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Pro-choice should be an informed choice.

In March, we referred to a British study of the drug RU 486 as a postcoital contraceptive. The drug, originally developed in France, is administered to women within 24-48 hours after intercourse before a fertilized ovum becomes implanted in the uterus. An editorial in The New England Journal of Medicine, in which the study was reported, stated that the drug should be approved for this specific purpose. An unwanted pregnancy prevented is a potential abortion avoided, it noted.

Pro-choice groups have brought heavy pressure on President Bill Clinton to take steps to allow the importation and sale of RU 486, extolling it as a preferred means of abortion. Their arguments suggest that the process is as easy as picking up a pill from one's local pharmacy and terminating a pregnancy in private at home.

The realities associated with the use of RU 486 belie any such suggestion. In their book, RU 486: Misconceptions, Myths and Morals, Drs. Janice Raymond, Renate Klein, and Lynette Dumble reviewed and analyzed hundreds of medical and scientific articles written about the drug. Contrary to publicity given by those who have simplified and idealized RU 486 and pushed for its distribution in the United States, the facts speak for themselves.

Instead of privatizing abortion, the use of RU 486 requires at least four, and as many as seven, trips to the hospital or clinic. The first requires a pregnancy test and a physical examination, including a pelvic exam. After 24 hours, the woman returns to take the tablets in the presence of a nurse or doctor. Seven days later, she returns for a dose of prostaglandin to induce uterine contractions and has another pelvic exam. If the fetus is not aborted at the clinic, she must wait hours, days, or even weeks. She must then return to the clinic for an ultrasound and pelvic exam to be sure the abortion is complete. Up to three additional follow-up appointments may be required.

As for the highly touted safety of the drug, the patient may experience nausea, vomiting, diarrhea, or cardiovascular shock, which can lead to a heart attack, fatal or nonfatal. Bleeding, sometimes severe enough to require transfusions, occasionally occurs. The short- and long-term consequences of prostaglandin usage also give the authors cause for concern, because prostaglandin is known to inhibit the immune response.

The drug will not be available to everyone who may want it. Its producers have continued to add to the list of those for whose use it would be restricted. These include heavy smokers, women under 18 and over 35, and those with cardiovascular risk, high cholesterol, high blood pressure, and menstrual irregularities.

Incidentally, the above-mentioned authors are not pro-lifers but ardent proponents of free choice, dedicated to bringing safe abortions to the world. They are very unhappy about the National Abortion Rights Action League's glib pronouncements on the virtues of RU 486.
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Publication:Medical Update
Date:Aug 1, 1993
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