Episode Transcript
[00:00:04] Speaker A: Hi everybody. Welcome along to the Dispatchers podcast. My name is Brendan Malone. It is great to be back with you again. And in this episode we have a special guest interview. We're going to be speaking to us author and researcher Rachel Roth Altizer, whose writings have been published in none other than the Wall Street Journal, the Washington Post and the New York Times, just to name a few. Last year she wrote a phenomenal and must read article that was published by First Things magazine called the Case against the the Abortion Pill. And that's what we're gonna be talking about today. And this is an important issue because the abortion pill has now become the abortion method of choice across the Western world. Right here In New Zealand, 66% of all abortions are now carried out using this particular method. But as you will hear, the development, the approval and the current use of this particular pharmaceutical product is highly questionable.
Yet despite that fact, this seems to be, as you will hear in our conversation today, this one pharmaceutical product where all of the normal safety concerns and regulatory considerations are thrown completely out the window and everyone seems to be okay with that. Well, today we're going to talk about that and more. I hope you really enjoy this conversation. And before we start, I just want to say a huge thank you to all of our subscribers, our supporters on both Patreon and Substack. And it's thanks to you that today's episode is made possible. If you want to support these episodes and also all of the important offline work that we do, like the mentoring and the public speaking work, you can do that by becoming a regular subscriber at either Substack or Patreon. I'll post a link for both in the show notes. And if you do become a $5 or more subscriber per month, then you will get access to exclusive episodes and also early releases of of public episodes as well. Thanks again to all of our subscribers and thank you for tuning in. I really hope you enjoy this conversation with Rachel Roth Altaizer. Rachel, thank you so much for taking the time to come on the dispatches and talk about this. Well, what I think is a very, very important issue and it's something that's not really discussed enough in the public square. I don't think the abortion pill.
You wrote a phenomenal article from my perspective.
[00:02:23] Speaker B: Thank you.
[00:02:24] Speaker A: First things, what was it that first drew you to this particular area of research?
[00:02:31] Speaker B: I. I was thinking about how I would answer that question. And so thank you for asking because I haven't gotten that before. I think we probably each have a origin story when it comes to digging into an issue like this. So I'd be curious to hear yours, too.
But I was going to start the way that I started my piece, which is to talk about a miscarriage that I had. And I will discuss that. But two things.
So, one, in college, I volunteered at a crisis pregnancy center. And I was incredibly naive. I come from a Christian family, married parents, had no friends who had experienced anything remotely like the young women that I was supposed to be somehow counseling. Although at the time I was like 20 years old. I'm not sure how much good I was doing there.
But what became really apparent in that clinic was that the stories that the media tells about who seeks abortion is not reality.
And so if you read the New York Times, you could be forgiven for thinking that the only people that seek abortion are well heeled urban professionals. But nothing could be further from the truth. The women I saw in that clinic were teenagers, they were homeless, they were living on a couch. And one woman told me she didn't know if the baby was her dad's or her brother's.
[00:04:12] Speaker B: And those are incredibly heavy things to carry that have so much, almost less to do with the mechanisms by which people procure abortions and more to do with the social conditions that I think really force women into unimaginable circumstances that really, I had never seen anything like that before.
So I would say that was my first exposure. And then in college, I had a very close friend, and it came to light later that she had gotten an abortion while we were in school together. And she never let on that that had happened. And she, like, sort of confessed it to me after the fact, like five years later.
And I just wish that I had known.
I wish that I had known she was in a crisis pregnancy. I wish she had told someone.
I was like, you know, I would have, like, raised your baby. Right. Like, I was like, I would have done anything for you if you had just asked for help. And so I think it's, you know.
[00:05:16] Speaker B: Yeah. That I thought of that story today that there's a lot of women like my friend, like those girls I saw in that, in those crisis pregnancy centers who are dealing with just the heaviest things that they'll ever encounter in their lives.
And I'm so disgusted with how our medical system.
[00:05:40] Speaker B: Preys on the vulnerability of women in these intense points of crisis. And so, just to wrap, I first came to writing about this issue professionally after I underwent a very traumatic miscarriage almost two years ago now, where I had had four Living children. And then I very quickly had a.
Three consecutive miscarriages and one of which ended in a labor and delivery.
And I was 15 weeks pregnant at the time and ended up checking myself into the hospital because my water broke and no one believed me. But I had had four children. And so I knew that I was in labor and I.
[00:06:37] Speaker B: In the hospital, they confirmed that there was no fetal heartbeat.
And I knew then they had, they told me that I could, you know, choose a DNC that morning, like wait it out or I could attempt a labor and delivery. And so I did that. And it ended up being kind of complicated. I like, hemorrhaged. I almost need a blood transfusion. I passed out. It was like, very traumatic for me.
And so that really began the process of me wondering what inducing that type of medical event might be like for a young woman who was seeking an abortion.
[00:07:17] Speaker B: And so I really began to write this piece.
[00:07:21] Speaker B: Just a couple months after that.
And it was like, very intense for me because there's women across my country and your country every day who takes drugs that induce medical events very similar to what I experienced. But instead of being in a hospital and receiving excellent medical care, they are at home alone passing out in their bathroom.
[00:07:44] Speaker A: It's quite astounding really, isn't it? Because you, you talked about this earlier, the sort of the exploitative nature of like, abortion, if you like, and I guess we've always sort of known about that particular issue and that factor in the whole abortion debate. But it seems to me now with the abortion pill, there's a whole nother layer of exploitation and it feels like it's even worse. That's going on here. And it begins actually with the history of the development of the abortion pill. You lay this out so well in your article. I just wondered if you could perhaps just give us perhaps some key insights into the, well, the unethical nature really of the development of the abortion pill.
[00:08:29] Speaker B: Yeah. So I think it's interesting when we talk about.
