RU-486: Coming Soon to a Provider Near You
By Tula Karras
May 5, 2000 -- Women will soon have another choice when it comes to unwanted pregnancies. The forthcoming drug, Mifeprex (mifepristone, formerly known in Europe as RU-486), offers women a medical abortion without the need for surgery. The Food and Drug Administration (FDA) is expected to approve the drug in the next few months.
Advocates of Mifeprex and other medical abortion drugs are hopeful that this new option will continue to fuel the trend of women making choices early on. "Any type of abortion that is performed in the first seven weeks of a pregnancy is extremely safe, but with medical abortions there's no anesthesia necessary and no surgery," says Richard Hausknecht, MD, a professor at Mount Sinai School of Medicine.
Hausknecht has been performing abortions in the United States since 1970, when they were first legalized. "The earlier the abortion is performed, the better," he says. "Medical abortions can be performed as soon as a woman knows she's pregnant, whereas most abortion clinics have women wait until they are at least seven weeks pregnant before performing a surgical abortion -- though a well-trained doctor can perform one at five weeks."
For years Hausknecht has been using methotrexate (which terminates the pregnancy) and misoprostol (which causes the uterus to contract), drugs that are not approved by the FDA for medical abortion, but are used off-label for that very purpose.
Why are abortion providers anxious for the FDA to approve Mifeprex if other drugs like it are already in use? It's not that the drug is safer, Hausknecht says. Women are at no lower risk from a medical versus a surgical procedure. But women prefer the noninvasive approach. "It's private," he says. "We extensively counsel a woman about what she can expect. She takes the drugs in our office, and then she goes home."
Another advantage to Mifeprex is that doctors can predict with greater accuracy when the spontaneous pregnancy loss will occur. In 50% of the cases, it's within four hours of taking the drug. In addition, "many physicians are leery of using drugs that are not FDA-approved, especially when it comes to such a controversial procedure as abortion," Hausknecht says.
Tula Karras is an associate editor at Healtheon/WebMD.
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