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by Steve Heilig
PART 1
Once upon a time I was an international drug smuggler. But please let me explain.
One foggy afternoon in the late 1980s I was sitting in the dungeon-like old medical library at UCSF, listlessly leafing through medical journals, procrastinating studying or other work. A brief news article jumped out at me, noting that brilliant European scientists had developed a pill that triggered abortions in early pregnancy, and that the medication, then called RU486, had already been shown to be both safe and effective. I recall feeling a surge of some kind of excited energy, along the lines of: This Changes Everything.
Before coming to the Haight and UCSF I’d done graduate work in public health down at UCLA, and never forgot a senior medical professor taking us students on a little tour of the hospital there. He walked us into a big hospital room and quietly said “Back in the 1960s, before Roe v. Wade legalized abortion, this was a ward for women suffering from the effects of illegal abortions. There were dozens of beds, almost always full. Many died. Blood had to be mopped from the floors. It reminded me of my time as a medic in wartime. But when abortion was legalized, the ward emptied out and was converted to other uses.” We just stood there quietly. He didn’t need to say more.
Later, my mentor and friend Dr. David Smith of Haight-Ashbury Free Clinic fame told me of watching a young mother die of an illegal abortion while he was training at San Francisco General Hospital in the 1960s, a tragedy he never forgot. By the 1980s abortion had been legal for over a decade but was still very controversial, to the point where clinics and doctors were protested, attacked, even murdered. So the new pills meant it would be much harder to target those committed to serving women, plus, wouldn’t almost every woman with an unwanted early pregnancy rather take a few pills than otherwise?
But the news of RU486 got out, and then-President George H.W. Bush vowed they would never be allowed in America, and banned it in 1989. That’s when I, and others around the country as it turned out, thought: We’ll see about THAT. And I embarked on a sort of crusade. First, I wrote articles about the new meds in the UCSF paper, and a review about the pills in the Journal of the American Medical Association. Then, with some veteran physicians at the San Francisco Medical Society where I also worked – some of whom also recalled the pre-Roe horrors – I drafted a policy statement urging that RU486 be made available in the USA. This was easily adopted not only in San Francisco but soon also by the California and American medical associations, which was very encouraging. The AMA adoption was even national news. I could then utilize the state doctors’ list to send a brief survey to California OB/GYNs, asking if they favored brining RU486 here and if they’d provide it to patients. The strong majority said yes to both questions and the published survey was again big news.
Meanwhile, a few of us drew up a research protocol for UCSF to test the pills, as even though it was already shown to work safely we knew US-based research would be needed for it to be approved here. Our proposal was approved but we still needed the actual pills, so we wrote to the French researchers and pharmaceutical company with our proposal, requesting a supply. It took some time – this was still pre-internet, involving lots of postage stamps – but eventually we were excited to receive an OK. But more months passed and the French sort of went silent. It turned out that the CEO-types of the European companies controlling these pills were very wary of getting involved in the American abortion debate in any way. We even heard some of them may have been personally threatened, which was all too believable. So it seemed we might be at a stalemate, even tough the French minister of health had called RU-486 “the moral property of women.”
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PART 2
Then one day I got a call from one Larry Lader, a veteran New York City abortion rights activist who’d seen my writings. He said he was coming to San Francisco and wanted to meet, and, might I be able to gather a few good OB-GYNs too? When we met, at the medical society HQ on Masonic Avenue, Larry’s proposal was this: Find a woman with an early unwanted pregnancy, fly her to Europe to pick up the pills and back into JFK airport in New York, tip off both federal authorities and the media so she would get busted and make RU486 a big public and political story.
It seemed an audacious plan and worth a try, so the OB/GYNs in our group started sending me potential patients. My job was to give them “informed consent” to the stunt – to make sure they knew they might wind up all over the papers and TV, and perhaps even get threatened. I also assured them they’d have all medical care and any other costs covered. A few thought it over and decided they couldn’t participate, until a young woman named Leona emphatically said “OK, let’s go.”
In sum, it worked exactly as planned. She arrived at JFK, was detained, and all the major papers and TV networks were all over it. A fast Supreme Court case – she had little time left to use the meds before being past the ten-week cutoff – denied her the pills. She was taken care of and hidden from the swarms of media folks demanding to talk with her. I was her main media flack and did countless interviews, and also was told I might be indicted for our “smuggling” efforts – although how many real smugglers tip off the authorities? Most importantly, Presidential candidate Bill Clinton, citing the coverage, pledged to bring these pills to American women. And TIME Magazine called RU486 “the pill that changes everything.”
We can’t claim our effort brought medication abortion to the USA but it helped put those wheels in motion. Still, it took the FDA eight years to approve it. As expected, many women started choosing pills over surgery, and as of now, almost two-thirds of abortions are done with mifepristone, as the medication is called.
This all occurred decades ago, hatched in our neighborhood. There’s no need here to get into the endless arguments about the morality of abortion. Women have been doing what they feel is best for them throughout history, often with little knowledge or involvement from men; women providing the service have been derided as murdered and “witches” and so on. “Nature” causes many early abortions on its own as well. Legal prohibition has never worked to stop it and only hurts desperate women — in fact, abortions have actually increased since Roe was overturned two years ago. And women now denied safe abortion in their states are traveling far and wide for help, and some suffering severe medical consequences. Is this “pro-life”?
There’s no more fundamental right than control over one’s own body. As Dr. Dave reminded us when founding the Haight clinic, “Healthcare is a Right, Not A Privilege.”
Universal access to contraception and reality-based sex education is what works to prevent unwanted pregnancy and abortion, and it’s safe to say that groups like Planned Parenthood have prevented more of those than any anti-choice activism ever has. Yet there are those who still hope to bring a real-life “Handmaid’s Tale” to America, and some of them are running for office. One doesn’t have to be a “childless cat lady” to know that’s a truly terrible prospect. We can’t let them drag us back to the bad old days. As many are rightly saying now, We Won’t Go Back.
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