RU-486 Not Seen as Alternative to Cities Without Abortion Clinics

by Flo Conner
The Boston Globe

CHATTANOOGA--When the city's only abortion clinic closed seven years ago, the AAA Women's Services became the only game in town.

The Christian anti-abortion organization runs abstinence programs for young people, encourages pregnant women to keep their babies or offer them for adoption, helps new mothers, and offers post-abortion counseling.

But in a city of 170,000, there are no formal family-planning clinics that provide information on abortion. And anyone who wants an abortion has to drive to Nashville, Knoxville or Atlanta.

Last month, abortion-rights supporters hailed the approval of the abortion drug RU-486 as giving women better access to abortions, especially in areas without an abortion clinic. But in a conservative, religious town like Chattanooga, the same public pressure that has nearly wiped out abortions is likely to limit widespread use of the drug.

"Every doctor who's pro-life is talking with every doctor who would ever consider using that drug and saying, 'Now, you wouldn't use that drug, would you?'" said Dr. Dennis Bizzoco, a Chattanooga podiatrist and longtime anti-abortion activist.

Abortion-rights groups say the situation in Chattanooga could be repeated in other towns that don't respect women's rights.

"It's a long-awaited victory for American women," Elizabeth Cavendish, legal director of the National Abortion Rights Action League, said of RU-486, also known by its chemical name mifepristone. "But change won't be immediate. Doctors will want to get familiar with the treatment, and we hope there won't be additional impediments thrown up by state legislatures."

Although a Kaiser Family Foundation survey in June found that one-third of ob/gyn physicians who don't offer abortions would prescribe RU-486, only 15 percent of the surveyed doctors were in rural areas. "If there's a strong local pro-life feeling, word will travel very fast," said Alina Salganicosf, co-director of women's health policy for the Washington-based foundation.

Access to abortion in Chattanooga has been virtually nonexistent.

According to the National Abortion Rights Action League, 90 percent of Tennessee counties have no abortion providers, and Chattanooga is the largest US city without an abortion clinic.

The Chattanooga Women's Clinic was the city's last abortion provider, which used to perform 2,000 abortions a year. (There were 474 abortions in 1997 in all of Hamilton County, where Chattanooga is located.) Across the street was the AAA Women's Services, which had $1,600 in the bank when it learned in 1993 that the clinic's building was up for sale.

In a week, the group raised $300,000 in local donations and outbid the doctor who performed abortions at the clinic. The group then terminated the lease for the clinic, which decided to shut down rather than move.

The building was turned into AAA Women's Services center, where a staff of 17 supervises an annual budget of $700,000 that comes mostly from local donations. In addition to free pregnancy tests, pregnancy counseling and abstinence programs, the group provides extensive help for new mothers, including a well-stocked closet of baby clothes.

The entire thrust of the center is simple, said Patricia Lindley, the group's community services director: "Save the child and protect the mother."

The building also houses a National Memorial for the Unborn. The names of 1,000 aborted fetus are written on a marble wall, which is arrayed with stuffed animals, notes, and toys placed by women expressing their grief after having an abortion. The memorial, open 24 hours a day, draws visitors from around the country.

Despite the strong local sentiments against abortion, there's a steady stream of Chattanooga women who seek abortions in other cities. A few local doctors will perform the procedures, but "you have to be well-connected," said Holly Christopher, a 36-year-old Chattanooga housewife who has become an informal, unpaid adviser for women seeking abortions.

The absence of an abortion clinic doesn't prevent women from getting an abortion, she said, but does make it more dangerous. Christopher helped another woman obtain an abortion recently, but had to drive her to Nashville for the procedure. "I was scared," she recalled of the three-hour drive home. "Here she was in the back seat with her legs up in the air. What would have happened if she'd begun to bleed out, or we had a wreck on the way back?"

Women come to Christopher for advice because she has never been shy about talking about her own experience of having an abortion at age 19. Christopher, who said she doesn't regret her abortion, doesn't promote it, either. She has been thrust into the job of counseling, she said, because "the only professionals out there doing counseling are pro-life, and that's sad."

RU-486 has introduced a new element into the abortion debate, said Gabrielle Pierce, a spokesperson for the Volunteer Medical Clinic in Knoxville, who said the clinic has been receiving many calls since the drug was approved. The clinic will offer the drug, but not for a couple of months, she said.

Because prescriptions for the drug will be limited, Pierce doesn't expect the clinic to lose patients from rural areas or cities like Chattanooga. "There's a lot of stigma placed on abortion," she said, "and doctors won't want to put up with the (harassing) phone calls."

The Feminist Women's Health Center in Atlanta has been conducting clinical trials for abortion drugs, and 97 percent of the women who choose to take an abortion drug would recommend it to others, said Lindy Wood, the clinical trial site coordinator. Because the drug requires a series of treatments, the clinic will provide RU-486 only to women who live in a two-hour driving radius, which includes Chattanooga. "I think more providers will offer it," Wood said, "but it will be interesting to see how many of them are willing to open themselves to the potential for controversy."

In Chattanooga, physicians disagree about whether local doctors will offer the drug. Dr. Phyllis Miller, an ob/gyn, said she will not offer it to her patients, but thinks other local doctors will, "depending on their feelings" on the issue.

Dr. Jay White, another ob/gyn, said he expects no local physicians to offer RU-486 to their patients. "If it were to get out, it would be suicide for your practice," he said.

"A doctor who provides RU-486 is going to find patients dropping him like a rock because they don't want be associated with an abortionist," said Laura Echevarria, spokesperson for the National Right to Life Committee in Washington. "RU-486 is not supported by the medical community or the public. The head of surgery is not going to have the local abortionist on his Christmas card list."