Drug-induced abortion is now legal in the US, but there's a snag...
AFTER a ten-year fight, the "abortion pill" RU486 is finally available in the US. But the pill's supporters fear theirs may be a pyrrhic victory, because production of a second pill that has to be taken with RU486 is now under threat.
RU486 (mifepristone) was approved in Britain nine years ago as an alternative to surgical abortions in the first two months of pregnancy. But American anti-abortion campaigners fought bitterly against it. Now that the US Food and Drug Administration has approved mifepristone, attention has turned to misoprostol, a prostaglandin pill originally developed to treat gastric ulcers.
Supporters of RU486 told New Scientist that they fear anti-abortion campaigners will target misoprostol supply because, although it is officially produced to treat stomach ulcers, obstetricians use it to complete the abortion process started by RU486.
The Reverend Flip Benham, national director of Operation Rescue-one of the most powerful anti-abortion groups in the US-says any drug firms involved in pharmaceutical abortion will be targeted by his group. "If you're going to go ahead and make this pill, you better know that Christians in America do not want to buy pharmaceuticals from you."
RU486 blocks the action of the hormone progesterone, causing the lining of the uterus to break down. Taken two days later, misoprostol makes the uterus contract and the cervix dilate, helping to expel the embryo. But now it seems even the company that makes misoprostol is getting the jitters.
For years, obstetricians have used misoprostol to dilate the cervix during labour. But only when the FDA was about to approve its use with the abortion pill-following pressure from RU486 supporters-did the manufacturer, Pharmacia, send out a sternly worded letter warning against misoprostol's use during pregnancy. The drugs company insists that the letter merely warned of adverse reactions in late pregnancy. But it has prompted many hospital pharmacies to remove the gastric ulcer drug from their shelves, to avoid possible lawsuits.
Campaigners who support a woman's right to abortion fear Pharmacia wants to distance itself from the abortion issue. They think that if the company is targeted, it may stop making the drug, which would prevent the use of the long-awaited abortion pill. "The only other drug that's used in Europe is not approved here," says Sandra Waldman of the Population Council in New York, which fought for the drug combination's US approval.
A spokesperson for Pharmacia would not comment on the company's plans for misoprostol, but says it has recently lost patent protection for the drug and that other companies could produce it. Stephen Fielding, who has studied misoprostol at the University of Rochester in New York, says the drug has so many uses that the company "will get a lot of heat from physicians if it tries to pull it off the market".
Author: Nell Boyce, Washington DC
New Scientist issue: 28th October 2000
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