ABORTION DRUG PROVIDES NONSURGICAL ALTERNATIVE.

Byline: The New York Times

In a new effort to develop alternatives to surgical abortions, the nation's largest group of abortion providers is encouraging doctors around the country to explore the use of the drug methotrexate to end pregnancies.

The drug has not been approved by the Food and Drug Administration for use in abortions but has long been approved for use in much higher doses in the treatment of certain cancers, arthritis, psoriasis and other diseases.

It is both legal and common for doctors to use drugs for purposes that have not been formally tested and approved by the government, even though such ``off-label'' uses may expose doctors to malpractice claims if there are complications.

A methotrexate abortion, which can only be performed in the early stages of pregnancy, is a two-step procedure. First, the woman receives an injection of the drug, which interferes with cell division and kills the fetus. A week later, she takes another drug, misoprostol, which causes uterine contractions and, sometime later, the expulsion of the fetus.

The process is similar to the one undergone with RU 486, the French abortion pill that has gone through clinical testing in this country but is still a long way from formal approval. The clinical trials of RU 486 also involve a two-step process, with misoprostol as the second step.

Abortion rights advocates say nonsurgical abortions have the potential to defuse the violence that has plagued abortion clinics in recent years because they require no special equipment and can take place in any doctor's office. Anti-abortion groups oppose all methods of abortion and stress that nonsurgical ones may not be safe and may cause women additional emotional anguish. The groups are boycotting the American subsidiaries of the European manufacturers of RU-486.

This weekend, at its annual meeting in San Francisco, the National Abortion Federation will present detailed instructions for doctors who are interested in offering methotrexate abortions.

``First we're going to present the data, the regular scientific information, what we did, and what happened,'' said Dr. Richard U. Hausknecht, a New York City obstetrician who quietly began offering methotrexate abortions two years ago.

``Then I'm going to share my cookbook; that is, all the details of how you do this. And then, later, we'll be setting up a physician-training program with Planned Parenthood in New York City. After the NAF meeting, I think you'll see a lot more doctors starting to use methotrexate.''

Officials at Planned Parenthood, the nation's largest abortion provider, are investigating offering methotrexate.