[00:08:34] Speaker B: The abortion pill, we're. We're really talking, as your listeners probably know, about two things. We're talking about mifepristone and we're talking about misoprostol, which is how this is delivered in the U.S. i'm not, I would assume that's what you're talking about when you say the.
[00:08:48] Speaker A: Exactly the same. Yep.
[00:08:50] Speaker B: Okay. So.
[00:08:53] Speaker B: And mifepristone is an anti progestin, which was developed like, truly as a method of birth control. So like progesterone would. You could take progesterone only birth control that that would be considered a mini pill.
So really, the potentiality for using this drug as an abortifacient was being investigated at the same time that the birth control pill was being developed.
And really for, but for several decades after the legalization of hormonal contraceptives, abortion pills were still not. Or using mifeprostone in this way was still not legal in, in many countries. And there was a lot of reticence and.
[00:09:37] Speaker B: Shame around sort of using this. And it's so interesting. I was like, looking back through my piece and I had mentioned that the creator of the abortion pill himself recounted to the New York Times, to the New York Times that during the develop, when he was developing this product, there were protesters who waited outside of his laboratories who had noticed that there was a connection between the manufacturer of the drug and the horrible atrocities that had occurred during the first or during the Second World War, knowing that there was some interplay between those drug companies.
And there were protesters who stood outside of his laboratory saying, you're turning the uterus into a crematory oven. And the New York Times, I mean, I, I flipped to the article just prior to this. Like the New York Times had literally recounts that. I just find that so odd and making, making us sound crazy when actually at the time of its development, there were people making connections like this quite publicly. But suddenly the development of that is now supposed to be like, hidden. And I think when you really dig into this, which I did in the piece, and there's a lot of interplay between.
[00:10:52] Speaker B: Like how NGOs are sort of held the lice, like the drug license agreement, it was donated. There was this really, this campaign that happened to sort of make this legal in the US because for so long it had been, you know, met with a lot of resistance. There was, people did not want this drug here.
[00:11:17] Speaker B: Right. For good reason. But then we really quickly, unfortunately, overcame that when the ease of abortion pills really burst into the mainstream.
[00:11:26] Speaker A: We hear commonly certainly here in New Zealand, this is a constant refrain that we hear that the abortion pill is safer. It's, it's, you know, safe early access. This is this, like, this is a mantra that has been repeated over and over again and has led to, like, the widespread use of the abortion pill drug here in New Zealand as well.
But, I mean, I mean, spoiler alert. I've already read your article, so I know the answer to this question, obviously. But for the sake of our audience, is this really the abortion pill as safe or certainly safer as has been claimed now for probably over a decade by the proponents of this particular drug.
[00:12:05] Speaker B: Yeah. I think obviously the most egregious of these, which your listeners will probably know or be familiar with, is the sort of assertion that taking abortion, the, that taking the abortion pill is similar to taking Tylenol, which is just not true. That's been debunked. But now that sort of has bled into how we conceive of taking this drug. And I would really push that. Like, it's challenging for me.
I'm not a doctor, but I can imagine asking a physician about a number of different pharmaceuticals and being like, can you really say that any drug is ever safe? Right. There are certainly some drugs with very limited side effects that we routinely prescribe patients, but there are drugs that have significant side effects, significant risk factors. Mifepristone has a black box warning on it. It is not what you would consider sort of like an everyday safe drug. It induces a medically generated event that creates adverse events. There are estimates one in five times.
And actually the FDA here in the US doesn't even require hemorrhage to be considered an adverse event, but they've done a lot of fancy footwork around what they consider to be typical use in these drugs. So when we hear safe, they just mean the drugs are working as intended and have typical use side effects. But for any patient who's interested in maternal health outcomes, some of these typical use side effects are really intense, they're horrendous, they're hemorrhage. I experienced that I passed out, that that would be considered typical use for this drug and allows abortion advocates to really be able to say that these drugs are safe within typical use. I don't consider that safe, but they, they do. And I'm not sure how they square that, but that's really bled into sort of the public consciousness when we talk about these drugs.
[00:13:58] Speaker A: In your article. I want to quote directly now from the article itself. You said the following. In 2000, the FDA approved mifeprostone for use in the United States, relying on subpart H of the code of federal regulations created during the AIDS epidemic to accelerate approval of drugs and treat, quote, unquote, serious or life threatening illnesses. In order to fast track approval, the FDA classified pregnancy as a life threatening illness with abortion as the cure. And like I look at that, that astounds me.
Unpack that a bit for us.
[00:14:34] Speaker B: Yeah, I think this really goes into the heart, cuts to the heart of what we mean by healthcare. And so this is really a Multi layered. I think it's kind of scandalous that this drug was classified this way. When you look through like I did this in research for the piece, like the other drugs that are sort of approved under subpart H, they're all like chemo drugs or aids. They're like people who seriously need treatment because they're dying.
But a woman in need of abortion is not dying if she like that. Those are not sort of like healthcare equivalents. And so it really recasts, I think, the specific use of subpar H, recast pregnancy as an illness. And so even if we might not be sort of speaking about that in like everyday terms, considering pregnancy is an illness, we can now look 25 years later seeing the effects of categorizing the abortion pill under subpart H.
It is now in the public consciousness how we talk about pregnancy. Common belief that pregnancy harms women, that it, that it isn't an unnatural state, that it is an illness, that it does need to be treated, that a cure does exist. Right. So it seems kind of innocuous in one sense, like, oh, it doesn't really matter, like why does it matter what category it was approved under? But now with 25 years of experience, we can see how, how categorization matters. It affects our language, our language affects our morals. Like these things are not sort of as separate as we would wish that they are.
[00:16:14] Speaker A: Yeah, that's a really great point. And I've often talked about the idea that it's not just law, but language is pedagogical, it is a teacher, it shapes moral beliefs and actions in society.
