Will the Stupak Amendment Affect Insurance Coverage for Miscarriages? I Think So


This weekend, a group of male pro-life Democrats gambled with women’s health, and women lost.  By broadly writing in that insurers can chose whether or not to cover "abortion services," pro-life amendments don’t just affect their intended victims — women seeking a way out of an unwanted or medically harmful pregnancy.  They also affect another group of victims — women whose pregnancies have already ended but have not yet miscarried.

I’m one of those women, and this past Halloween I had what the hospital officially termed an "abortion."

Hospitals and doctors in general do not have terminology to classify a difference between the termination of a live pregnancy and one in which the fetus has already died.  To them, a D&C is a D&C, regardless of the state of the "conception materials" removed.  Regardless of how many times I made sure to mention to the staff, either for the sake of my sanity or to spare me some sort of imagined shame, that I was ridding myself of my "dead fetus," to them, it was all the same.

I had learned the day before that the baby I thought was nearly 12 weeks old had no heartbeat, and had actually died at 8 weeks.  I was given three options: wait for a miscarriage to occur on its own, something I was told my body had no intention of doing anytime soon, take medication that would expel the fetus, passing it in my own home (classified a "chemical abortion") or come in for a D&C to remove the fetal materials. 

As much as I struggled with the sudden realization that the pregnancy was over, I also found myself trying to decide financially what I was willing to do.  A chemical abortion would cost $40, but I would be alone, bleeding, and it could still be incomplete and I would require a D&C anyway, since my pregnancy was so advanced.  Surgery would be quick, total, and under controlled circumstances, but would likely be our full maxed insurance amount of $1500.  And of course, there was the free option of waiting for my body to finally realize I wasn’t pregnant, but after 4 weeks the risk of infection was steadily climbing, increasing my chances of future miscarriage, infertility, or even death.  With a toddler at home, and still nursing hopes for extending our family some day, this was not an option.

I chose the quick and total route of the D&C, despite the costs, prioritizing my health and the health of possible future children.  I was lucky, and could afford to make that choice, because currently, my insurance cannot chose to refuse to cover what the hospital as termed an abortion.

Thanks to the Stupak amendment, that can now change.

Abortion is a very broad term.  The pro-life contingent would like you to think it only applies to selfish, irresponsible women, murdering babies out of fear of inconvenience.   That’s a caricature they have invented to push their own agenda.  Many of the women who seek out abortions are women who have been raped, who have learned that their child could not survive, have learned that giving birth could physically and permanently harm them.  Or, thanks to newer and vaguer language, women who have already lost the life they were carrying, and need intervention to save their own.

I was one of the latter.  I hope I will be lucky enough to never be again.  But if I am, I hope the insurers don’t force me to carry that fetus until I medically harm myself, all for the sake of saying that they do not cover abortion services.

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  • clinicescort

    Robin, I’m so sorry for your loss.

  • hello-ladies

    Robin, I am sorry for your loss. I had a similar experience and wondered about this when the amendment passed Saturday. This is heartbreaking. Thank you for sharing. http://www.helloladies.com

  • christie

    on your loss. Six years ago I fell into the second group of women–those who find out their baby has a birth defect they can’t survive. I’m grateful that my husband’s company had an insurance plan which covered my L&D at 21 weeks. If they hadn’t, I would’ve been stuck with a $10,000 hospital bill, and empty arms.

    http://www.ourheartbreakingchoices.com

     

  • jill-stanek

    Dear Robin,
    I’m very sorry for your loss.

     

    FYI, as a labor & delivery nurse I encountered mothers who expressed dismay that their miscarriage was technically called an "abortion" on their chart.

     

    But the terminologies are indeed different. There was more written on the chart to specifically describe what happened.

     

    "Induced abortion" is the purposeful abortion of a baby who is alive when the procedure begins, what pro-lifers battle. "Spontaneous abortion" is the term for miscarriage, when a baby dies and is expelled naturally.

