Dear Options,

Providing an option to surgical abortion, RU-486, or mifepristone, is a drug that causes early medical/chemical abortion in pregnant women by blocking receptors of progesterone, a hormone needed to maintain pregnancy. Early means within 49 days from the first day of the last menstrual period. Combining RU-486 with a low-dose prostaglandin (a chemical substance found in the body, that can also be manufactured artificially, with a number of different effects on bodily processes, such as uterine stimulation or contractions) appears to increase effectiveness without increasing side effects. According to results from clinical trials conducted in the United States and in France, mifepristone is effective in inducing a complete early abortion in 92 to 95 percent of women. Side effects of the drug combination include bleeding, cramping, nausea, vomiting, short-term fatigue or weakness, and occasional diarrhea.

Mifepristone has been available in Europe for several years, and has proven to be a safe and effective means of abotion. In the United States, the U.S. Food and Drug Administration (FDA) first approved it in 1996 as a safe and effective abortion method, but because it was not manufactured and distributed in the U.S., it was not generally available. As a result, methotrexate (a drug widely in use for the past forty years to treat illnesses, including cancer) was being used to induce abortion since its action is similar to RU-486.

With final FDA approval on September 28, 2000, mifepristone will soon be available to American women as Mifeprex from Danco Laboratories. Within a month, anyone considering alternative options to surgical abortion can talk with a health care provider about this drug. As per the FDA ruling, women interested in getting RU-486 receive a Medication Guide that details who can and cannot use the drug and potential side effects. Eligible women who choose RU-486 need to visit a specially-trained health care provider three times for the entire procedure:

• first, to receive a three pill dose by mouth;
• second, to take misoprostol, a prostaglandin, two days later; and,
• third, to return in approximately two weeks to be certain there was a full abortion.

Mifepristone is administered under a health care provider's close supervision because in a small percentage of women for whom the combination of medical drugs is not effective to produce complete abortion, a follow-up surgical procedure is sometimes needed. The reason for this regimen is to ensure that mifepristone is used correctly, safely, and effectively.

Columbia students who may choose or need an abortion can speak with one of the clinicians at Health Services. Primary Care Medical Services provides pregnancy screening, counseling, and access to care for students. Although mifepristone will not be prescribed at Health Services, information on medical (as well as surgical) abortion and referrals to local women's health facilities that plan to provide this service are available. Call x4-2284 for an appointment in the pregnancy screening clinic.

By the way, mifepristone is not the same thing as emergency contraception (also known as "the morning after pill" or ECP). Emergency contraception is available to women who have had unprotected intercourse and are concerned that they could become pregnant. It is a hormonal medication that is taken within 72 hours of intercourse and acts to prevent pregnancy. Emergency contraception, when taken correctly, can reduce the possibility of pregnancy by 75 - 89 percent. To learn more, search through the emergency contraception section in Alice's Sexual Health archive.

For more detailed information on mifepristone, check out the following:

• Mifepristone Information web page on the FDA's Center for Drug Evaluation and Research web site
• Mifepristone: Expanding Women's Options for Early Abortion on the Planned Parenthood web site
• Mifeprex web site
• Mifeprex toll-free hotline: 877.4.EARLY OPTION (-432.7596)

Alice

Related Q&As

Where can you get the morning after pill?

Can oral contraceptives cause an abortion?

Parental consent for abortion?

What about abortion? Where? How?