I want to quote another section of your, of your, your article here. Cause I think this is really important as well.
And these two things seem related. So you've got this really shonky way of approving the drug and treating pregnancy effectively. Something that's not.
But you then also go on to say the FDA typically requires two randomised blinded placebo controlled trials demonstrating significant efficacy and minimal risks to approve a pharmaceutical. Mifeprostone, however, was approved on the basis of a single published trial that was non blinded, naturally non randomized and utilized only a historical non concurrent control. The FDA also waived the requirement that mifeprostone undergo a separate pediatric approval process in order to be used in women and girls under 18. Can you break that down for our listeners as ordinary lay people? What does that mean specifically?
[00:17:21] Speaker B: Well, I think in the easy, clearest terms is it means FDA broke its own rules when approving.
Right. And so when you see a, a regulatory body making exceptions that should raise questions for consumers. And there's areas in which like sort of the liberal consensus would have a lot of questions if FDA was routinely breaking its own rules. We see that now. I, I mean TSA, there's, it's interesting in this, 25 years later, in the particular moment we are now with sort of what's happening politically in America with rfk, there's a lot of scrutiny on the decisions he's making from sort of our liberal elite. But where was that scrutiny when applied to drugs like mifepristone that were pushed through in clear violation of FDA's own regulatory standards? And I think you could have an opinion wanting.
[00:18:22] Speaker B: It seems to me that if you wanted abortion to be legally accessible, then you would want it the way that the drug was approved to be sort of airtight so that you could have an answer if someone was to come at you. And it just doesn't seem very strategic to me.
If abortion advocates really want this to be as accessible as they claim, then why not make the approval process as sort of perfect as possible so that there wouldn't be people like me who sort of ask inconvenient questions. That just seems like poor strategy. This is very clearly an egregious oversight.
[00:19:01] Speaker A: Speaking of egregious oversights, in the article, you also make this comment that there was a sort of COVID up, you say, baked into the approval of the abortion pill itself.
Can you explain that a little bit for us?
What, what exactly you mean by that?
[00:19:16] Speaker B: This is, I think this sort of the most important part to talk about when we evaluate the safety of an abortion pill. Of the abortion pill. They.
[00:19:26] Speaker B: Assumed that not only would non prescribing providers treat and triage after effects and adverse effects from abortion pill use in the ed, but they also conflated miscarriage with abortion, which is very insidious.
And so I think the design of how this drug was to be taken was and, and approved was to make it look as indistinguishable from miscarriage as possible.
So that when there would be questions about the drug's use, it would really be unclear whether the patient was suffering from a miscarriage and an abortion and give both the medical community and sort of the liberal consensus a way to sort of collapse these and just say they're the same thing. There's nothing to see here.
[00:20:20] Speaker A: There's been talk certainly the last US election, this became a bit of a high profile moment where you have these conversations and they keep popping up really in the post Roe era. Now after the Dobbs v. Jackson decision, anytime you have a death where there's an abortion correlation now the blame is always put on the law change and you got rid of Roe and look what's happening. It's a very sort of compelling narrative that's been there for several decades. It was never fully true, this whole idea of, you know, abortion and death and all the rest of it, but it's still compelling and powerful for people. And people, you know, everyone's got a wife or a mother or a daughter or someone they know, close friend and they think, oh, they could be a victim of this. But you've got these high profile cases that crop up now regularly. Amber Thurman was one. Tim Waltz mentioned her in particular.
[00:21:10] Speaker A: Tell me, what are your thoughts and how do you sort of grapple with those kind of deaths? Because it seems to me often we certainly don't get the full truth in the mainstream media. And I think of Amber Thurman in particular. She's related directly to the abortion pill, her death. Right?
[00:21:27] Speaker B: Yeah. So I actually had pulled up the original ProPublica piece. So who has been sort of highlighting these really egregious. Like I think it gets complicated here because there's a need for people who love life, who love women, who love babies, who want to see women's health care in America improve like that would that that's how I categorize myself. I think we need to be honest about the ways in which our current healthcare system fails pregnant women. That doesn' mean that abortion regulations are the one that are failing pregnant women. But I really put that back onto individual providers. And so this is like a. I think Amber Thurman's is a great case because even the reporting here is so partisan that it's just not even helpful. Like anyone with any basic knowledge of how this works could read this piece and easily unseat most of the claims that they're making. So I'll just like look at the first.
[00:22:22] Speaker B: Segment here. It was she had taken abortion pills and she encountered a rare complication. She had not expelled all the fetal tissue from her body. Firstly, we know that that's not a rare complication that actually happens one in five times. That's called like.
[00:22:38] Speaker B: A non complete abortion. And so you would need a surgical intervention in order to completely clear any leftover POC products of conception from the like uterine cavity. So one that's not rare. It said she showed up in into the hospital to the hospital in need of a routine procedure to clear it from her Uterus caused a dnc. But just that summer, her state had made performing the procedure a felony. So performing a DNC is not a felony.
Performing a DNC in order to end the life of a growing baby is a felony. But Amber Thurman, at the time, at least from what we know, did not have a living baby in her womb. Right. So she could have been evaluated just like any other patient who is true, who had under undergone a miscarriage or an abortion. They both needed surgical. Could both need surgical intervention to sort of complete that process. There was nothing stopping and Amber Thurman's doctors from treating her in accordance with standards of care, which would be evaluating her for retained products of conception, evaluating her risk of assessment, like a sepsis infection, and then offering her what she needed at the time, which was a DNC to clear the products of conception. None of that is illegal under Georgia law. None of that. That's actually good health care. That should have been done. There was clearly she. She was.
There was something else happening, some sort of malpractice. So I would say this is clear evidence to me not of an abortion regulation gone wrong, but of provider malpractice.
