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No-Touch Abortion

When the Dobbs decision went down, ER doctor Avir Mitra started to prepare for the worst — botched, at-home abortions that would land pregnant people in the emergency room. To prepare himself and his colleagues for the patients they might see, and to think through how best to treat them, Avir asked Laura MacIsaac, one of New York City’s leading gynecologists and abortion experts, to come talk to his ER department. But what Dr. MacIsaac had to say in her lecture wasn’t what Avir expected: she didn’t talk about how we’re going back in time and the horrors of self-harm as a means to an abortion. Instead, she painted a picture of progress — how in the last 40 years, through private practice and clinical trials all around the world, the process and science of providing and having an abortion has changed dramatically, mostly because of two types of pills: misoprostol and mifepristone. On this episode, Avir and Senior Correspondent Molly Webster visit Dr. MacIsaac to hear more, and also learn about a new study that indicates the process of abortion is on the precipice of even further change.  Special thanks to Mariana Prandini Assis and Pam Belluck. Episode Credits:Reported by Avir Mitra and Molly WebsterProduced by Sarah QariMixing help from Arianne WackFact-checking by Diane KellyEdited by Becca Bressler Our newsletter comes out every Wednesday. It includes short essays, recommendations, and details about other ways to interact with the show. Sign up (https://radiolab.org/newsletter)! Radiolab is supported by listeners like you. Support Radiolab by becoming a member of The Lab (https://members.radiolab.org/) today. Follow our show on Instagram, Twitter and Facebook @radiolab, and share your thoughts with us by emailing [email protected]. Leadership support for Radiolab’s science programming is provided by the Gordon and Betty Moore Foundation, Science Sandbox, a Simons Foundation Initiative, and the John Templeton Foundation. Foundational support for Radiolab was provided by the Alfred P. Sloan Foundation.
Duration
29m
Broadcast on
14 Oct 2022
Audio Format
other

When the Dobbs decision went down, ER doctor Avir Mitra started to prepare for the worst — botched, at-home abortions that would land pregnant people in the emergency room. To prepare himself and his colleagues for the patients they might see, and to think through how best to treat them, Avir asked Laura MacIsaac, one of New York City’s leading gynecologists and abortion experts, to come talk to his ER department. But what Dr. MacIsaac had to say in her lecture wasn’t what Avir expected: she didn’t talk about how we’re going back in time and the horrors of self-harm as a means to an abortion. Instead, she painted a picture of progress — how in the last 40 years, through private practice and clinical trials all around the world, the process and science of providing and having an abortion has changed dramatically, mostly because of two types of pills: misoprostol and mifepristone. On this episode, Avir and Senior Correspondent Molly Webster visit Dr. MacIsaac to hear more, and also learn about a new study that indicates the process of abortion is on the precipice of even further change. 

Special thanks to Mariana Prandini Assis and Pam Belluck.

Episode Credits:Reported by Avir Mitra and Molly WebsterProduced by Sarah QariMixing help from Arianne WackFact-checking by Diane KellyEdited by Becca Bressler

Our newsletter comes out every Wednesday. It includes short essays, recommendations, and details about other ways to interact with the show. Sign up (https://radiolab.org/newsletter)!

Radiolab is supported by listeners like you. Support Radiolab by becoming a member of The Lab (https://members.radiolab.org/) today.

Follow our show on Instagram, Twitter and Facebook @radiolab, and share your thoughts with us by emailing [email protected].

Leadership support for Radiolab’s science programming is provided by the Gordon and Betty Moore Foundation, Science Sandbox, a Simons Foundation Initiative, and the John Templeton Foundation. Foundational support for Radiolab was provided by the Alfred P. Sloan Foundation.


