this manner in only a handful of countries outside the U.S., and most reproductive rights advocates agree that such isolation stigmatizes abortion and exacts a high emotional cost from the women who choose it. And of course, the scarcity of clinics makes them easy targets for the protestors who routinely picket abortion facilities. If MIC centers could offer their patients this early option, they reasoned, it would relieve much of the emotional toll and public shame of a visit to an abortion clinic. Rautenberg and her colleagues know that introducing medical abortion will not be a simple matter.
Abortion is often, religiously and culturally speaking, out of the question.
Right now, with the help of a two-year grant from OSI s Reproductive Health and Rights Program, MHRA administrators are figuring out how to get past these obstacles. Rautenberg expects that both patients and clinic staffers many of whom come from the communities they serve, and share their patients misgivings about abortion will need training in medical abortion, both to familiarize them with the procedure and to overcome any ethical reservations they might have. MHRA will also have to find a source of permanent funding for the project, since 75 percent of its patients are uninsured, and most of MIC s budget comes from federal and state programs that don t cover abortion. And MIC centers must clear several legal hurdles as well, such as limits on who can provide abortions, where they can be performed and what regulatory and licensing protocols they must follow. Once these steps have been taken, MHRA will introduce medical abortion at a pilot center.