[00:24:15] Speaker A: And as you've mentioned there at the heart of that particular case too, and this is the thing that astounded me, that never really got talked about enough, was that once again, it was the abortion pill that was the impetus for all of this and a woman who sent home with that drug.
[00:24:31] Speaker B: Right. And so I think. I just think back to this. It's a medically generated event. And so.
[00:24:38] Speaker B: I just find that to be so interesting. Like, I think about healthcare a lot. I have a son who is born profoundly disabled. I spend a lot of time in the medical community. I like, am very interested in it. I'm like, like to nerd out. So I find it really confusing that we send people home with a drug that generates a medical event when they were otherwise healthy. And I. I'm not sure if you had planned to chat more about this, but I want to talk sort of about how this is prescribed. Women like Amber Thurman, the way that this drug is available now, don't actually need a confirmation of pregnancy in order to access these drugs. So what that means is that we're treating a condition with a therapeutic without accurately providing women with a diagnosis. That means there is no informed consent if you cannot accurately diagnose a woman for pregnancy. Right. Whether through an exam, like a clinical exam, unfortunately, if only this was true ultrasound, which was never required.
So we don't There could be a woman like Amber who is prescribed this at 15 weeks pregnant. She could have been 17 weeks pregnant. She could lie. She could make up the last date of her. The date of her last menstrual period. Women are not operating under informed consent. And part of that informed consent is what happens when I take this drug and. And what do I need to do next? But as I think the Amber case is really unfortunate because the patient provider relationship was designed in that case to be severed. She was.
And what I mean by that is the originating provider is not who treated her in the ed. Right. So those doctors have no familiarity with her case. They're just the ED provider on call. They might not know any. They. I mean, it's unfortunate that she waited 20 hours, but they hadn't. That's not her OB. That's not her. A treat she could have.
It's like in no other circumstance do we give women these drugs without sort of requiring them to have an ongoing provider relationship, who then is able to treat them for any adverse effects after the event?
[00:26:44] Speaker A: Tell us a little bit about Keisha Atkins, Another case. I was quite shocked when I read about her case in your article where there was like, a.
A falsified death certificate. I just looked at that situation. I think, how the heck is this, A, able to happen, and B, how is it able to continue standing? It seems absolutely shocking to me that something so egregious and so it seems fundamentally basic about medical ethics that that could just be allowed to happen after you've got someone in a situation involving this abortion, pill, drug.
[00:27:16] Speaker B: Yeah, I think.
I mean, the US Is a complicated place. Obviously, we have different states do things differently. Like, New Mexico, where this case happened, just has a history of pretty egregious treatment of women when it comes to abortion.
But you'll know, you'll notice, like, Keisha was a young black woman, like I. That is an indictment on anything, an indictment of how we really value the lives and health care outcomes of minorities here in the US that they would think so little of Keisha that they would think feel entitled to falsify her records to hide what they had done. Would they have done that if she was, like, a wealthy white woman? It's hard for me to imagine that.
And so I think there's a serious inequality here that makes the most vulnerable people in our country even more vulnerable in the hands of people who are preying on them.
[00:28:14] Speaker A: Yeah. So you've got a situation there where, like, as you say, you've got a vulnerable young Woman who, whose death is attributed directly to the abortion pill. Right. And then they just cover it up.
[00:28:28] Speaker B: Yeah, And I, I think this is very common. So our reporting in the US is not.
[00:28:35] Speaker B: Is not standardized. And the one thing I uncovered in this article is that when providers treat her case is a little sort of extreme. But when providers treat women who are experiencing complications as a result of induced abortions in the ed, they're under no requirement to record her use of the drug. Think about that. Let's say you treated a man in the ED for symptoms of a heart attack and it comes to light that he had taken a medication that had induced an unnatural heart attack for whatever reason do. And so you're going along, you're treating him for a heart attack and you just decide to omit the drugs that he had taken that led to the event. I, it's really unfathomable to me. I can't think of another circumstance in which providers like, routinely admit this information. But I had one physician tell me, actually multiple, that they do it, like to protect women from stigma. But isn't that they themselves stigmatizing this woman and her future medical care when they fail to accurately disclose any drugs that she had taken that led to the event that they're treating her for?
[00:29:48] Speaker A: What, like, tell me a little bit more about that. Like, so, and I think you wrote so well about this in your article in particular, what are the implications of that being a routine practice now? And why is the accuracy of recording that causative event, you call it the genesis of that particular complication? Why is it so important that that's actually recorded accurately as well?
[00:30:10] Speaker B: This really gets like deep into the weeds. But I think that there's a way that we could sort of attack this issue from a medical coding perspective, requiring that physicians record medication. And I had one physician told me that because of hipaa, they did not have to disclose that she had taken this drug. That's not how HIPAA works. Like, that's not true. They're her doctor. Like, they do have to actually record the medications that she's taken when in the fact, when they're actually treating her for the event that the medication caused. Like that literally makes no sense. And so this is such like, so below the standard of care we would expect for any other medical event. It's hard to square this when we think about our healthcare system in general.
But I think this is really purposeful because the aim here, of course, is to really continue to conflate miscarriage with abortion in triage. Ed departments so that there is no, there is no data. The system is designed so that there is no data, so that bad actors can always claim plausible deniability. And in that case, vulnerable women will always be the ones who are hurt.
[00:31:18] Speaker A: So basically, again, this is that cover up you talked about being baked into the system. And this leads into my next question because is it me or am I right in feeling like all normal health and safety considerations are basically, they're effectively being completely or largely ignored with this one particular pharmaceutical product. Like you, for example, in the article state US Studies that conclude that medical abortion is safe. So these are the abortion pill. Abortions are frequently subject to design limitations such as the exclusion of an incomplete abortion as a complication, which is exactly what you're just sort of talking about there. It seems this one product is treated this way.
