RU 486 Advocates Plan for the Millennium

From the time of the first announcement about RU 486 in 1982, abortion advocates have consistently talked about introducing it worldwide, especially into so-called “developing” or “Third World” countries where surgical abortion is not widely available. But that has not occurred. The dangerous RU 486/Cytotec prostaglandin chemical abortion technique (RU 486/PG) is currently licensed in three European countries and only one non-European nation, the People's Republic of China.

Action is underway to market RU 486/PG more widely. A group of 46 leading RU 486 advocates and researchers held a 2_-day conference in Bermuda from January 10 to 13, 1998 to “explore the issues surrounding the introduction of a practicable means of safe and effective early medical (chemical) abortion in the developing and re-restructuring world,” stated the report of the meeting. (Presumably, the “re-structuring” countries would include Eastern European countries formerly under Soviet domination.)

According to the published reports, formal presentations during the first two days described the status of research and licensing, policy issues, and providing chemical abortion services. During the final half-day session, the conferees formulated a consensus statement recommending specific actions for researchers, funding organizations, abortion providers, and policymakers.

The conference was sponsored by the New-York-City-based Population Council and the Wellcome Trust from the United Kingdom. The Council published a 29-page report titled “Towards Safe and Effective Use of Medical Abortion,” and representatives from both organizations published a 2-page article summarizing key aspects of the deliberations in the July 24,1998 issue of the leading U.S. journal Science. (Unless otherwise noted, all citations below to statements made at the meeting are from the Population Council's report. Both publications summarized the proceedings and seldom presented direct quotations from the speakers.)

The published reports of the conference provide valuable insights for Pro-Family and Pro-Life supporters in two ways. First, speakers at the meeting gave some new information about the hazards of RU 486/PG abortion. Second, the publications outlined details of the ambitious plans to overcome some of the medical and practical hurdles that the abortion advocates believe are impeding world-wide use of RU 486.

Chemical Abortion Dangers

Scattered among the usual rhetoric proclaiming the “safety” of RU 486/PG abortion, abortionists offered some new information about the dangers of chemical abortion.

A representative of the Special Programme of Research, Development & Research Training in Human Reproduction of the World Health Organization (HRP/WHO) stated that there have been three reported cases of anaphylactic shock from RU 486/PG abortion. This complication is an allergic, life-threatening drug reaction and had not been previously reported.

During a discussion period, someone raised concerns about the counseling that pregnant women who are considering RU 486/PG abortion should receive about the potential damage to the unborn baby. The report stated that women should be informed that “if they don't abort and pregnancy continues, there is a higher incidence of congenital abnormalities.” Lawsuits may occur in cases of mis-counseling. “There is one pending law case of a baby who had a birth defect in the United Kingdom,” stated the report.

A point of contention among the conferees was using the anti-cancer drug methotrexate (MTX) for abortion. “Opinion diverged widely,” stated the report, with “strong support” for its use from delegates from the U.S. The Science article noted that MTX “is not as inexpensive as misoprostol (Cytotec) or as easy to administer as mifepristone (RU 486). In addition, many physicians remain uneasy about methotrexate because of its possible toxicity and teratogenic effects.”

Spreading RU 486/PG Worldwide

The fundamental premise underlying the Bermuda meeting was that introducing chemical abortion into “developing countries” would reduce the purported high rates of morbidity and mortality from unsafe abortion around the world. Citing a WHO report in 1993, the Science article claimed 70,000 deaths per year from unsafe surgical abortion around the world, almost all in developing countries. (The Population Council report claimed 100,000 without citing a source.) Neither report presented any documented proof of their claim.

The Science article asserted that chemical abortion “methods may be particularly important in resource-poor conditions where inadequate surgical services for abortion may entail a very high risk of infection and reproductive tract injury.” Based on ten years of experience, there was “unanimous agreement that mifepristone (RU 486) has `come of age' for use in early medical (chemical) abortion,” stated the authors.

The final report of recommendations on how to overcome the medical and political obstacles hindering introduction of RU 486/PG grouped the findings into four major categories. Here are some highlights.

