FREE ESSAY ON RU-486

RU-486

For more than 10 years, European women have been able to use mifepristone, known there as
RU-486, as a pharmaceutical alternative to surgical abortion during early pregnancy. 
Availability to women of the so-called abortion pill in the United States has been
delayed, though, by the tense political climate of the abortion debate. 
On Thursday, the federal Food and Drug Administration approved mifepristone for sale in
the United States. The pill, to be marketed under the name Mifeprex, will be available
only through physicians. It should be available in about a month. 
The approval of mifepristone is the result of the FDA's careful evaluation of the
scientific evidence related to the safe and effective use of this drug, said Dr. Jane
Henney, commissioner of food and drugs. The FDA's review and approval of this drug has
adhered strictly to our legal mandate and mission as a science-based public health
regulatory agency.
Mifepristone, or the early-abortion pill, is as significant a technological advance for
women's health as the birth-control pill was 40 years ago, said Gloria Feldt, president
of Planned Parenthood Inc. It will enable them, if they choose to terminate a pregnancy,
to do that earlier (and) to do it without surgery. For many women, that is a very
positive thing. 
The pill is far less invasive than a surgical abortion and can be given in a physician's
office.
Mifepristone differs from the morning-after pill approved by the U.S. Food and Drug
Administration in 1998. Planned Parenthood has described the morning-after pill as
emergency contraception (that) can prevent pregnancy up to 72 hours after unprotected
intercourse. 
A synthetic steroid, mifepristone interferes with a fertilized egg's ability to adhere to
the lining of the uterus. To cause abortion, it is used early in pregnancy with another
drug, misoprostol, which prompts uterine contractions. 
Studies have shown that the drug is 92-95.5 percent effective in causing abortion when
used within the first seven weeks of pregnancy. A very small percentage of patients need
additional surgery or blood transfusions. For most, the process is over in a few hours --
a week at most. Side effects include uterine cramping, heavy bleeding, nausea and
fatigue. 
The FDA said bleeding and spotting typically last for about nine to 16 days. It can be so
heavy in about one of 100 women, that a surgical procedure would be required to stop the
bleeding, the agency said.
Anti-abortion activists oppose the use of mifepristone and misprostol, saying it is
misleading to refer to an at least two-week-old embryo as a fertilized egg and that the
method poses health consequences to women. 
American women need to know it will take the life of their unborn child, and there is a
serious health risk to themselves, Laura Echevarria, a spokeswoman for the National Right
to Life Organization, told Reuters. 
The organization's Web site points out that 2 percent of women who used the drug
combination experienced such severe bleeding they required surgery, and that during U.S.
trials one woman nearly bled to death. 
FDA-approved rheumatoid arthritis drug methotrexate also can be used like mifepristone,
but it is not used often because it is less effective. 
Mifepristone helps women in the sense that in some cases, they can end their pregnancies
much earlier, said Stanley Henshaw of the Alan Guttmacher Institute. Nowadays, with
sensitive pregnancy tests, some women know they're pregnant even before they miss their
first period. 
Surveys of physicians done in the state of Washington in 1996 and 1997 indicate that
slightly more than one quarter of them would be likely to prescribe mifepristone if it
became available. Many in that group said they viewed medical abortions as safe,
effective and private. 
But there are other issues surrounding access as well. 
Right now there are lots of laws in many states that restrict abortion practice, said Dr.
Mitchell Creinin of the University of Pittsburgh. Medical abortion is not going to be any
different. 
According to French ministry of health officials in Paris, mifepristone is used in about
10 percent of the 200,000 annual abortions done in the country. In more than a decade,
researchers there have found that the pill has not replaced surgery as the most common
method of abortion. It also has not increased the number of abortions.
The Centers for Disease Control and Prevention in Atlanta, Georgia, noted recently that
the abortion rate in the United States is now at its lowest level in 20 years. 
The cost for an abortion using mifepristone is expected to be comparable to that of a
surgical procedure -- about $300.