[00:32:00] Speaker B: Yeah, I mean, I think another good example of this, I'm not sure how much, you know, your listeners.
[00:32:07] Speaker B: Know or find like what we call here in the US gender affirming care. Right. So giving children hormones that disrupt their normal biological processes in order to help them, quote, feel at home with what they believe to be their true gender. Right. I feel like this is another good sort of example where actually some details just came out quite recently where there were providers who were talking about doing sort of sex change surgeries saying in lieu of like sort of good studies, we're just going to go for it because these patients desire it. And so I wanted to make sure that I was able to talk about the, the role of desire because I think that that is the character that is unnamed when we talk about abort the abortion pill.
The studies are designed this way because people desire them to be designed this way because we want to honor women's desire to unwant their child. And so when medical ethics are not supposed to be designed around desire, what I desire as a patient, of course, unless when it comes to sort of like let's say cancer, end of life, et cetera. Like my desire to, to is, is not supposed to factor in to my.
[00:33:26] Speaker B: Physician'S like, ethical understanding of how to treat my case.
And I think that this is.
[00:33:34] Speaker B: A really scary shift when we talk about medicine, the power of someone's desire and how that is able to shift even the way that we do studies and evaluate the safety and efficacy of drugs. Does it really matter if it's safe if someone desires it? And unfortunately to the medical community I would say, yeah, that safety is of a secondary concern when desire is always sort of seen as the Primary concern is meeting someone's desire.
[00:34:04] Speaker A: So effectively what you're saying there is, you're talking about like a form of medicalized liberalism, the autonomous self choosing individual and it's satisfied in a medicalised way. And also I think there's a correlation clearly with the, I think egregious and intensifying attacks on freedom of conscience of medical practitioners to actually have their own desires to decline to be involved in these situations. That's under constant attack as well. And that's another expression of that same problem, right?
[00:34:32] Speaker B: Yeah. And I'm not sure like what the culture is like in New Zealand, but I know here, like in the Supreme Court case that I was. The backdrop was sort of where I was writing about this piece is these physicians were alleging that, you know, treating these women for abortions was violating their conscience. It was causing them harm in the ED when they were not the prescribing providers, but were then in the emergency department treating women dealing with the sort of negative after effects of abortion. And the.
When you listen to the oral arguments, one of our Supreme Court judges was like, well, if you didn't want to do it, you have conscious protections, you can still step out. And so we still utilize that here in the US where we like, I think at least recognize that providers have a right not to provide abortions. But I think on the back end, the sort of conscious protection not to treat women coming into the ed, it is really violating because you're sort of saying they're putting that back on providers and saying if you see a bleeding woman in front of you and you know she's had an abortion, you could just step out of that situation. But like, what good doctor does that? They're cleaning up someone else's mess. They're sort of being forced into conscious, conscious in, into a violation scenario. Anyway, this was sort of at the heart of the Supreme Court case which, which unfortunately was dismissed.
The Supreme Court found that the plaintiffs did not have standing to bring this case and therefore they did not rule on the merits. And so as of now, mifepristone in the US remains unchanged. And even just several months ago, you can tell how little our administration has an appetite even to address this issue. But a new generic form of mifepristone has just been approved in the U.S.
[00:36:27] Speaker A: Tell us a little bit about that because that is something that I wasn't aware of. So tell us about this new generic version of it.
[00:36:34] Speaker B: Well, it was a surprise to all of us because we had thought that there was appetite right under the Department of Health and Human Services to sort of, at least there had been in sort of our Senate hearings. RFK had seemed like he wanted to evaluate the sort of our guardrails around how we prescribe mifepristone. But then FDA went ahead and pushed through a brand new generic form. And so I think there's a lot of conservatives who feel abandoned by our current political party when we think about the future of abortion rights in America.
[00:37:15] Speaker A: That's a question I really wanted to ask you as well actually, and I hadn't planned to, but you've really reminded me of that is the question of the current regime. A lot was talked about how this was going to be.
Well, a lot more of a pro life regime there was going to be and there was a lot of promise there and there were some early indications that look good. But it does seem of late that that might now be in some doubt. Is that really what you're getting at here with what you've just said?
[00:37:42] Speaker B: Yeah, I mean, I think for me, I know it's funny to talk to someone who's not American about this, but I think the, the more comfortable American Christians get with de identifying themselves with any particular political party and remembering that they primary orientation is not fundamentally political but again religious, that we will have an easier time evaluating our political candidates.
And that seems to be a real challenge for us. So. Yes, it does. It had seemed like there was some appetite to sort of dig into this issue. But I was at an event on the Hill not too long ago and I had a senator's aide tell me that his senator was really the only one right now interested in.
[00:38:30] Speaker B: Digging into this issue at all. And I think that's a very sobering position. But it's a position that Christians have been in for a long time. Right. That what we believe to be true about life is not guaranteed to be sort of proliferated by our political parties, but must primarily for us be a matter of consciousness and conviction that comes before any sort of political promises that we are willing to take at face value.
[00:38:59] Speaker A: It's interesting cause I. Yeah. As an outsider, but someone who has read widely about the history of the pro life movement in America and particularly before Roe v. Wade and how really it's a complete flip of the switch. When I present on this here in New Zealand, people are often shocked. Cause in their minds they think Republicans, they're the anti abortion party, Democrats, they're the pro abortion party. It didn't used to be that way prior to Roe. It's A complete flip. But the other thing is that it seems after that flip happened in the early 70s and the Pro life movement was sort of marginalised then pushed completely out of the Democratic Party, it feels like the pro lifers found they didn't find a comfortable home with the Republican Party. The Republican Party was an uneasy sort of alliance and at times, even when they had power, they still didn't act to actually address issues.
[00:39:46] Speaker B: Yeah, and I think that's a great.
