WASHINGTON — The Food and Drug Administration's approval of the abortion pill RU-486 could make the procedure more accessible than ever to millions of women in communities with no abortion provider, supporters of the drug say.
At the same time, however, these advocates make a seemingly contradictory claim: Despite wider availability, RU-486 will not prompt any increase in the number of abortions.
Are they right? In truth, many health analysts said, it is hard to know.
In predicting what will happen in the United States as the drug comes into use, the most compelling clues come from Europe, where more than half a million women have used it in the last decade.
In France, where the drug was invented, women have had access to it since 1989. Abortions have not increased. In fact, they have fallen. Just before the pill was introduced, France reported 13.4 abortions per 1,000 women of reproductive age. That dropped to 12.4 abortions in 1995.
The same has been true in Britain, where the drug was introduced in 1991, and in Sweden, where it arrived in 1992. Although many women are using the drug, abortion rates are in decline.
"My guess is that abortions will not rise in the United States, based on the experience in France, where they appear to have gone down," said Dr. Beverly Winikoff of the Population Council, a New York nonprofit group that was instrumental in bringing the drug to the United States.
But Winikoff and others also noted that there are big differences between the United States, where abortion is a volatile political issue, and most of Europe, where government plays a far larger role in delivering health care. "You can't just paste the experience of Europe onto the United States," said James Trussell, a Princeton University economist who focuses on reproductive health.
To begin with, abortion in France is a government-sanctioned service offered by the national health system, and it is widely available throughout the country, Trussell said. French women do not face the hurdle of having to search for a clinic. And abortion rights is not a highly charged political issue, so no women are scared away from clinics by the prospect of picketers.
"They just don't have to worry much about access there," Trussell said.
In the United States, by contrast, 86% of counties have no abortion provider. In fact, state regulations, protesters and other factors have reduced the number of providers to just over 2,000 in 1996, down from 2,900 in 1982.
