RU486
fetus at 2 months
RU486,
also known as Mifepristone, Mifeprex, and "the Abortion Pill",
is for women who have gotten pregnant and want to terminate the pregnancy
early, non-surgically. It was developed in France 22 years ago, but
it was recently approved by the FDA for use in the United States. In
the US, women are able to use RU486 up to 49 days since the first day
of the last menstrual cycle, although studies are showing that it could
be effective up to 63 days, though the success rate may decrease slightly
after 49 days.
What is it and how does it work?
RU486 is a combination of two drugs, taken 48 hours apart. The first
drug, called Mifepristone generically, better known by the brand name
Mifeprex, blocks the receptors for progesterone, a hormone that is necessary
to maintain pregnancy. The uterus begins to soften and disintegrate,
and it is thought that it may accelerate the production of natural prostaglandin,
which makes the cervix softer and stimulates early contractions.
The second drug is called Misoprostol (brand name, Cytotec), which gives
rise to strong uterine contractions and it expels the embryo (it is
called an embryo until it is 8 weeks old, at which point it is refered
to as a fetus)..
Effectiveness and Side Effects:
There are basically no side effects associated with the first drug,
Mifeprostone. The common side effects are attributed to the second drug,
Mifeprex. About 15% of women experience nausea, vomiting, or diarrhea.
Most women experience some bleeding and contractions, but this is considered
normal, and part of the procedure. The incidence of bleeding is actually
higher for RU486 than for a surgical abortion; the average woman bleeds
for 8-9 days with RU486, as opposed to 5 days for a surgical abortion.
Rarely side effects will include fever, headache, and other minor side
effects. As the pregnancy continues, the amount of bleeding and incidence
of complications that may result in the need for a surgical abortion
increase. RU486 is 92-95% effective in ending a pregnancy.
If surgery is required to end a pregnancy due to complications in using
RU486, doctors have found that the procedure is actually easier as a
result of the drug, because the cervix is already soft and open as a
result of the abortifacient drugs.
Surgical Abortion or Medical Abortion
(RU486)?
If a woman decides to have an early abortion, she has options to consider.
While taking a pill to end an abortion sounds painless and easy, there
are serious disadvantages to using RU486, and many women still opt to
have a surgical abortion.
Cons to Using RU486:
Using RU486 is time consuming. It requires several visits to a doctor
or clinic. On the first visit, a woman receives counseling and 3 tablets
of the first drug, Mifeprostone, to be taken right away. She is free to
go home, but will return in 48 hours to take 2 tablets of the second drug,
Misoprostol. The women will now likely miscarry at home.
Miscarriage happens within 4-6 hours for 50% of women, and by 24 hours, 90% of women have miscarried.
Twelve to fourteen days later, the woman must return
to the doctor for a pregnancy test, to determine that the pregnancy is
indeed terminated.
In a sense that a woman has to wait to miscarry, and still needs to recover from any side effects and bleeding, a surgical abortion is quicker.
Pros to Using RU486:
RU486 offers more privacy, as the woman is usually able to miscarry in
her own home. She can also get the drug from a doctor, so she can avoid
having to go to a clinic.
It is possible that RU486 is safer than a surgical abortion, though an
early surgical abortion is a very safe procedure-much safer than an appendectomy.
For many women, the psychological aspects of RU486
are the major drawing point. Some women are frightened of the instruments
used for surgery, or just afraid of the concept of the surgical procedure
itself. RU486 offers more control for many women over the whole process.
It seems more natural-very much like a natural miscarriage-and many woman
want to know what is happening with their bodies. Some women even want
to see the material that is expelled as part of the process.
RU486 has been especially good for young teenagers who become pregnant, especially if they have a supportive parent who helps guide them through the process.
Ethics of RU486:
Unlike the Emergency Contraceptive Pill,
RU486 does cause an abortion; its purpose is to end a pregnancy. There
is no end to the heated debates on the topic of abortion, as some people
believe that it is the "innocent murder of a child." Others
believe that the embryo is not yet a child, and that it is every woman's
right to end the pregnancy if she is unable to care for a child, or
she doesn't want a child.
At 49 days, the embryo is about 13mm long. The future nose and ears are visable, and the retina and lens in the eyes have formed. The eyelids and upper lip have begun to form, and the fingers are starting to separate into individual digits. The embryo has its own blood type, as the blood cells are now produced by the liver, instead of the yolk sak. The embryo begins to move inside the uterus.
People who are against abortion are sometimes afraid that having a pill that causes abortions will make getting abortions too easy and people will use it as a form of birth control. The time, stress,