I love that description of how like, I think for Christians that shouldn't be surprising. I don't expect my sort of current political party home. Although, you know, it saddens me, I don't expect them to hold all of my priors as an orthodox Christian. I think that's quite unrealistic. Like I'm much more cynical about how like, politics works. And so for Christians, again, it's getting comfortable knowing that really this issue more than anything else sort of makes us social pariahs, it makes us political pariahs, it makes us confusing to people who place politics as their primary orientation when they view the world. Because as a Christian, that is just not.
We've gotten it backwards. Right. If we see that first, because we will always be disappointed.
[00:40:42] Speaker A: Jumping back into the abortion pill topic, I've got a couple of questions I really would love to get some answers from you on. First of all, why do you think that the abortion pill has now become. It clearly has become the method of choice for abortions.
Like in New Zealand, for example. Just to give you some understanding of our local scene, 66% of all abortions now are using the abortion pill out from only like three years ago, 38%. And as I look at the rest of the world, it seems to be that's where the trend is heading.
Do you have thoughts on why you think this is becoming clearly the method of choice?
[00:41:22] Speaker B: Yeah, I mean for one, surgical abortions are not fun. I mean a D and C, they're not a fun procedure. Now with the availability of like home pregnancy tests that can detect pregnancy so early, I think women are really finding out about this like at four or five weeks and they're take sort of ordering through telehealth, these prescriptions that induce an abortion in like a relatively. I don't want to say harmless because we do know that one in five women experience adverse events. Right. But in a risk that they're willing to take. Right. Waiting. Firstly to do a surgical abortion, you have to even wait. Like there would just be a longer. You would have to go to A legitimate provider. Firstly, you would have to see a doctor, an abortion provider who can actually put you to sleep and do a surgical procedure. Those are expensive.
An abortion pill you can get, you can get organizations here in the US to give you a grant to purchase abortion pills through telehealth. So it's like extremely low cost, like compared to a surgical procedure. It's totally a no brainer to me why this is becoming more and more and more widely used and widely accessible. It's just a low lift, like it's just easier.
[00:42:37] Speaker A: It seems to me too that there is a, there's a dystopian advantage for the system as well, if you like, in that they don't have to, you know, fill up a hospital bed. They don't have to really. It's almost all care and no responsibility here, take this pill and go home.
But it's like again, this is this dichotomy. It's being sold as, yeah, it's caring, it's safe, it's easy, but in actual fact when you do that, that's anything but those things.
[00:43:06] Speaker B: Yeah. And I think the, I mean I'm working on a story now, like I was involved in this, really interesting, was trying to uncover what was happening in Washington state where different levels of providers in the US are not able to prescribe abortion pills. So not just doctors, nurse practitioners, but in this case it was a pharmacist. Pharmacists. And I love this story because it really highlights how little people care about women's safety when it comes to abortion pills. Abortion drugs, inducing medical abortions. Right. They say that it's about women's choice, women's bodily autonomy, preserving women's health. But in actuality what I discovered in Washington state was that pharmacists, so not even like medical doctors, nurse practitioners, physicians, assistants, but pharmacists, were prescribing the abortion pill regimen through an asynchronous telehealth platform operated off California using Washington state physicians license, which.
[00:44:04] Speaker B: Interestingly I'm not even sure is legal because what was happening is that it was an asynchronous, so a messaging platform and that's actually legal in Washington state. You have to have a primary relationship with a clinical provider in order to then use asynchronous messaging to get a prescription fulfilled, filled. And so they're breaking the law. And I actually like got into a huge tangle with like the health.
Anyway, I've threatened with lawsuits. I have lots of interesting information about that. But there's clear evidence that even now abortion providers are operating legally. Like that's not a surprise. Just no one cares.
[00:44:44] Speaker A: Tell us a bit about those telehealth services because we've got one here, a dial and abortion service. And you ring the 800 number they will even. Well there seems to be some indication New Zealand that the, the new government might have actually changed this a little bit. But previously up until very recently they were even currying like sending via a courier the drugs directly to your door to carry out the abortion.
I look at this and I think this looks exactly like an 0800 DIY dial in abortion service. Like a backstreet abortion that you ring up for yourself, which we were told was not supposed to be safe. But there's other issues like you, you highlight like the, what you might also call a lack of a clear chain of custody. Like someone might engage with telehealth, then have a complication, but they're not going back there to deal with it. So there's a breakdown in recording complications and everything. There's big ramifications for this, it seems to me. What, what are your thoughts on the telehealth approach?
[00:45:41] Speaker B: Yeah, I think this Washington State case is the best example because I had like the head of the Washington State State Pharmacy association on the phone with me prior to sort of her knowing what I was really researching, who really told me that pharmacists had the full ability, just like any ob GYN to treat complications from a medically induced abortion.
Sorry, I was, I was unaware that that was part of a pharmacist scope of practice.
So I think what.
I find that hard to believe that we would treat any other medication the same way. And so I, it's interesting, I really like what you said there it is sort of bringing it back full circle. Aren't we supposed to not be doing back alley abortions anymore? So why are we doing them now? Right. Isn't this if it. And I think that really sort of proves ethically how people we.
God has given everyone, every human heart a conscience. Right. And so if this is truly an a non like ethically tinged evil issue, then why isn't it out in the open? Why can't we just do this in any sort of healthcare setting? Why is it so secretive? Because I think that really shows the dark evil that the devil really delights in making this like such a secretive process.
[00:47:01] Speaker A: I guess the million dollar question then is and I guess this is where we put our chips on the table, should these telehealth lines in your opinion be shut down because of the questionable ability to actually guarantee patient safety, informed consent and even wider community safety like we're seeing is now reported. And certainly I've seen a couple, at least in England, I think in America as well, where people are acquiring the drugs under false pretenses so they can like slip them into the drinks of a girlfriend or a mistress who's got pregnant and like there's a non consented abortion happening without giving it to someone else. There's massive issues here. Do you really think this is a safe enough practice to carry on?
