RU486: extending women's choices
By Kath Gelber
The Catholic church in Australia has called for a halt to current trials of RU486, the so-called "abortion pill". The trials, taking place under the auspices of the World Health Organisation (WHO), are part of an international study into the efficacy, safety and potential uses of the drug.
The Melbourne and Sydney trials, being conducted in compliance with the rules of the National Health and Medical Research Council, are investigating use of the drug both as a contraceptive (taken as a "morning-after pill") and for early term abortion.
The secretary of the Australian Bishops Committee for Family and Life, Bishop Pat Power, declared the Catholic church's fundamental opposition to the pill and warned it could harm women's reproductive organs. He has claimed that some feminists support the anti-RU486 cause.
However feminists disagree over the usefulness of the drug. Author, Dr Renate Klein, calls the drug a "problematic drug cocktail" and warns that, "if chemical abortions become the dominant treatment, in future years when the dangers are finally recognised, women may well be faced with substantially reduced conventional abortion services". Klein argues the use of prostaglandin in association with RU486 leads to high risks for women.
Many feminists, however, argue for the trials to take place. This is essential, they say, in order to retain and broaden access to terminations for all women. Trials that are properly conducted and supervised may show that RU486 provides a safe method of abortion. If this is the case, it may assist in the de-medicalisation of the procedure, as well as in retaining access to early-term abortions where clinics and hospitals may have waiting lists.
Of the 55 women who have participated in the Sydney "morning-after pill" trials so far, the success rate of the termination of pregnancy has been 100%. According to Professor of reproductive medicine at the University of Sydney, Professor Ian Fraser, the drug has been "extraordinarily well tolerated", adding that the drug is "significantly safer" than carrying through a normal pregnancy.
Experience from other countries has provided some guide as to the potential usefulness and problems associated with RU486.
RU486 is currently available in France, Britain and Sweden. In France it has been used by over 100,000 women since it was introduced in 1989. Today, approximately a quarter of all abortions in France are carried out using it. In Britain, a product licence was granted for RU486 in July 1991 after intensive scrutiny by the Medicines Control Agency. Its distribution, as in France, is subject to stringent controls which confine its use to National Health Service gynaecological units.
There has been one death associated with its use; in 1991 a French woman, who was a heavy smoker and in her 13th pregnancy (factors which would be expected to disqualify RU486 treatment), died after suffering a cardiac arrest. She had been treated with a synthetic version of the hormone prostaglandin used in association with RU486. Since that time new versions of prostaglandin have been developed which, it has been claimed, are less likely to cause circulation and coronary problems.
Other possible risks identified with the use of RU486 so far include the duration and amount of blood loss, significant pain and vomiting, nausea and diarrhoea.
In the US clinical trials are taking place this year. In this case, all US patent rights have been donated by the company to the non-profit research group, "The Population Council", which specialises in developing contraceptives and family planning for developing countries.
When the trials were given the go-ahead, Secretary for Health and Human Services, Donna Shalala said, "This action is an important step towards providing the women of America access to non-surgical alternatives to pregnancy termination".
It was argued by advocates of abortion rights that if a safe and effective alternative to surgical abortion exists, women in the USA should have access to it.
While results of the current round of trails are still to come, the debate is continuing. Pro-choice activists who defend the trials are not arguing that the use of RU486 is trivial or a "miracle" method. Neither are they advocating that it be used as an excuse to end the training of medical personnel in surgical abortion procedures. Rather, RU486 has the potential to compliment surgical abortion and perhaps expand the available choice and broaden access to abortion for all women.