First, in the area of “Biomedical Research and Development,” there was strong interest in finding a way to use the anti-ulcer drug Cytotec (misoprostol) for abortion because it is already on the market around the world. The report called for abortion tests to determine the optimum dose, route of administration, upper limit of gestational age for use, and how it can be employed in places where RU 486 is not available. The Science article observed that in Brazil women “use it to induce bleeding and then seek help from medical services as they would for spontaneous miscarriage.” A speaker from South Africa, Dr. Helen Randera-Rees, described how her abortion facility uses Cytotec vaginally followed by manual vacuum aspiration.

Second, concerning “Providing Mifepristone” (RU 486), the conferees advocated taking an indirect approach similar to Cytotec. They recommended licensing RU 486 “for uses not prohibited by current legislation,” such as inducing labor after fetal death or oncology. Once the drug was on the market for a non-abortion use, they expect it could be used for abortion.

The Science article also noted the considerable uncertainty concerning possible problems with a supply of RU 486 for clinical use in developed countries, especially with “the reluctance of some pharmaceutical manufacturers to associate themselves with any abortifacient drug.” The conferees noted that production was well under way in China, and they encouraged western manufacturers to become partners with the Chinese.

Third, discussions about “Local Health Service Delivery” provided several illuminating revelations. Dr. Beverly Winikoff, a senior official at the Population Council, which controls the U.S. patent for RU 486, indicated once RU 486/PG is on the U.S. market, some of the tight restrictions on its use may be changed or eliminated. She “argued that is not essential to establish elective surgical abortion services as a back-up before medical (chemical abortion) services are introduced,” stated the report. The abortion facility would not have to have surgical abortion services since women could receive treatment at any facility equipped to handle a miscarriage. Moreover, Winikoff “noted that non-physicians can provide medical (chemical) abortion, just as they provide IUDs. Ultrasound is not essential to every setting,” stated the report. She also explained that tests in the U.S. and four other countries indicated that it “may not be necessary” for women to visit the abortion facility to take the prostaglandin and that the cut off for using RU 486/PG could be extended well beyond 49-days (7-weeks).

In countries where abortion is illegal, the conferees stated that “there is a need for post-abortion care, and to examine how medical (chemical) abortion would fit into this service.” The published reports did not elaborate on this point, but the implication is that abortion drugs might somehow be introduced under the guise of providing women with medical care for miscarriages.

The fourth set of recommendations on “Advocacy and Legal Issues” was based on the assertion that “Advocacy for medical abortion is essential, irrespective of the prevailing legal position regarding abortion.” In other words, abortion proponents should ignore the legal restrictions on abortion in their effort to promote chemical abortion methods. One crucial component of their strategy is to “focus opinion on the social injustice of unsafe abortion.” That “problem” could of course be “fixed” by chemical abortion.

Conclusion

The published reports of the Bermuda conference offer a brief glimpse of the messianic zeal that the Population Council and other organizations have to spread the gospel of chemical abortion around the world. They are committed to push ahead despite the ever-growing body of information about the physical and psychological dangers from their own tests and clinical experience.

Fortunately, in order to garner wide support, the abortion advocates publish reports such as these, which offer Pro-Life and Pro-Family advocates some insights into their long-range plans and better ammunition against RU 486/PG in the public debate.Subject Index to The RU 486 Report (September 1994 - December 1998)

(Listed by article name, date of publication, and page, with oldest article first)

Cytotec (misoprostol)

Misused with RU 486, Jan. 1995, p. 1.

“Citizen Petition” side effects, Feb./Mar. 1995, p. 3-4.

Misused for 2nd Trimester Abortion, Feb./Mar. 1995, p. 6.

Used with methotrexate (MTX), see “methotrexate” listing.

Methotrexate (MTX) and Cytotec (misoprostol) Prostaglandin Abortion Method

Poses Threat, Apr. 1995, pp. 1-4.

More Tests Begin, May 1995, p. 2-4.

Study Ignores Dangers, Nov. 1995, pp. 2-4.

Researcher Opposes Abortion Use, Dec. 1995 p. 1.

Not "Standard of Care," Dec. 1995, p. 2.

Two Chemical Abortion Methods May Be On U.S. Market Soon, Apr. 1996, p. 1.

FACT SHEET, Comparison of Chemical Abortion Methods: RU 486/Prostaglandin and Methotrexate (MTX)/ Prostaglandin, Oct. 1996, p. 2.