[00:47:38] Speaker B: Yeah, of course not. I mean, can you imagine ordering a prescription under false pretenses and giving it to someone else for any other healthcare condition? Can you imagine doing that? I mean, it just doesn't make sense. And so again, when drugs are sort of treated with special permissions and you can see how rules are being broken really for anyone, regardless of how you feel ethically about the question of human life, that should be concerning because don't we want women's health care in America to become better? I mean, that's what we're constantly told, right? That America has sort of the lowest level of maternal health of any like developed nation. Right. Don't we want that to get better? Isn't fixing this and how we deliver like abortion drugs part of that? If, if I was a liberal, I would want this to be as safe as possible, meaning as transparent as possible.
But because this issue is so obviously wrong and it really cuts to the heart of the human condition, there's no way in which it can come to the light. It is designed to be done in the dark.
[00:48:45] Speaker A: Tell us a little bit too, just to.
[00:48:49] Speaker A: Hone in again a little bit more on this telehealth service. You've got another added complication that we don't have in our country.
And that added complication, of course, is interstate shipping of products. And now also I'm starting to see certain states are saying more liberal states are saying, well, even if our physicians have acted illegally, we won't allow other states to pursue prosecutions against them. This is quite serious.
[00:49:13] Speaker B: Yeah. So I ran into this again under the Washington State case because I was told that I couldn't have the names of any of the pharmacy, the pharmacists who are providing abortion drugs. That I was requesting these documents and that were public access that had been filed with the Washington State Department of Health and was told that all of this information was to be redacted because it would be subject to state shield laws.
But that's not true. And so it's sort of being used and thrown around, I think, to really bully people into saying we're going to protect our own. You know, your state's backwards, our state's progressive, our guys are going to be good guys and ship things to your state. And it's obviously the Wild west and no one cares enough certainly in the administration really to drill down and to figure out why this is how that there could be an actionable stop, like the public will is just not there. There's no moral outcry, no one cares.
[00:50:15] Speaker A: Should the abortion pill be banned outright? If not in your mind, what legislative and practical changes do you think actually do need to be made then? Because it seems that it's the Wild west and this is a dangerous product to have the Wild west approach being taken with this particular drug.
[00:50:35] Speaker B: Of course, I would love for no woman in America to be able to induce a medical abortion. Do I think that these drugs will become illegal? No. My best case scenario would be reinstating some FDA guidelines that originally been placed on the drug and perhaps adding a few more, such as requiring an ultrasound to confirm gestational age before for giving a woman the abortion pill regimen, having them come into a clinical setting, be face to face with a provider, undergo ultrasounds before.
[00:51:12] Speaker B: The administration of this pharmaceutical and after to cons to confirm a successful abortion and to demonstrate that there had been no leftover products of conception that can actually really infect women and cause them like, yeah, serious sepsis infections problems later in like subsequent pregnancies, like there.
I just don't understand.
It seems to me, again, if I was a pro choice liberal, I would want this to be done as safely as possible. And instead they've continually continuously eroded safety standards to make it like what you said, really akin to like sort of a back alley black market.
And how is that?
Like, anyone who's concerned about women's health care should be really grieved and angered by the state of this in the.
[00:52:02] Speaker A: US I've got a couple of questions just to finish with.
[00:52:08] Speaker A: Here in New Zealand, we are relying on mainstream media reporting about events that happen in the United States. We don't have firsthand eyewitness accounts often, unless you go looking beyond the mainstream media.
And so we've heard reporting about the recent U.S. supreme Court case regarding the abortion pill, but it still seems we're not really getting the full facts here. There's certainly a narrative that's being presented and you know, the typical liberal claims about, you know, women's choice being eroded, et cetera, et cetera. But can you tell our listeners a little bit about exactly what that U.S. supreme Court case entails and where things are at in that regard?
[00:52:47] Speaker B: Yeah, so I had spoken to this a little bit earlier. This case unfortunately was dismissed because the plaintiffs were found not to have like, sufficient legal standing to bring this case. So they were arguing the group of doctors who was alleging that treating patients for the.
[00:53:09] Speaker B: In emergency departments who were experiencing adverse effects as a result of induced medication abortions who were provided by other healthcare providers.
[00:53:18] Speaker A: Right.
[00:53:18] Speaker B: Not them. They were alleging that this was causing real harm to their practice and violation to their conscience. And unfortunately, the Supreme Court said, dismissed this case, saying that there was not sufficient proof that these plaintiffs had adequate legal standing in order to bring the case to. And then at which point the Supreme Court could have actually ruled on the merits of the case, which was never done. And so I think it's possible that there could be an opportunity for states to now enter as plaintiffs alongside the doctors. Another state has sort of joined that this issue could be brought back up. But I just think the appetite, it's almost like the moment is gone. Like I think the appetite is, has dissipated. I, I just don't think we'll see this come back around. I think the political moment has passed.
[00:54:04] Speaker A: What would be the implications if there was a successful victory in that particular case? What would practically would change?
[00:54:11] Speaker B: Yeah, so I think practically what the best case outcome, I mean, right, dream world would have been FDA remove mifepristone from the market because the original approval process would have been demonstrated to be shady. Right. And women's health to be jeopardized when taking this pharmaceutical. That would not, would not have been the realistic outcome. The realistic outcome would have been instating what's called REMS provisions, which are safety provisions that are put around the use of a pharmaceutical like this, which is known to have pretty significant effects for patients. Right. And so that would have been reinstating things like three office visits with a provider and disallowing the use of telehealth when prescribing this medication.
So I think that would have been the best case scenario, would have been making this drug sort of less accessible, harder to access and honestly safer when it was accessed. Now, again, that moment, I feel has really passed.
