Some call it the Abortion Pill, but the inventor of RU486 prefers to call it a “contragestive,” saying that the word abortion is “automatically negative and guilt-inducing.” Last year, Etienne Baulieu told the New York Times, I resent [it] when people present the very early interruption of pregnancy as killing a baby, morally or physically. I think it’s a crime to say that.” Despite Baulieu’s resentment, RU486 is a product designed to provoke a chemical abortion in early pregnancy. In 1970, Baulieu’s team of scientists at France’s national Institute of Health and Medical Research discovered the receptors in uterine cells that receive messages from the hormone progesterone, which tells the uterus to prepare itself to receive the newly-conceived embryo. Researchers at the pharmaceutical company Roussel Uclaf, for whom Baulieu works as a consultant, then went to work looking for anti-hormones that would block progesterone from reaching the receptors. Blocking progesterone would make the uterus a hostile environment for the embryo and thus cause an abortion. By 1980, the scientists had their blocker and registered it as Roussel Uclaf 38486.
The results of the first set of human trials of the drug were published in 1982. RU486 induced abortions in 9 of the 11 women who participated in the study. Later trials found that RU486 had a higher “success” rate when given in conjunction with prostaglandins. But, even then, a chemical abortion is not guaranteed and some women will undergo a surgical abortion or need surgery for the excess bleeding caused by the drug. Others will change their minds about wanting to abort their babies and will face possible delivery of a disabled child.
A British study of 97 women gives some firm information about “success” and “failure” rates. Twenty-eight women underwent vacuum aspiration (surgical) abortions; 30 were treated with prostaglandin pessaries; 20 received RU486; and 19 were given a RU486-prostaglandin combination. The women ranged in age from 33 to 56 days’ gestation. The purpose of the study was to compare the “success” rate for chemical abortion to that of surgical abortion, the rationale being that if chemical abortion is to be widely used it must have “success” rates comparable to surgical abortion.
The report of this study (published in the British Journal of Obstetrics and Gynaecology, March 1988) recorded no “complications” for the 28 women who underwent surgical abortions. However, the “complete” abortion rate was 96 per cent: one woman underwent further surgery to remove “necrotic deciduas” (dead tissue) four weeks after the abortion.
The prostaglandin pessary treatment was considered the least effective method: 87 per cent of the women required medication for pain, 23 per cent suffered vomiting and 33 per cent diarrhea. The pessaries were administered every three hours. Two women aborted after four pessaries, the other 28 received the maximum dose of five pessaries. One woman (3 per cent of the total receiving pessaries) required “uterine evacuation for ongoing pregnancy” two weeks later.
The women treated with RU486 alone recorded fewer side effects, such as gastrointestinal irritation and pain, than did women treated with prostaglandins alone or the RU486-prostaglandin combination. But the drug has a 40 per cent failure rate: it worked for only 12 out of the 20 women treated.
The eight for whom it did not work underwent surgical abortions two weeks later. In addition, one woman who received RU486 alone needed “emergency uterine evacuation” (because of heavy bleeding) three days after the treatment. Another woman required a blood transfusion after she had a surgical abortion following the failure of RU486.
While treatment with RU486 and prostaglandin combined recorded a higher abortion rate (95 per cent success), the women in this group suffered increased vomiting (32 per cent). The one woman for whom RU486-prostaglandin did not work recorded a positive pregnancy test four weeks later and went through a surgical abortion. (She would have been pregnant for 9 to 12 weeks.)
The report states that this trial substantiates the findings in other trials. The report notes that although the failure rate in using RU486 alone is considered “unacceptable,” a higher rate of 85 per cent complete abortion has been reached when RU486 is administered within 10 days of the missed menstrual period. The report calls for further trials to find the optimal dosages and to see what these treatments may do to the women’s subsequent fertility.
Prostaglandins have been used for some time to induce early abortions. They effectively provoke uterine contractions to expel an embryo, but the heavy dosages needed also cause nausea, diarrhea and pain. RU486, on the other hand, highly effective in killing the embryo, does not always stimulate contractions. Combining RU486 with low-dose prostaglandin, therefore, overcomes the “side effects.”
Another trial of RU486, conducted by Etienne Baulieu and two others in France with a grant from Roussel Uclaf, recorded a 19.5 per cent failure rate when RU486 alone is used one day before the woman’s menstrual period is due.
This trial, a report of which appeared in Fertility and Sterility in October 1988, was conducted on 139 women “at risk of pregnancy” – that is, all had participated in “unprotected” sexual intercourse and had “expressed their willingness to interrupt a possible pregnancy.” They also agreed “to undergo mechanical pregnancy interruption” if RU486 failed.
Blood tests determined that a total of 48 women were pregnant, a pregnancy rate of 34.5 per cent. All 139 women received RU486 and the number of days elapsed from their last menstrual periods ranged from 21 to 37. (For the pregnant women, this gives between 26 and 37 days as the length of gestation.) Nine women who remained pregnant despite RU486 underwent vacuum aspiration abortions.
