Mifepristone, known as RU-486 in France, is now available in the U.S. under the brand name Mifeprex™ (manufactured by Danco Laboratories, LLC). Mifepristone causes abortion in early pregnancy, providing women with a medical alternative to aspiration (suction) abortion.
In the United States, medical abortion using mifepristone may be provided by a physician or other clinician under the supervision of a physician who is
- capable of providing surgical intervention or is capable of referring for surgical intervention
- able to diagnose ectopic pregnancy
- able to assess gestational age – Planned Parenthood believes the best way to do this accurately is by sonogram
Check with your doctor to see if she or he will prescribe mifepristone, or contact Planned Parenthood or the National Abortion Federation to find a clinic or provider in your area.
In the United States, medical abortion using mifepristone requires three visits to the clinician:
- At the first visit, a woman receives a mandated medication guide provided by the manufacturer, Danco. The guide will provide information about how the medication works, as well as information about possible side effects. Before treatment begins, a woman must sign an informed consent, also provided by the manufacturer. She then swallows a dose of 600 milligrams of mifepristone under the guidance of her clinician.
- Two days later, she returns for the dose of 400 micrograms of misoprostol. The misoprostol induces uterine contractions, and the pre-embryo or embryo and other tissue that develops during pregnancy are passed out through the vagina.
- Approximately fourteen days later, she must visit her clinician for follow-up. (Creinin & Aubny, 1999; FDA, 2000)
It can be surmised that when mifepristone becomes widely available, early aspiration abortion as practiced today will be chosen less frequently among eligible women. Among the expected effects of such a change are these:
- More providers may be willing to offer the pharmacological regimen than currently offer surgical abortion services. A recent national survey of physicians conducted by the Kaiser Family Foundation found that one in two obstetrician/gynecologists say they are likely to offer mifepristone when approved by the FDA (KFF, 1998). Nearly half of the obstetrician/gynecologists who do not now provide abortions have said they would provide medical abortions when mifepristone is approved (KFF, 1998). This change will make abortion more accessible for the 32 percent of American women aged 15-44 living in the 86 percent of U.S. counties that otherwise have no abortion providers (Henshaw, 1998).
- The substitution of medical for surgical abortion reflects a shift toward earlier pregnancy termination. Medical abortion – using either mifepristone or methotrexate (a drug approved by the FDA for cancer treatment in 1953) – has been increasingly available in the U.S. The Alan Guttmacher Institute reports that approximately 4,200 medical abortions were performed in 1996 and, during the first half of 1997 alone, 4,300 medical abortions were performed (Henshaw, 1998).
- Mifepristone may offer women more privacy in the abortion decision, along with greater personal control over the process of pregnancy termination.
- There is no evidence that the availability of mifepristone for medical abortions increases a nation’s rate of abortion. In France, where mifepristone has been available in health centers since 1989, the abortion rate has declined (Henshaw et al., 1999).
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