RU-486

RU-486 is a steroid abortifacient, taken in the first seven weeks after conception to terminate pregnancy. RU-486 causes abortion through pill form rather than through placement of objects into the uterus. RU-486 is known as a medical abortion rather than a surgical abortion because it works without the direct placement of tools into the woman's body. The embryo is expelled, simulating miscarriage, which may occur anywhere—it is not limited to the confines of a medical environment. A lengthy battle took place before RU-486 gained final U.S Food and Drug Administration approval in 2000. RU-486 is also known as mifepristone; this name is gaining popularity in the United States.

RU-486 works by divesting the uterus of progesterone, making the womb inhospitable to the prolongment of pregnancy. The abortion process using RU-486 is lengthier than that of traditional methods, including vacuum aspiration or dilation and curettage, as a result of multiple steps in the abortion process and medical appointments. The process begins with an ultrasound confirming less than 49 days of gestation. Then RU-486, or antiprogestin mifepristone, is taken. Forty-eight to 72 hours later, the woman takes prostaglandin either at home or at a medical facility, orally, by injection, or by suppository. The woman later expels the embryo, usually within a few hours of taking the prostaglandin. A final appointment, generally scheduled within two weeks of the second step, [Page 1258]is necessary to ascertain the success of the process. There are many possible adverse effects, including uterine contractions, diarrhea, headaches, back pain, heavier bleeding, nausea, abdominal cramps, and fatigue. Rarer complications include excessive bleeding requiring blood transfusion. At this time, the long-term adverse effects of RU-486 are unknown.

RU-486 is known as a medical abortion because it works without the direct placement of tools into the woman's body.

Since its introduction to U.S. markets in 2000, use of RU-486 has steadily increased, while the overall abortion rate has decreased. Doctors who may not give surgical abortions may be willing to prescribe the RU-486 regimen rather than making women seek out abortion specialists. A slow adoption of RU-486 as a method of abortion in the United States is similar to the pattern established in European nations allowing RU-486.

First approved for use in France in 1988 by the Ministry of Health, considerable setbacks delayed the use of RU-486 in the United States. Final Food and Drug Administration approval was contingent on knowing manufacturing information, which was impossible because most U.S.-based pharmaceutical companies did not want to upset the pro-life community. Eventually, the Danco Group, a small pharmaceutical company, agreed to back RU-486. Mifepristone is currently produced in China by Shanghai Hualian under the patent Mifeprex. As a result of the increasingly murky situation regarding access to contraceptives and emergency contraceptives at pharmacies across the country, Danco Group distributes Mifeprex to doctors and clinics only. According to the Guttmacher Institute, an estimated 22 percent of all abortions in the first seven weeks are through medical and not surgical abortion.