Long-Awaited Abortion Pill Will Offer More Privacy--But No Less Controversy
Four years ago, Rory Hoag was a 22-year-old on a study-abroad program in Paris when she unexpectedly found that she was pregnant. She made the painful decision to end the pregnancy--and then faced a further anxiety. "The idea of having an invasive surgical procedure in the context of a medical system I didn't understand and with doctors I didn't know really scared me," she recalls. "And I didn't want the other students to know what I was going through." In France, though, there was an alternative: abortion by medication instead of surgery.
A gynecologist prescribed a drug called mifepristone, commonly known as RU-486. Two days after taking it, Hoag went to the hospital, where she was given another drug, misoprostol, to induce uterine contractions. After four hours of nausea and intense cramping, she went home. Hoag, who now runs a Planned Parenthood clinic in Gainesville, Fla., says she was relieved not to have to go in for surgery. "I was able to go to the doctor and keep the matter private."
Mifepristone has been available in France for 11 years and has gained regulatory approval in 13 other countries, but the passionate politics of abortion in the United States has kept it off the market here. That may be about to change: Final talks are underway between the Food and Drug Administration and the Danco Group, the company sponsoring mifepristone in the United States, to clear appro-val for the American market. Called Mifeprex, the drug could be available sometime this year.
No easy solution. For women who have made the decision to end a pregnancy, medical abortion can offer the comfort of being at home for much of the process. Women who have taken part in clinical trials of mifepristone in the United States say they appreciate the privacy. "I wanted to share this just with my partner," says one 36-year-old woman from Washington State who requested anonymity. And activists on both sides of the abortion debate agree that the pill may ultimately broaden access to abortion for American women. One Kaiser Family Foundation survey of over 750 physicians and nurses, most of whom are not abortion providers, found that over half said they were likely to incorporate mifepristone into their practice. "Lots of doctors are not surgical types," says Diana Dell, assistant professor of obstetrics/gynecology and psychiatry at Duke University Medical Center. "They are going to be more comfortable offering an early-stage, medical procedure."
Mifepristone won't make abortion as simple as popping a pill, however. A medical abortion resembles a miscarriage. The Washington woman took the misoprostol at home and spent the next few hours experiencing intense cramping and bleeding. "I didn't expect it would last so long," she says. The logistics aren't easy, either, involving at least three visits to the doctor as well as a few hours of bed rest. The method will be subject to the same legal restrictions as surgical abortion, and those who believe abortion is wrong think it is no less wrong when the means is medical rather than surgical.
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