     

    A "missed abortion" or "incomplete abortion" are terms for natural prenatal deaths where the baby is not expelled at all or incompletely. See definitions here:
    http://medical-dictionary.thefreedictionary.com/induced+abortion

     

    You are correct that the same surgery (usually D&C) is performed for induced abortion as well as missed or incomplete abortions. But a D&C is called "abortion" for induced abortions and "D&C" when removing a baby who has previously died. Again, see the definitions I linked to.

     

    The Stupak/Pitts amendment speaks to induced abortions. It uses the same verbiage as the Hyde Amendment, which has never been confused to exclude D&Cs for missed/incomplete abortions. Read the bill and you’ll see it is impossible to determine otherwise: http://docs.house.gov/rules/3962/Stupak3962_108.pdf

  • liberaldem

    I’m very sorry for your loss. Your eloquent post points out the problems when legislators do not adequately consider complex issues.

  • vicki

    Dear Robin,

    Thank you so much for sharing your story. I was totally unaware that these types of procedures were seen as the same thing. How devastating for women every where that our law makers could be so blind and cruel.

    I can say this as I, too, went through what you went through except for me, it has been eighteen years. I have since been blessed with a wonderful son. I pray that you may also be blessed in the future with more children.

    I know the legislators believe they are helping the ‘people’ but truly, I feel they should just stay out of our health care issues and leave these decisions between the patients and their doctors.

  • mark2

    Jill you are dangerously incorrect.  The Stupak amendment does not limit itself to induced abortions.  Furthermore, the language is not exactly the same as the most recent version of the Hyde Amendment.  A side-by-side comparison will make this clear.

     

    You are not a lawyer nor are you trained in statutory interpretation.   It is unclear how this language will be interpreted by the courts.  Furthermore, the uncertainty will certainly affect insurers and doctors who will not want to expose themselves to liability in the face of fairly clear statutory language.  As such, it almost certainly will lead to insurers acting in the ways forewarned in this article.

     

    Had Rep. Stupak wanted to limit the bill to only affect induced abortions he could have written it to say so.  Had you wanted to learn how to read legislation, you should have gone to law school.  You shouldn’t be giving legal advice, especially when you’re wrong.

    • prochoicegoth

      You’re talking to the woman who lied about her supposed experiences with "born-alive abortions". What do you expect?

  • veganemelda

    First off, I am so very sorry for your loss.

     

    Recently, I received a call from a women in a similar situation. She had a wanted pregnancy, the baby (I’m using her words to respect her loss) died, and her insurance refused to cover her needed abortion. They told her they couldn’t cover it until she developed an infection that would threaten her life.

     

    The hospital she was going to get her procedure at quoted her at least $9,000 to even start the procedure (it would cost more). I asked if she could get to Chicago where it would cost between $2,000 – $3,000. Despite being a state away, it was easier for her and her husband to drive here for a several day procedure then to stay in her home state and come up with at least triple the money.

     

    The Hyde Amendment, which is supposed to "help" women in these situations, couldn’t. Her insurance company wouldn’t. I am absolutely disgusted by everyone in the situation who wouldn’t help this distraught couple. And these are people who did everything "right." If a married, middle class, white couple can’t access a medically needed abortion, what hope do the rest of us have?

  • saraeanderson

    Had Stupak meant to only restrict access to elective abortion, he could have done so.  Okay, well, it’s extremely possible that he didn’t want to.

     

    Had you wanted to learn how to read legislation, you should have gone to law school.

    So if a woman is to get legally-sanctioned healthcare she should really have gone to law school?  I’ve never seen a clearer example of the attitude that laws exist to protect people with the means and inclination to get into the courtroom asap, and not the unwashed non-attorneys out there.  

     

    You say yourself that it’s not clear how this will be interpreted.  Physicians don’t want to get caught up in a nasty and expensive legal battle when they think they can avoid it, and Jill’s conservative reading is probably going to be a popular one amongst lawsuit-shy practictioners.   

