Is RU-486 Its Own Worst Enemy?CARLA COON
This "drug cocktail" is obviously lethal for the pre-born child, but it can be equally threatening for the mother who ingests it.
The abortion pill known as RU-486 has been mired in controversy since its introduction in France in the 1980s. With the approach of this synthetic steroid, a relatively untested drug, concerned pro-life and women's groups are asking whether we really know all the risks.
RU-486, named for the French company that developed it, Roussel UCLAF, is an antiprogestin. It is based on a chemical called mifepristone, whose structure is similar to the hormone progesterone. The look-alike steroid halts the progesterone production essential to sustaining the uterus and the growing fetus in pregnancy. Deprived of the nourishment normally provided by the endometrium wall, the baby dies. The drug also causes the lining of the uterus to slough off as in a menstrual period. The effectiveness of RU-486 alone for causing an abortion is only 6 times out of 10 uses - 60%. However, developers found that when mifepristone is used in combination with a drug called misoprostol, or prostaglandin, the abortions are more often completed. Prostaglandin causes the uterus to contract and the cervix to dilate, forcing the body to expel the baby. This raised the "success" rate of RU-486/prostaglandin to between 85% and 92%, if taken before the ninth week of pregnancy.
This "drug cocktail" is obviously lethal for the pre-born child, but it can be equally threatening for the mother who ingests it. An Iowa woman bled to death in a clinical trial of RU-486.
This, despite Planned Parenthood's report of "no complications" for the test involving 238 women. Another death occurred in France in 1991. Since then France has put tight controls on the use of the drug.
Common side effects include severe cramping, nausea, dizziness, vomiting and bleeding. The bleeding is about three times heavier and much more prolonged than a normal period and lasts 12 to 42 days. In Roussel's own study, bleeding was so severe in 7% of women that blood transfusions were required. RU-486 abortions have caused heart attacks and breathing difficulties. Sixty percent of women need pain medication, with 30% requiring a morphine-strength drug.
The drug may also be something of a chemical timebomb inside the women who have used it. As a powerful man-made steroid, with along half-life, RU-486 could possibly damage a woman's eggs, and cause future infertility. The delicate balance of hormones that regulate a woman's cycle each month could very well be temporarily or permanently altered by such pills. Researchers admit that, in the absence of any long-term follow-up studies, they simply do not know the repercussions of the RU-486 regimen.
The failure rate of up to 15% means that surgical intervention is necessary to complete these abortions. Those that fail to have the surgical abortion and whose babies survive are faced with untold problems. As of 1991, 21 babies were born after RU-486 failed to abort them. Some had congenital abnormalities, some immune diseases, others infections, and still others deformities. These are the observable difficulties, but the long-term effect of both mifepristone and misoprostol on the babies is still unknown.
Scientists have pointed out that the drug's mechanism is extremely complicated. The chemical structure of RU-486 itself is similar to that of DES, a synthetic estrogen used in the 50's and 60's to prevent miscarriage. Many of the children whose mothers used DES grew up to find themselves sterile, and to have a host of related problems. These possibilities alone have led Roussel UCLAF, fearing litigation, to require women to sign an agreement to a surgical abortion if the pill fails.
NOT FAST, NOT EASY
Chemical abortions using RU-486 are not simple. Compared to traditional abortions, which take one or two visits to the abortionist, RU-486 patients can expect a long, drawn-out process. In France, a woman must first fill out medical history forms. have a pregnancy test, and an ultrasound and pelvic exam to determine the age of her baby. She is then sent home for one week of reflection (required in France). When she returns to the facility she will be given RU-486. Two days later, she returns again to receive prostaglandin, and is observed for four hours for possible complications. Many women expel their dead baby during, this time. She comes back one week later to ensure that the abortion is complete. If the pill fails, she undergoes a surgical abortion by suction, or D and C (dilatation and curettage).