Planned Parenthood Starts Nationwide Methotrexate/Prostaglandin Abortion Test, Oct. 1996, p. 3.

Methotrexate/Cytotec Prostaglandin Abortion: An Annotated Chronology and Bibliography, Jan.-Feb. 1998, p. 5.

RU 486 (mifepristone) Boycott

Status, Sept. 1994, p. 2.

Gathers Steam, Feb./Mar. 1995, p. 5.

New Boycott Target, June 1995, p. 1.

21 National Groups Declare Renewed RU 486 Consumer Boycott, Mar. 1996, p. 1.

RU 486: Where Do We Go From Here?, Sept. 1996, p. 1.

Renewed Boycott Pressure on Hoechst Needed, Dec. 1996-Jan. 1997, p. 1.

Hoechst “Donates” European RU 486 Patent to Avoid Consumer Boycott, Apr. 1997, p. 1.

RU 486 (mifepristone)/ Action Items

What You Can Do, Nov. 1994, p. 4

RU 486 as “Medicine,” Nov. 1994, p. 3.

“Citizen Petition” Follow up, Feb./Mar. 1995, p. 4.

Soundbites, Feb./Mar. 1995, p. 6.

Sample Speech Against RU 486, Aug. 1995, p. 1.

Safety Concerns at Center of Debate, Sept. 1995, p. 1.

What Is Happening With RU 486? Questions, Answers, and Theories, Feb. 1996, p. 1.

Two Chemical Abortion Methods May Be On U.S. Market Soon, Apr. 1996, p. 1.

Local Opposition Vital To Prevent More Doctors From Performing RU 486 Abortions, May 1996, p. 1.

Assessing the “Acceptability” of Chemical Abortion Methods, June 1996, p. 1.

Quick Response to Media On Upcoming RU 486 Publication Essential, July 1996, p. 1.

FDA Advisory Committee Recommends RU 486 Approval, Aug. 1996, p. 1.

RU 486: Where Do We Go From Here?, Sept. 1996, p. 1.

RU 486 “Approvable” for U.S. Market by mid-1997, Oct. 1996, p. 1.

FACT SHEET, Comparison of Chemical Abortion Methods: RU 486/Prostaglandin and Methotrexate (MTX)/ Prostaglandin, Oct. 1996, p. 2.

Hoechst “Donates” European RU 486 Patent to Avoid Consumer Boycott, Apr. 1997, p. 1.

Great Opportunity to Refute Myths about the Non-Abortion Uses of RU 486, Sept.-Oct. 1997, p. 1.

The Facts Against RU 486 Abortion: An Update, Mar.-Apr. 1998, p. 1.

The RU 486 Abortion Technique From Discovery to Marketing, 1980-1988: A Chronology and Bibliography, Jun.-Jul.-Aug., 1998, p. 1.

RU 486 Edging Closer to Marketing in U.S., Sept.-Oct.-Nov., 1998, p. 1.

“Chinese Clone” of RU 486 Slated for Non-Abortion U.S. Tests, Sept.-Oct.-Nov., 1998, p. 2.

Chinese Marketing RU 486 Technique, Sept.-Oct.-Nov., 1998, p. 2.

RU 486 Marketing May Spread Across Europe, Sept.-Oct.-Nov., 1998, p. 3.

RU 486 Labeled Abortion Drug in “Emergency Contraception” Publicity, Sept.-Oct.-Nov., 1998, p. 3.

RU 486 Prominent in Congressional Deliberations, Sept.-Oct.-Nov., 1998, p. 6.

RU 486 (mifepristone) Proponents / Food and Drug Administration (FDA)

Goal of Adding Abortionists, Nov. 1994, p. 1.

“Citizen Petition” Given to FDA, Feb./Mar. 1995, pp. 1-2.

FDA Wary of Citizen Petition, May 1995, p. 1.

Key Post to RU 486 Advocate, May 1995, p. 4.

Objective Evaluation Impossible for FDA, Oct. 1995, p. 1.

What Is Happening With RU 486? Questions, Answers, and Theories, Feb. 1996, p. 1.

Federal Research Underway on New Abortion Drug, Feb. 1996, p. 3.

RU 486 Hits Roadblock In Australia, July 1996, p. 4.

FDA Advisory Committee Recommends RU 486 Approval, Aug. 1996, p. 1.