  • mrsl

    No funds authorized or appropriated by this Act (or an amendment made by this Act) may be used to pay for any abortion or to cover any part of the costs of any health plan that includes coverage of abortion except in the case where a woman suffers a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the woman in danger of death unless an abortion is performed, including life-endangering physical conditions caused by or arising from the pregnancy itself or unless the pregnancy is the result of an act of rape or incest.

    Option to Purchase Separate Supplemental coverage or Plan – nothing in this section shall be construed as prohibiting any nonfederal entity (including an individual or a State or local government) from purchasing separate supplemental coverage for abortions for which funding is prohibited under this section, or a plan that includes such abortions, …

  • mark2

    You’re making the same mistake Jill is.  You’re not an attorney and you don’t understand how these bills work.  One needn’t be an attorney to get legally-sanctioned healthcare – but that’s not what you and Jill are doing.  Both of you are trying to parse complicated legislation and are making baseless proclamations about its impact without possessing the skills to do a good job of it.  We are all entitled to an opinion and to participate in a debate on these matters, but to claim that you know how this bill will be implemented is to claim a specialized training that you don’t have.

     

    And it is clear that you don’t have it.  I raised uncertainty to demonstrate a chilling effect.  You seem to believe that the desire to avoid a legal battle will lead individuals and institutions to read the bill in Jill’s particularly inaccurate and unsupported manner.  That’s hillarious and wrong.  Uncertainty will not cause institutions to read in the word "induced" where it does not exist and where the context does not give clues to its presence.  Risk aversion and uncertainty will lead to the restriction of all potential violations.   Practioners who are lawsuit shy are not going to risk a lawsuit by hoping someone like Jill, a non-lawyer, is right.  This is such a basic point that I would hope you needed no specialized training to understand. 

     

    Understanding the canons of interpretation that undermine your claim about the absence of the word ‘induced’ is much harder.  I don’t expect people without this training to know how this works at first glance and it’s an understandable mistake.  But if you were really committed to intellectual honesty, you’d at least make a good-faith effort to understand how this bill would be interpreted instead using the actual tools of the trade.  Instead, you are just blindly asserting that your side must have it right because you said so.  That’s not how this works. And it’s disingenous to posit the two as equals.

  • jgbeam

    I don’t believe anyone on either side of the abortion issue would object to funding removal of a naturally dead, unborn child at any stage of gestation. If this is how Stupak or any other piece of legislation reads it is wrong and should be corrected.

    Jim Grant, Pro-lifer

  • jill-stanek

    Mark2, you’re being intentionally obtuse. Your read of the Stupak amendment (posted by MrsL above) would indicate socialized healthcare with the Stupak amendment wouldn’t pay a woman to miscarry.

     

    Veganmelda, your story makes no sense. The woman whose tragedy you describe would not have had an "abortion" to remove a dead baby. Read my previous comment describing terminology.

     

    Furthermore, it appears she was quite far along. It is much safer to deliver normally – let nature take its course – rather than go through a "several days procedure." I don’t know the details, nor do you, but the conservative approach is always best. Still, again, your story makes no sense. The mother’s doctor could have broken her bag of waters or given her medication to try to stimulate her labor.

     

    It seems to me what actually happened here was she was carrying a terminally ill baby she did not want to carry, which was why the "procedure" would have been so expensive and why the insurance company wouldn’t cover it unless her health was at risk.

  • halli620

    I don’t know anything about hospital terminology, but I’m wondering if more "humane" hospitals have the option of terming "miscarriage services" exactly that in order to avoid any confusion (as well as emotional distress to the families)?

    Secondly, where online is a copy of the amendment available? Robin, I am very sorry for everything you’ve had to go through, but I ask that you not trivialize the option of a medical abortion just because it was not right for you. You should of course be entitled to your choice, but I feel you could have explained your reasons for not choosing a medical abortion without making it seem as horrific as being "alone and bleeding," and maybe how likely or not it actually would have been that a later week like yours would still have needed a D&C (since the completion rate is supposed to be 98% for up to 8 weeks, it seems like the chances of it working for you would still have been fairly high). Granted, mine was earlier, but I just don’t want your quick mention of your reasons for not choosing a medical abortion to make other women think that it is a horrid, dreadful experience, which it is not.