[00:55:10] Speaker A: Do you have thoughts on the abortion pill reversal issue? Like it's become a bit of a thing here in New Zealand, obviously using progesterone, which is a pharmaceutical product that we know actually works to help reduce Miscarriage. And now we're being told, no, you're not allowed to use it for that very same purpose. When a woman changes her mind partway through the two stage abortion pill process here in New Zealand, our Ministry of Health, and this is a really questionable decision or ruling if you like, they just sort of announced we've got this new policy and we will prosecute people even with a threat of jail time and major fines if they even recommend abortion pill reversals here in New Zealand. Just to give some comments context, it is not illegal to use drugs off label as long as there is informed consent and it's not being done in an unsafe way.
And also on top of that, there was no ruling from our parliament. So it wasn't our politicians who said, oh, we're changing the law here. It was just a group of bureaucrats who one day just announced that they were implementing this new policy and that people could face jail time.
Is this an issue here for you in America or are your thoughts generally on abortion pill reversal?
[00:56:21] Speaker B: Yeah, so I had actually done some research on this today because I, I didn't cover this in the piece. And so I spoke with a physician who knows a lot about this, who is part of like a major pro life organization here in the US and just educated myself on this. What I find really dystopian specifically about the New Zealand ruling is if someone has been given advice about reversing their abortion, this may be a breach of their rights. That is what I read on the New Zealand like health Ministry website. I find that a very remarkable statement because let's say if desire is king, which is how we got here in the first place, let's say I desired to stop my abortion, why would that be a breach of my rights that could lead to the prosecution of my physician? Isn't my desire paramount? So if I decide to opt out of this procedure like I could for any number of other medical procedures, why would influence informing me that that is a potentiality be somehow a breach of my rights? I find that like, like quite remarkable. So then I went on to see how in America how we sort of handle this.
And ACOG says claims regarding abortion reversal are not based on science, do not meet clinical standards.
ACOG ranks its recommendations on the strength of evidence and evidence does not support prescribing progesterone to support a medication abortion. Legislative mandates based on unproven, unethical research are dangerous to women's health. Just fascinating. I mean you could have literally substituted the abortion pill for that and it would have been exactly relevant. Right. So it just doesn't make a ton of sense. And so the studies I was seeing here is that, like, up to 66% of the time, it can be effective to administer intramuscularly. So not orally, it's not as effective. Right. But if a woman takes a drug like this and panics and she's like, I don't want an abortion, I. And she calls a hotline and a prescriber, like my friend sends her progesterone through, and she's. Through a pharmacy, she's able to administer that, there's quite a good chance that her baby's life could be saved. It's remarkable to me that the medical consensus would continue to hone in on the fact that they feel that there's not adequate research, when actually there is quite sufficient research in order to prove that this is something that women should have in their arsenal and be able to see, take. And especially, as you mentioned, we're seeing these cases where women are being given these drugs and there is no consent. Shouldn't they be able to take a drug like this as an antidote? And what I was reading actually prior to this was there is so much robust evidence for administering progesterone, because guess what? We administer antidotes to poison, and this is essentially a poison. And so when you give.
[00:59:05] Speaker B: And like an extra amount of progesterone over and against what had been given in the original dose of mifepristone, it actually unseats the mechanism by which mifestone is binding to those progesterone molecules and can, like, it can. It really can reverse it. Like, we know that drugs work like this. We use it in other ways when people have been poisoned. Like, that's insane to me. So there is actually like, quite substantial biochemical evidence to sort of assert that a drug like this could be possibly used.
Could more studies be helpful in being able to sort of convince the wider community that this would be a viable option? Absolutely. But again, if women's desire is paramount and if a woman changes her mind, shouldn't she have the available opportunity to do that? That just doesn't make sense.
[00:59:54] Speaker A: Rachel, I want to thank you so much for taking the time that you have to come on and have this conversation. I found it really fruitful. I've got one last question I'd love to ask you, though, as an insider. We hear a lot of talk about the post Roe pro life scene in America, and sometimes it's hard to make heads or tails of what's going on. How do you feel in a sense the pro life movement got a major victory with the overturning of Roe, but then it also feels like it's in some ways it wasn't quite prepared for the practical realities of that or there's been a bit of a almost like an uncertainty in the movement and it's faced new challenges that it wasn't quite ready for. How do you feel about where the product movement and everything is at in that regard in the States right now?
[01:00:37] Speaker B: Yeah, it's really just a non issue and so I really think that demonstrates sort of how fickle American attitudes are when it comes to these really complex ethical issues. Like we're not in an election cycle right now and so this is really not part of what Americans are talking about. Like no one cares. So it's utilized as a tool by politicians when they want to drive votes in a certain way. Right. But we're in between cycles. So there is no public appetite in order to uncover more sort of stories or.
[01:01:06] Speaker B: Anything else about this because people don't like to think about abortions. Like no one wants to think about that in their spare time. So it's not sort of a winning political issue for either side right now, especially when there's things like the economy or immigration that are really taking a lot of our headlines. So I think for me at least, I think a lot of us who are Christian first in orientation, right. And then not not political first, we're Christian first. We find ourselves in a necessarily lonely place that I think is needs to be better prepared for by Christians that we should not always expect to have the support or political will behind us to help us get our ethical positions over the finish line. But that is the long, slow work of Christians that will continue to regardless of changing political winds.
[01:01:51] Speaker A: Well said, Rachel. And what a great place to end.
Look, just again, I'm just so grateful for you to and as you said to me when I reached out to you, normally you get a lot of hate mail coming your way, not so many positive ones. So I'm glad that we're able to contribute something good at the end of the year. But thank you so much for your time.
[01:02:09] Speaker B: Thanks. I really appreciate it.