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Oh, wait, you're listening to radio lab from WNYC. Hi, I'm Lulu Miller. I'm what if not, sir? This is radio lab. And for the last five or so months in this country, I mean, really the last 50 years in this country, abortion has been in the news constantly in this one very specific way that you are no doubt familiar with. Two camps, one wants to restrict abortion access, one wants to open it up, and they just battle back and forth, back and forth, back and forth. But it turns out that all the while, there was another story unfolding, a scientific story. And it's one that a lot of people were not paying attention to us included. It totally caught us off guard when we heard it. And so that is the story we're going to tell today. It comes to us from contributing editor, an ER doctor, Avira Mitra, here we go alongside Hello, our very own senior correspondent, Molly Webster. I don't know, I was just going to say Avira, you start. Avira's going to tell you a story. I love an Avira story. All right, cool. And we should say before we get rolling, this story talks about abortion and has some kind of graphic descriptions. So if you don't want to hear that today, this is a good one to skip. Right. So I guess this one started because, okay, for me growing up, my mom, she's an OB guy. And I just remember her telling me about stories of her performing abortions back in her day. This would have been like the late 70s. Wait, wait, wait, wait. I'm just picturing like Muppet baby, Avira. Like even before you were a doctor, your mom would tell you doctor stories. Yeah, I just grew up around so many medical stories, both my parents or doctors that we talk about things at the dinner table that a normal family would be horrified. They would be actively vomiting. And I'm just like, oh, yeah, pass the salt, please. So basically, you know, when she would talk to me about these procedures, they were pretty invasive. Like it was not a small deal, if that makes sense. Right. And even now in a hospital or clinic, it's pretty safe, but it's still something we take seriously. I mean, safe because we take it seriously. So for the last couple months, ever since the Supreme Court decision about abortion, I've been thinking about like, what is this going to mean for us in the emergency department now that we're living in this post row world? Because you know, like regardless of what you think about abortion, if people aren't able to get them, I'm anticipating a lot more patients showing up in the ER with like complications or people who have attempted to do their own abortions and hurt themselves in the process. So basically, you know, now at my job, you know, I have to occasionally organize conferences to teach ER residence things. And so I ended up hosting this OB doctor named Laura McIsaac, where I work, who for many years has been running the division in my hospital that deals with the abortions that we do. Now, what I was anticipating was sort of like this high drama, ER type of lecture of like, all right, when a patient comes in with a coat hanger abortion, these are the things you got to think about. It's going to be sepsis. Here's how you evacuate, or, you know, uncontrolled bleeding, where you, you know, what type of blood are you going to do? How are you going to match the blood? This is what I was in my mind picturing the lecture would be about. But it actually wasn't like that at all. What she sort of talked about ended up kind of blowing my mind in a completely different way.
So I emailed Molly and I was like, Laura, hi, good handshake. Let's just go talk to her. I'm so glad that it was more interesting than you expected. And basically she told us while we've all been arguing about the politics, the legality and the morality of abortion, the actual practice of it has been really on its own trajectory. Since I've been doing this work, it's changed probably more than any other thing I can think of. For the majority of abortions happening today, we're not talking about surgeries. No, it's with the medications to induce abortion pills. And while I knew that you can take pills to induce an abortion, I hadn't really thought about like how much this really does change everything about what it means to get an abortion. And how much of that has really just happened in the past few years since COVID and in a weird way because of COVID. Okay, so the story starts back in the 80s. Roe v. Wade just happened and you have greater access to abortions. And the way that we did abortions was surgically, right? So it was like

Transcription truncated.

When the Dobbs decision went down, ER doctor Avir Mitra started to prepare for the worst — botched, at-home abortions that would land pregnant people in the emergency room. To prepare himself and his colleagues for the patients they might see, and to think through how best to treat them, Avir asked Laura MacIsaac, one of New York City’s leading gynecologists and abortion experts, to come talk to his ER department. But what Dr. MacIsaac had to say in her lecture wasn’t what Avir expected: she didn’t talk about how we’re going back in time and the horrors of self-harm as a means to an abortion. Instead, she painted a picture of progress — how in the last 40 years, through private practice and clinical trials all around the world, the process and science of providing and having an abortion has changed dramatically, mostly because of two types of pills: misoprostol and mifepristone. On this episode, Avir and Senior Correspondent Molly Webster visit Dr. MacIsaac to hear more, and also learn about a new study that indicates the process of abortion is on the precipice of even further change.  Special thanks to Mariana Prandini Assis and Pam Belluck. Episode Credits:Reported by Avir Mitra and Molly WebsterProduced by Sarah QariMixing help from Arianne WackFact-checking by Diane KellyEdited by Becca Bressler Our newsletter comes out every Wednesday. It includes short essays, recommendations, and details about other ways to interact with the show. Sign up (https://radiolab.org/newsletter)! Radiolab is supported by listeners like you. Support Radiolab by becoming a member of The Lab (https://members.radiolab.org/) today. Follow our show on Instagram, Twitter and Facebook @radiolab, and share your thoughts with us by emailing [email protected]. Leadership support for Radiolab’s science programming is provided by the Gordon and Betty Moore Foundation, Science Sandbox, a Simons Foundation Initiative, and the John Templeton Foundation. Foundational support for Radiolab was provided by the Alfred P. Sloan Foundation.