    May your family soon have happier experiences to make up for the memories of this sad one.

  • progo35

    Robin-I wish you peace and comfort in the wake of your tragic loss.  

    Mark-In the cultural milieu, "abortion" tends to mean an intentional ending of a pregnancy, not the removal of one in which the fetus has already died. It is condescending and illogical to argue that one must have legal training in order to read legislation accurately.

     

    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • sfall

    Thanks, Jill for clarifying this. The title of this article was very alarming. I have had a missed abortion, aka miscarriage, twice. Both times my OB made me have a high tech hospital ultrasound to verify that the baby had died because he did not perform abortions. My insurance was billed for a D&C and not an abortion. There was never any confusion. I trust your assessment, Jill…but I also have a pro-life friend who is an attorney and I will consult her.
    Thanks for writing the article, Robin. By raising the question, we can hopefully get to the answers. I wanted to point out that you and several others who have opposed the Stupak amendment have made a point of saying that men were driving this decision. I want you to know that there are tens of thousands of women who support this. In fact, the people that I know that are most passionate about this, are women.

  • lawoman

    I had the same thing happen with my first pregnancy, and also chose the D&C.

    The other thing I wonder about with the Stupak ammendment is what will happen to women with etopic pregnancies? Will they be unable to get insurance to cover until their fallopian tube ruptures and they are in immediate danger?

  • mariekw

    As a former employee of the insurance industry, I can tell you that the wording of the Stupak amendment absolutely does leave room to interpret it the way the author says: disallowing coverage to remove the dead fetus by performing a D & C after a natural miscarriage. It also absolutely does allow insurers or government administrators of the new plan to disallow coverage for removal of a pregnancy that threatens the health of the mother (such as in the case of an ectopic pregnancy, or pregnancy of a woman who has one of many other medical conditions that leave little or no hope of the possibility of a safe pregnancy.) When insurers, or government officials with authority over them don’t want something to be covered, and there is the slightest ambiguity in the wording of the regulations, believe me, the insurers won’t pay for it or the government won’t allow them to pay for it.

  • cand1date

    You seem to think this legislation somehow over turns or restricts Roe v Wade, when in fact all it does is limit what procedures can be publicly or privately funded. This talk of  risk aversion and lawsuits is unnecessary in this context, as no doctor will be faced with a lawsuit for performing an abortion of any type. The only person this affects is the woman and whether or not she will have to pay for any kind of abortion procedure (induced or not).

  • megan-evans

    In medicine, a miscarriage is denoted as "SAB" for spontaneous abortion and "TAB" is denoted as therapeutic abortion for an elected abortion.  All of which is documented in the patient chart as such.  In legal matters, lawyers won’t be looking to the "cultural milieu" Progo.

     

  • crowepps

    As a law, this bill is not going to be interpreted by ‘the culture’. It will be interpreted by police officers, district attorneys and attorney generals; by lawyers for the doctors, clinics, hospitals and women involved; by judges who have to rule on their disagreements; and by justices who have to determine where it is constitutional. I don’t think it’s condescending or illogical to recognize that legislation written by lawyers can and is twisted into a pretzel when other lawyers gets their hands on it, or that legislation can have unintended effects that are profoundly difficult to deal with.

  • megan-evans

    Jill,

    You are quite wrong about it being much safer to carry a dead fetus until it naturally is expelled from the body than to abort it.  The decomposing fetus can cause a life threatening infection-including sepsis and DIC-possible causing the mother severe medical issues that will require her to stay in the hospital for days if not weeks.  The infection could even kill her!  The abortion is much safer and does not take "several days," but more like 24 hours.  

     

    And in this case, the conservative approach would be to abort the dead fetus, not to allow the woman to continue to carry it!!   

     

    I’m sorry, but aren’t you an RN?  It greatly disturbs me that you believe this information and are possibly counseling people on it.  