RU 486 “Approvable” for U.S. Market by mid-1997, Oct. 1996, p. 1.

Details Emerge About “Stealth” Abortion-Pill Company, Nov. 1996, p. 1.

Lawsuits May Delay RU 486 Debut, Dec. 1996-Jan. 1997, p. 2.

With Key RU 486 Lawsuit Settled, Proponents Aim for U.S. Sales by Year's End, Feb.-Mar. 1997, p. 1.

Hoechst “Donates” European RU 486 Patent to Avoid Consumer Boycott, Apr. 1997, p. 1.

New Contract Dispute Delays U.S. RU 486 Marketing, July 1997, p. 1.

Status of Chemical Abortion Drugs Under Development in the U.S., Aug. 1997, p. 2.

Lawsuits Partially Settled, But Obstacles Remain to RU 486 Sales in U.S., Nov.-Dec. 1997, p. 1.

Key RU 486 Marketing Effort Stalled, But Research Continues,” Jan.-Feb. 1998, p. 1.

RU 486 Prominent in Congressional Deliberations, Sept.-Oct.-Nov., 1998, p. 6.

RU 486 Proponents Plan for the Millennium, Dec. 1998, p. 1.

RU 486 (mifepristone) Side Effects / Dangers

Dangerous Fallout, Nov. 1994, p. 2.

“Citizen Petition” filed, Feb./Mar. 1995, pp. 1-4.

Not As Easy As Promised, Part I, July 1995, p. 1.

List of side effects and dangers in sample speech, Aug. 1995, pp. 3-4.

Safety Concerns at Center of Debate, Sept. 1995, p. 1.

Not As Easy As Promised, Part II, Oct. 1995, p. 4.

Safety and Efficacy Questions, Nov. 1995, p. 1.

Not As Easy As Promised , Part III, Dec.1995, p. 4.

RU 486 “Near-Death” Accident in Iowa Raises Safety Questions, Jan. 1996, p. 1.

Assessing the “Acceptability” of Chemical Abortion Methods, June 1996, p. 1.

FDA Advisory Committee Recommends RU 486 Approval, Aug. 1996, p. 1.

FACT SHEET, Comparison of Chemical Abortion Methods: RU 486/Prostaglandin and Methotrexate (MTX)/ Prostaglandin, Oct. 1996, p. 2.

New Insights from Abortion-Pill Test, Aug. 1997, p. 1.

The Facts Against RU 486 Abortion: An Update, Mar.-Apr. 1998, p. 1.

Article on U.S. RU 486 Test Gives More Details About Dangers to Women, May, 1998, p. 1.

RU 486 Proponents Plan for the Millennium, Dec. 1998, p. 1.

RU 486 Testing

No News, Good News, Sept. 1994, p. 1.

No NY State Funding, Sept. 1994, p. 2.

Australian Tests Suspended, Sept. 1994, p. 3.

Status of tests (table), Sept. 1994, p. 4.

Tests Begin, Nov. 1994, p. 1.

Trial Starts in St. Louis, May 1995, p. 1.

12th Test Site Announced, July 1995, p. 4.

Trials End, Nov. 1995, p. 1.

Two Chemical Abortion Methods May Be On U.S. Market Soon, Apr. 1996, p. 1.

Assessing the “Acceptability” of Chemical Abortion Methods, June 1996, p. 1.

RU 486 Hits Roadblock In Australia, July 1996, p. 4.

Canadian Official Rejects Fast-Track Approval for RU 486 Abortion, May 1997, p. 1.

U.S. Testing of “Chinese” RU 486 “Clone,” July 1997, p. 3.

New Insights from Abortion-Pill Test, Aug. 1997, p. 1.

Status of Chemical Abortion Drugs Under Development in the U.S., Aug. 1997, p. 2.

Key RU 486 Marketing Effort Stalled, But Research Continues,” Jan.-Feb. 1998, p. 1.

Article on U.S. RU 486 Test Gives More Details About Dangers to Women, May, 1998, p. 1.

The RU 486 Abortion Technique From Discovery to Marketing, 1980-1988: A Chronology and Bibliography, Jun.-Jul.-Aug., 1998, p. 1.

“Chinese Clone” of RU 486 Slated for Non-Abortion U.S. Tests, Sept.-Oct.-Nov., 1998, p. 2.