In summing up the results of this trial, abortion must be used when RU486 fails, because there is no information on the effect this drug has on the developing child.
Baulieu’s trial did not note serious side effects, but the British trial discussed earlier in this article reported a severe haemorrhage in one woman. Others have also recorded high incidents of haemorrhage. Most notably, a report on RU486 prepared by the National Confederation of Catholic Family Associations in France discovered that serious haemorrhaging occurred in 823 out of 2,000 cases.
The damaging effects of RU486 on mothers, and the babies who survive the treatment, are not yet known. However, pro-life experts have already raised serious concerns. Dr. John Willke, head of the U.S. National Right to Life Committee, points out that fetal birth defects are an almost certain probability.
“Remember how this drug acts,” he wrote in the NRL News last November. “It deprives the very young developing baby of an absolutely vital nutrient hormone. This hormone, Progesterone, is needed for a proper organogenesis, i.e., proper development of the structure of the body and its organ systems.”
Willke reports that researchers insist on back0up abortions while the drug is undergoing closely supervised trials. As he points out, this will not always be the case and some women will change their minds about aborting their babies. He sees RU486 as another, enormous, Thalidomide tragedy.
“The chemical structure of RU486 is very similar to the chemical structure of DES,” explains Dr. Willke. “This was the synthetic estrogen that was widely used in the 1950s and 60s to try to prevent miscarriages. It was ultimately proven ineffective for this, but is also proved to be a time bomb. When the girl babies of mothers who had taken this drug became mature women, some of them were found to have severe defects of their female organs, and some developed cancer of the vagina.”
“RU486 has a similar structure,” says Dr. Willke. “Its make-up is such that it is quite possible, inside the body, to have a reaction which produces a free radical. This free radical could interact with the DNA of both the mother and the baby. If it interacts with fetal DNA there might be a reaction similar to DES, which would give her children problems in later years. It could also cause problems in her future babies. There would also be a possibility that it could cause maternal cancer.”
Today we do not know what possible long-term effects to expect. Dr. Willke says that the necessary research is not yet taking place and that it will take years before the fears can be proven or disproven. “The point we must make,” he insists, “is that, while we can’t prove that these long-term problems definitely will happen, the drug maker cannot prove that they will not.”
The invention of RU486 has been hailed as a great step forward for all women and especially those in the Third World. The population controllers argue that the often primitive conditions under which their doctors work means increased risk of infection and death: a pill is often both simpler and safer than surgery. But what we, in our modern hospitals call ”minor” side effects of RU486 – excess bleeding, vomiting and diarrhea – can kill women in underdeveloped countries.
RU486 has already been extensively tested in developing countries such as Puerto Rico. The first country outside France to license the drug is China, whose draconian “one child” abortion policy is failing. Baulieu has said that from China, he expects to see RU486 spread through Asia and Japan. In addition, Roussel Uclaf has signed a contract with the World Health Organization that provides for the distribution of RU486 at cost price in developing countries.
Controversy over RU486 erupted last year. Roussel Uclaf announced it would not market the drug: the French government ordered the company to resume production. Shortly after, Roussel spokesman Dr. Jaques Gareau insisted that the company had no immediate plans to market the drug here.
In a letter to the Montreal Gazette in October, Dr. Gareau stated, “RU486 is in the early clinical evaluation phase in Canada as approved by the government health authorities. Its availability for marketing in Canada will depend entirely on its eventual proven safety and efficacy profile, and on the outcome of the current government debate on abortion legislation.” If eventually approved – Gareau said not before 1991 – RU486 would be dispensed only through doctors affiliated with “birth control” centres, not through family doctors and pharmacies.
Such restrictions did not please Toronto abortionist Nikki Colodny. On CBC’s “The Journal,” Colodny argued that this pill should be available on demand. She reiterated the radical feminist position which rejects any control over abortion by the medical profession. Colodny’s and Morgentaler’s free standing abortuaries in Toronto both claim to offer “birth control services.” Under Gareau’s definition both would be allowed to dispense RU486 and the tight control over the product envisaged by Roussel would quickly evaporate.
Of more immediate concern to the pro-life movement, however, is Dr. Gareau’s statement that RU486 is in “the early clinical evaluation phase” as approved by the federal government. He told The Interim in an earlier interview (see February 1989 issue) that trials in Montreal studied the effect of using it along with vacuum aspiration abortion. He insisted that this was a “study” and not abortion, even though all the pregnant women in the study either aborted through RU486 or underwent surgical abortions when the product failed.
The “early clinical phase” means that human tests have been done in Canada. An unknown number of women have killed their babies using this product. A number of women will have required surgery to stop excessive bleeding. If Canadian researchers follow the rules used elsewhere, some women whose babies survived RU486 will not have been given an opportunity to carry on with the pregnancy – the women must agree beforehand to a surgical abortion.
Even if the federal government refuses to license RU486 in Canada, other progesterone-blocking drugs (such as Epostane) are being tested in other countries. Professor Jerome Lejeune, the world-renown French geneticist, calls these drugs an “anti-human pesticide.” The era of chemical abortion has barely begun.