  • progo35

    "In legal matters, lawyers won’t be looking to the "cultural milieu" Progo."

     

    No kidding. But any lawyer with a brain knows that there is a clear difference between an induced abortion for elective purposes and surgery to remove a deceased fetus from a woman’s womb.  

     

    "Well behaved women seldom make history."-Laurel Thatcher Ulrich

  • jaxparrothead

    Jill’s comments are correct. My wife and I have nearly 50 years experience in the medical insurance field, 1/2 of that with government health programs (Medicare, Medicaid, etc). A miscarriage and an ectopic pregnancy are considered life-threatening situations and are now, and will be under Stupak, eligible for reimbursement. Proper diagnosis codes must be entered and the provider of the service must be licensed to perform that service. This would only change if the definition of the disease or condition is changed. If someone’s doctor told them otherwise, they should change doctors immediately. Private insurance companies differ, it would depend on the language in the contract, but I have never seen any type of insurance, government or otherwise, that would deny this charge.
    I do agree that the term "danger of death" is very broad, but Stupak unequivocally states "certified by a physician". It does not specify any particular physician.

  • ninefjer

    Robin, the same thing happened to me. I recently contacted my Congresswoman to voice similar concerns. Commentors debating how the procedure is labeled or billed miss the point. There is a clear stigma attached to a D&C or D&E procedure. Abortion opponents don’t stop to ask whether a pregnancy was lost or ended and may not be versed in the finer points of medical labeling or billing. Doctors who fear abortion opponents do not learn or offer the procedure. What does that mean for women like us who need a D&C or D&E after a miscarriage? It means we have to worry if there will be capable, qualified physicians to provide the service. Limiting the procedure for some affects all of us!

  • princess-rot

    I’m not a doctor, or a med student, and even I can figure out that carrying around what basically amounts to a decomposing corpse that has, via the placenta, a direct connection to your blood supply and by that system, all your organs, is a really bad thing. It’s not use sitting on your laurels and hoping nature will take it’s course, even if it does the miscarriage could be incomplete and you’ll have rotting fetal tissue left behind that could cause diseases. We don’t leave surgical utentils in the body because it causes infection. We don’t leave dead fetuses in women, either.

  • egadspeople

    I recall years ago when the practice of waiting for the fetus to naturally exit the womb was commonplace.

    Women have every reason to be insensed by the Stupak Amendment, and any other wording actually included in the H.R. 3962 bill that denies them full health coverage.

    Congress needs to break down the text into manageable sized documents so people can actually download it for review. Write to Pelosi and ask her to make sure that gets done. Then, start asking your reps and Senators for their very specific viewpoints on the areas of the bill that are objectionable. If they can’t, or won’t answer, it’s because they haven’t read what they are planning to vote on. That’s not acceptable for something so critical.

    Keep all letters civil, void of threats, and do not write with emotional outrage. I have a bad feeling that this administration uses the tactic of getting women as angry as possible so he can laugh us off. It sure worked for him during the primary.

  • mrsl

    It is still commonplace in some areas to allow natural miscarriage. I did it back in 2002 and my sister-in-law did it in 1993. I went on to have another baby and my SIL had four more. D&Cs really raise the risk of Asherman’s syndrome.

  • crowepps

    It is much safer to deliver normally – let nature take its course – rather than go through a “several days procedure.” I don’t know the details, nor do you, but the conservative approach is always best.

    If you don’t know the details, why are you sure that you know what procedure would be safer? The fetus was dead. Your alarm over the types of procedures done on women who are carrying a dead fetus and your promotion of ‘natural labor’ to resolve those pregnancies might just possibly contribute to the misunderstanding you were so surprised by on another thread.

    Had anyone told me before today there are pro-aborts who actually believe pro-lifers are up in arms against surgically removing babies who have died naturally en utero but have not spontaneously delivered I would have said they were crazy.
    http://www.rhrealitycheck.org/blog/2009/10/27/the-born-alive-tale-myth-turned-political-tool?page=1

    Particularly in the case of ‘missed abortion’, where by definition the dead fetus has not been ‘naturally aborted’ but there has been no heartbeat for TWO MONTHS, it doesn’t seem to me there’s much point in being fussy about the means – removing the corpse in the most economical way that is medically safe for the woman should be the only consideration.

