Twelve years ago, before Plan B was readily available without a prescription and before the RU-486 was legal in the U.S., Amalia Dominguez (pictured) wanted to have an abortion.

Amalia Dominguez was 18 and desperate and knew exactly what to ask for at the small, family-run pharmacy in the heart of Washington Heights, the thriving Dominican enclave in northern Manhattan. “I need to bring down my period,” she recalled saying in Spanish, using a euphemism that the pharmacist understood instantly.

So the pharmacist gave her a prescription for misoprostol, which at that time was solely used for ulcers and is now part of the one-two punch of most chemical abortions when used in concert with RU-486 (mifepristone).

Its use without a doctor's care to induce abortion is, to say the least, not recommended by the manufacturer.

A spokesman for Pfizer, which manufacturers Cytotec [misopristol], declined to comment beyond saying that the company does not support the off-label use of its products and noting that the label includes “F.D.A.’s strongest warning against use in women who are pregnant.”

That warning, in capital letters, also notes that the drug “can cause abortion.”

But it does not always do so, not least because notions of how best to use it vary from inserting several pills into the vagina to letting them dissolve under the tongue. The side effects can be serious, and include rupture of the uterus, severe bleeding and shock.

So why in the age of birth control, legal surgical abortion and legal chemical abortions do women still use this and other equally dangerous and ineffective methods to end pregnancy?

Researchers studying the phenomenon cite several factors that lead Dominican and other immigrant women to experiment with abortifacients: mistrust of the health-care system, fear of surgery, worry about deportation, concern about clinic protesters, cost and shame.

“It turns an abortion into a natural process and makes it look like a miscarriage,” said Dr. Mark Rosing, an obstetrician at St. Barnabas Hospital in the Bronx who led the 2000 study, which was published in the Journal of the American Medical Women’s Association. “For people who don’t have access to abortion for social reasons, financial reasons or immigration reasons, it doesn’t seem like this horrible thing.”

Lee and Buckley cite stories of women scared of their parents and friends finding out, scared of deportation, women who felt unwilling to demand the use of condoms in their relationships for fear of being labeled as promiscuous and who often used the euphemism of "bringing on their periods" to linguistically deny the reality of inducing an abortion.

But, as with other methods of inducing abortions, these women risk incomplete abortions, health problems and even death, just to avoid clinic protesters, gossip, religious shame and even the potential for deportation. Safe, legal and rare is great, but where is shame-free in that formulation?

For Privacy’s Sake, Taking Risks to End Pregnancy [New York Times]

We all know well that to get rid of your baby at home you should generally submit yourself to the inimitable mix of RU-486 and — UGH — cytotec they give you at the abortion clinic? I looked on the internet and all the sites you get upon Googling "herbal abortion" are like "DUUUUUDE, TAKE OUR WORD FOR IT THAT THIS IS A MATTER FOR MODERN MEDICINE."

Herbal Abortions

Earlier: Yale Senior Undergoes Multiple Self-Induced Abortions In The Name Of Art

But enough of that; here we have a man, not a closeted gay Bible-thumping Evangelical career fearmonger but a middle-of-the-road retiree clearly realistic enough about the abortion debate not to let it steer his presidential vote away from a pro-choice candidate, exploiting the very weakest opportunity to pass an unconstitutional law because that's just how nuts people get over the abortion debate.

Anyway, I direct your attention to it not because I think it will pass, but because I truly wonder: why don't middle-of-the-road Catholics just go ahead and embrace the abortion pill already?

If you think abortion is wrong — not "murderous" enough to let it eclipse all other policies guiding your political decisions, perhaps, but not a good thing — shouldn't you look at RU-486, sort of like the Plan B "Morning After" pill, as a form of harm reduction? I know lots of Catholics (sigh) who privately do. It is generally only approved for the first seven weeks of pregnancy, before the whole "beating heart" thing, before the ultrasound looks like anything but a mess of cells, before the embryo even technically can claim the designation "fetus." But beyond that, pill abortions, performed at home without anesthesia, suck. They're personal. They hurt. Sometimes like hell. You bleed for a week, or longer. Look it up on the internet: women invariably describe them as "emotional." They are. If you're down for feeling a sense of loss about the whole thing, if you're at all reflective, if you — fuck, if you want to atone, you know, go ahead, it's your call — it's totally the way to go. And most importantly, once you've had one, you don't really want to do it again. (Not that you ever do, really.) I'm not saying anyone should feel this way about the choice to have an abortion. But a lot of us do. So why should we be treated like we're trying to score hallucinogens?

Missouri House Adds Abortion To Restrictive List [Kansas City Star]

Although a FDA spokesman said "[We are] not aware of any evidence to suggest the issue that occurred at the leukemia drug facility is linked in any way with the facility that manufactures the mifepristone", Shanghai Hualian doesn't exactly have the greatest recrod: In 2002, shipments from the company were stopped at the U.S. border because they were unapproved or mislabeled, and pharmaceutical behemoth Pfizer won't import from Hualian at all because of its concerns with quality issues.

What is currently unclear and mildly troubling is why all the mifepristone in the United States is manufactured by a single company at a single factory in a country with a checkered history of drug regulation. Instances of bribery in the Chinese drug industry are so extreme that the top drug safety official was executed last year because he had accepted money to approve drugs. In addition, the same inspector responsible for the factory producing the tainted cancer drug, Gu Yaoming, met with F.D.A. brass in conjunction with the RU-486 factory inspection, all of which makes Tuesday's news that the FDA is the equivalent of 13 years behind in inspecting foreign drug manufacturers all the more inspiring!

Finally we have to wonder whether this news will affect the number of non-surgical abortions in the United States. Since RU-486 was introduced in 2000, the percentage of abortions performed through the pill has risen steadily, and at this point 14% of all abortions are "miffy" induced. Does this new information make you wary of taking RU?

Tainted Drugs Linked to Maker of Abortion Pill [New York Times]
Related: For F.D.A., A Major Backlog Overseas [NY Times]

Earlier: Experts Don't Understand Why Fewer American Women Are Getting Abortions