The time from start to finish can be a veritable nightmare for women, with painful cramping, hemorrhaging and dozens of trips to the bathroom for diarrhea and nausea. Worst of all, the psychological trauma of mothers who see the remains of their deceased child discarded in a toilet bowl or on a pad has proven severe enough in France, support have sprouted like
It was the French scientist Dr. Etienne-Baulieu who announced in 1982 that he had successfully aborted four children using RU-486. By 1988, Roussel UCLAF petitioned the French government for permission to market the pill. By 1992, RU-486 was allowed in China, England and Sweden. Afraid of strong pro-life pressure (especially boycotts), Roussel decided to donate the patent rights to the U.S. Population Council n 1994. Since then, the Population Council, the Clinton administration and other pro-abortion forces have peen working overtime to persuade :he FDA to approve the drug for use in the United States. The FDA has tasked the council for further clarifications and agreed to keep the identity of the manufacturer secret for fear of pro-life protests.
Who will dispense RU-486 in America and how? Abortion supporters are anxious for RU-486 to be widely available despite the health risks. They envision abortion being more accessible as family doctors and OB GYNs prescribe the pills, and infinitely more private as women can abort in the privacy of their homes. To that end, there are several differences between the French protocol for RU-486 and the guidelines being proposed for the U.S. Here, abortion supporters are trying to get the FDA to make an ultrasound optional. It's mandatory in France. Other procedural changes sought are the elimination of a complete blood count and for prostaglandin to be taken at home instead of at the abortionist's office.
The issue of where to administer the prostaglandin is particularly volatile. RU-486 supporters know that a great number of regular doctors will not prescribe the pill if it means mothers will be cramping and bleeding heavily in their offices, not to mention making trips to the bathroom for nausea and diarrhea. It would mean major renovations to their offices.
WHAT CAN WE EXPECT?
In the United States there is a noticeable lack of regulatory supervision of abortion services. The entire industry is so politically guarded that abortionists are not held liable for even serious violations of the most basic medical standards. Many of us are familiar with how much it takes to even temporarily close an abortion clinic with copious infractions.
If we want safety, the last thing we need are chemical abortion kits for do-it-yourself terminators. With abortion politics being what it is, that may be exactly where we are headed. Supporters have consistently fought every kind of precautionary measure suggested for women seeking abortion, such as waiting periods, clinic and abortionist's licensing requirements, parental consent, informed consent and careful screening policies. The potential for disaster with abortifacient prescriptions is astronomical. Yet, given our present system's lack of controls, it is unlikely we will have even half of the safety measures mandated in France.
SEEING IS DISBELIEVING
Ironically, the privacy aspect lauded by RU-486 supporters may be the factor that will cause countless mothers to literally see abortion for what it is. Chemical abortions have psychological ramifications that go far beyond those of surgical abortions. In a surgical abortion the mother is somewhat sheltered from the direct responsibility for the act. An abortionist performs the procedure, while she lies sedated and mentally removed from the machines and hands that do the work. With RU-486, the woman herself takes the pills, bears the pain and bleeding, and in a disturbing number of cases beholds the remain of her killed child.
We are already hearing the testimony of women who thought of their babies as lumps or blobs of tissue only to have their eyes opened wide by RU-486 abortions. RU-486 babies are not torn up as in surgical abortions. Many mothers will see their whole baby lying stiff in the placental sac. Rare is the mother not deeply affected by such a sight.
Abortion supporters hope that, by moving abortion out of the clinics and into the home, they will squelch the abortion debate once and for all. Their out-of-sight, out-of-mind assumption is naive. RU-486 will bring the horror of abortion home - in a way that may shock a lot of women.
Carla Coon "Is RU-486 Its Own Worst Enemy?" The National Catholic Register (May 28, - June 3, 2000).
Reprinted by permission of the National Catholic Register. To subscribe to the National Catholic Register call 1-800-421-3230.
Carla Coon is editor of LifeNews, a publication of the New York State Right to Life Committee.
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