  • crowepps

    But any lawyer with a brain knows that there is a clear difference between

    Honey, I’ve got to tell you, I’ve been working with lawyers for almost 30 years, and whether or not the lawyer “knows that there is a clear difference” depends on what his client’s is paying him to “know”. If the client is opposed to ALL abortion and wants those women to carry around those dead fetuses, the lawyer isn’t going to see any difference at all.

  • mhataul

    Robin,
    I am deeply sorry for your loss.

     I am an attorney with Americans United for Life, and am a former counsel for two U.S. Senators. I want to clear up some confusion over the Stupak Amendment. The Stupak Amendment does, in fact, mirror the Hyde Amendment in that it applies the same prohibitions on federal funding of abortion to programs that are authorized and appropriated through H.R. 3962, that the Hyde Amendment applies to programs appropriated through LHHS (like Medicaid).

    I pasted the current Hyde language below, as well as a link to a chart on our website that compares the Hyde Amendment and the Stupak Amendment, and a memo analyzing the Stupak Amendment.

    The Hyde Amendment has been applied to Medicaid and other programs funded through Labor, Health and Human Services Appropriations since 1977. While the exceptions to the Hyde Amendment have varied at times (currently federal funding is allowed for abortions in cases of rape, incest, and the life of the mother), the underlying prohibition has remained the same.

    Just as the Hyde Amendment does not prohibit Medicaid coverage for treatment following a miscarriage, the Stupak Amendment would not prohibit coverage by an exchange-participating plan for treatment following a miscarriage. The sponsors of the Stupak Amendment (which, by the way, are not all men) carefully drafted the language to mirror the existing federal policy that has worked for 30+ years.

    I hope that this reassures you and others who have commented on your story. The Stupak amendment would do nothing to prevent women receiving affordability credits under health care reform from obtaining comprehensive reproductive health care. The Amendment just continues the longstanding federal policy of not paying for elective abortions.

    Best, Mary

    http://blog.aul.org/wp-content/uploads/2009/11/Comparision-Chart-b-t-Hyde-and-Stupak.pdf

    http://blog.aul.org/wp-content/uploads/2009/11/Stupak-Pitts-Backgrounder.pdf

    SEC. 507. (a) None of the funds appropriated in this Act, and none of the funds in any trust fund to which funds are appropriated in this Act, shall be expended for any abortion. (b) None of the funds appropriated in this Act, and none of the funds in any trust fund to which funds are appropriated in this Act, shall be expended for health benefits coverage that includes coverage of abortion. (c) The term ‘‘health benefits coverage’’ means the package of services covered by a managed care provider or organization pursuant to a contract or other arrangement. SEC. 508. (a) The limitations established in the preceding section shall not apply to an abortion— (1) if the pregnancy is the result of an act of rape or incest; or (2) in the case where a woman suffers from a physical disorder, physical injury, or physical illness, including a lifeendangering physical condition caused by or arising from the pregnancy itself, that would, as certified by a physician, place the woman in danger of death unless an abortion is performed. (b) Nothing in the preceding section shall be construed as prohibiting the expenditure by a State, locality, entity, or private person of State, local, or private funds (other than a State’s or locality’s contribution of Medicaid matching funds). (c) Nothing in the preceding section shall be construed as restricting the ability of any managed care provider from offering abortion coverage or the ability of a State or locality to contract separately with such a provider for such coverage with State funds (other than a State’s or locality’s contribution of Medicaid matching funds). (d)(1) None of the funds made available in this Act may be made available to a Federal agency or program, or to a State or local government, if such agency, program, or government subjects any institutional or individual health care entity to discrimination on the basis that the health care entity does not provide, pay for, provide coverage of, or refer for abortions. (2) In this subsection, the term ‘‘health care entity’’ includes an individual physician or other health care professional, a hospital, a provider-sponsored organization, a health maintenance organization, a health insurance plan, or any other kind of health care facility, organization, or plan.

