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Pill Doesn't Alter Abortion Ethics, RU-486 Creator Says

Health: As drug's entry into U.S. nears, French inventor cites medical benefits but says it's just a 'different technique.'


LE KREMLIN-BICETRE, France — For Charlotte, a 28-year-old single Frenchwoman who works for an Internet company, the RU-486 abortion pill was no miracle drug. Two weeks after taking it, she still hurts and still bleeds.

But the hardest part for the gentle, sensitive Parisian was being the central actor in the abortion itself. There was no anesthesia, no wake-up-and-it's-over relief. She wasn't even in a clinic at the critical time.

Instead, it happened as she sat on the toilet in her boyfriend's apartment, alone.

"I was worried about having to participate, about seeing things, about the blood," the young woman says, speaking on condition that her last name not be used. In retrospect, though, she has decided that she made the right choice.

"An abortion by surgery would have been harder," Charlotte says. "It's a violation of the body. What a horror."

One of the most controversial pharmaceutical achievements of modern times, the French-invented RU-486 pill will soon be available in the United States. Last month, the Food and Drug Administration authorized its sale and use, subject to certain conditions.

Abortion foes in the United States see the approval of the yellowish-white tablet, which will be sold under the brand name Mifeprex, as a further trivialization of the taking of life. "RU-486 kills innocent human beings," Judie Brown, president of the American Life League, has protested. "It's chemical warfare aimed at the littlest babies."

The pill, which has been on the market for 12 years in France, selling for the equivalent of $12.80 apiece, has even become an issue in the U.S. presidential campaign. Texas Gov. George W. Bush, the Republican candidate, has called the FDA's decision to permit it "a mistake," arguing that it will favor abortions instead of discouraging them. His Democratic rival, Vice President Al Gore, in contrast, heartily endorsed the FDA's action as widening "the right of women to choose."

For its creator, prominent French endocrinologist Etienne-Emile Baulieu, the pill doesn't make resolving the difficult moral issues surrounding abortion any easier--it just makes the process less invasive for the pregnant woman.

"It's something that is scientifically and medically good for women, but it doesn't alter the ethics of abortion," says the 73-year-old specialist on human hormones, interviewed at his hospital laboratory in this southern Paris suburb. "It's a different technique, that's all."

Few medical products, however, have aroused greater hopes and fears. In societies where abortion is taboo, such as Saudi Arabia, some women or their families have been prepared to pay virtually any price to obtain Baulieu's pill, which is distributed and used in France under strict supervision.

Each year, American women also contact family planning clinics in this country by the hundreds, hoping to persuade medical personnel to ignore government regulations that allow abortions only for women who have lived in France for three months.

"The abortion pill is a great stride forward," says Christine Der Andreassian, nurse counselor at Broussais Hospital in Paris, where 15,000 women have undergone abortions with RU-486 in the last 12 years. "What happens when a woman goes into an operating room and experiences a vacuum [surgical] abortion? Her legs are held open; it's very intrusive. The whole process disturbs women very much."

In his jumbled office, where paintings and collages compete for space with dense medical texts on methods of contraception, Baulieu waves a letter on White House stationery that he has just received. Signed by First Lady Hillary Rodham Clinton, it calls the FDA's authorization of RU-486 "an important development in women's health."

In 1980, the French scientist invented the synthetic steroid--mifepristone--that became the basis of the abortion pill, which works by stopping development of pregnancy and causing the fertilized egg to detach from the wall of the uterus. Eight years later, the product was authorized here for commercial use. (The "RU" in its name stood for Roussel Uclaf, the French drug maker for which Baulieu worked as a consultant.)

France's health minister at the time praised it as "the moral property of women." Opponents of abortion, who succeeded in having sales suspended in France for a time, predicted that the pill would make having an abortion no more of a bother than swallowing an aspirin for a headache.

The statistics clearly show the fears of abortion foes were unjustified. The most recent figures from the French government's General Directorate of Health, for 1990-98, show only an overall 6% increase in abortions, to 214,000 in 1998.

In the period from 1990 to 1995, the number of abortions in France actually declined slightly.

"There is no relationship between availability of the pill and the number of abortions in France," says Marie Chirouze, spokeswoman for the government health agency.

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