RU-486: The Abortion Pill
Waiting eagerly for a decision from the Food and Drug Administration (FDA), pro-choice and pro-life activists rallied to voice their opinions on the drug mifepristone, also known as RU-486. However, the battle has just begun because RU-486, otherwise known as the abortion pill, was just approved for use in the United States on September 28, 2000. This controversial drug, first used in France, has been sparking debates in the U.S. ever since it was discovered in 1980. Now that it has been approved, many argue that this drug will make abortion more prevalent; however, others believe the approval of RU-486 is a positive decision and can greatly benefit women in the future.
RU-486, also known as mifepristone/misoprostol
To date, RU-486 has been responsible for more than half a million medical abortions in Europe (Mann, 2000). Mifepritsone is a synthetic steroid with anti-progestantional effects. The mechanism by which this works is the anti-progestantional activity resulting from competitive interaction with progesterone at progesterone-receptor sites. The end result of this competitive interaction is the termination of pregnancy (FDA, 200). Termination occurs because of a shortage in progesterone. The lack of progesterone will not allow the fertilized egg to adhere to the lining of the uterus. In order to expel the unattached egg, another drug, misoprostol, must be taken to induce uterine contractions; therefore, mifepristone is taken first and misoprostol is taken 24 hours later. Within hours the uterus breaks down and the pregnancy ends.
Before the drug was approved, many clinical studies were done and have shown it to be between 92-95.5 percent effective in causing a complete medical abortion. However, small percentages of women experience some complications with the drug. A study done on women in the U.S. showed that in 7.9 percent of the women (N=827), surgical intervention was necessary. Also, 1.6 percent needed medical intervention mostly for excessive bleeding, 4.7 percent had incomplete abortions, and 1 percent had ongoing pregnancies at the end of the study protocol. In French trials, a total of only 4.5 percent of women received surgical intervention, incomplete abortions, or ongoing pregnancy at the end of the study (FDA, 2000). Also, there are no data on the safety and efficacy of mifepristone in women with chronic medical conditions, women who are heavy smokers, or women who are more than 35 years of age and smoke more than 10 cigarettes a day. These patients were generally excluded from the clinical trials (FDA, 2000).
As a result of the clinical trials and other studies, the FDA requires that the patient should be given a copy of the medication guide and patient agreement. These require that each patient understand and sign a form that has information on what side effects can and probably will occur, in addition to other pertinent information regarding the drug. The side...