  • markinsonmarshal

    It was a great pleasure reading this post.I’m highly impressed to know that people are so much concerned about the miscarriages and abortions taking palace in current times.
    configuration management

  • sschoice


    Robin, thanks for your moving (and motivating) story, it adds a lot of insight into the stress and confusion that restrictive amendments like Stupak’s would add to women in your situation, as they try to choose the best option for themselves when faced with pregnancies involving threats to their health.

     

    The details of legislation and insurance company policy on top of the medical terminology involved is so complex and removed from everyday life that it is easy to mystify the effects and detach onself from the real-life impact of restrictions on access to abortion. Stories like yours add insight to what we’re being faced with in the current debate over abortion coverage by insurance companies affected by health care reform, however one interprets what the Stupak amendment, the Capps amendment, and whatever other amendments will be proposed and attempted to be understood.

     

    There is a significant typographical error worth correcting in the post of your story above, though. As posted at this time, in the fifth paragraph there are the following sentences:

     

    As much as I struggled with the sudden realization that the pregnancy was over, I also found myself trying to decide financially what I was willing to do. A chemical abortion would cost $40, but I would be alone, bleeding, and it could still be incomplete and I would require a D&C anyway, since my pregnancy was so advanced. Surgery would be quick, total, and under controlled circumstances, but would likely be our full maxed insurance amount of $1500.

     

    A medical abortion (also known as chemical abortion), mostly likely using RU-486 would more than ten times $40, or over $400, so there’s at least a zero missing after the $40 in the above text.  Also, you mentioned how medical abortion would likely not be appropriate in your case, and that’s correct, but if one were to elaborate on it one might have also said that medical abortion is recommended to be used before 7 weeks (we’ve sometimes seen 9 weeks in advertising) LMP, so it seems unlikely it would be recommended in the situation you were in at 12 weeks.  We’re not aware of a clinic (based on some quick Google searching) where RU-486 is regularly used at 12 weeks, though in some special circumstances and with appropriate supervision it might be appropriate to do so.

     

    We got some of the information in the paragraph above from a factsheet at the Feminist Women’s Health Care Center website at this address, describing their costs and some of their policies for medical abortion:

     

    http://www.fwhc.org/abortion/compare_medical_surgical_ab.pdf

     

    That factsheet requires Adobe Reader or Acrobat.  If one can’t open that file, similar information is available at this page on their website.

     

    It is obvious from your story that you needed insurance coverage for surgical abortion and support in doing that in more ways than simply medical, and you were able to get that from your health care providers and (it’s implied) the family members in your life. It’s good to know you got coverage and support to do so.  

     

    We need more stories like these told to help people understand the what women like you face in situations like these — and women who are much poorer and younger than you, who may be more likely in distant or strained relationships with their partner or families, and those whose condition is not so likely to develop life-threatening complications.

     

    Stories like these are the most powerful way we know to respond to anti-choice threats, including the political compromises which are likely to occur as Stupak, et al, are debated.  We’re really not so much concerned about absolute bans on elective abortion coverage like some say may happen if the Stupak amendment was in the final bill signed by Obama as we are changes in insurance company policy that will create debates in turn between patients, doctors, and insurers over what constitutes a significant enough threat to a woman’s life or health to qualify for abortion coverage associated with a plan covered by subsidized health insurance.  The latter would be more in keeping with the effect, if not the intent, of anti-choice policies in general: to restrict abortion access to relatively poor and young women, perhaps in the interest of "abortion reduction" or promoting surrendering custody of their child, once born, for adoption.  As with all other abortion restrictions, whatever anti-choice restrictions may remain in place once health reform is passed will surely affect them most, and may have little or no effect on better educated, better resourced women whose voices will more likely be heard as the political compromises to come are negotiated.

     

     southern students for choice-athens