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Mifepristone: not a panacea

By Helen Ransom - posted Wednesday, 2 November 2005


It’s been more than ten years since the abortion drug RU486 (mifepristone) was banned for use as an abortifacient in Australia.

A new bid to bring the drug into the country has begun. In the Medical Journal of Australia of October 3, 2005, obstetrician Caroline De Costa called for a reversal of the ban.

This was quickly picked up by politicians from all major parties, among them Labor Health spokeswoman Julia Gillard and Democrats leader Senator Lynne Allison, who described RU486 as “a safe alternative to surgical abortion”.

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Coalition MP and former general practitioner, Mal Washer, described Australia as “out on a limb”, lagging behind other industrialised countries such as the US, Britain and New Zealand. Yet Coalition MP and former obstetrician, Senator Alan Eggleston, insists that the drug poses unacceptable health risks to women.

Dr De Costa plans to lodge a formal application with the Therapeutic Goods Administration in December. The final decision rests with Health Minister Tony Abbott.

Some important points have so far been glossed over in the latest round of reports and commentary on RU486. The first relates to the growing belief the current abortion rate is unconscionable.

There is one surgical abortion for every 2.8 live births in Australia. A recent survey commissioned by the Southern Cross Bioethics Institute reported that 64 - 73 percent of Australians think this is unacceptably high. RU486 might reduce the numbers of surgical abortions, but it’s not going to reduce the abortion rate.

A case in point is the "morning after" pill, which the federal government approved as an over-the-counter drug in early 2004. Marketed as an “emergency contraceptive” in many cases it is actually an abortifacient, because it prevents a baby implanting in its mother’s uterus.

A study of 2,117 women aged 15 to 24, published in the Journal of the American Medical Association in January showed virtually no difference in the abortion rate between women who had easy access to morning-after pills and those who got the pill from their healthcare provider. And in Britain, easy access to the morning-after pill has seen rises in sexually-transmitted diseases and no drop in the number of abortions.

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A second point is that RU486 does nothing to promote women’s welfare: not only does it kill unborn babies, it puts the lives and health of mothers at significant risk.

RU486 is a man-made steroid which acts against the progesterone pregnant women naturally produces to sustain the unborn child, cutting off its nourishment and killing it in utero. A second chemical, misoprostol, is also used in the process. It causes cramping and contractions, flushing the now dead baby from its mother’s womb.

RU486 has other uses, such as inducing women in labour who are very overdue, and treating breast cancer and some diseases of the womb. But the experience of this drug as an abortifacient in countries such as the United States should sound warning bells to women across Australia.

In US trials of the drug, 99 percent of women reported at least one adverse effect - fourteen were hospitalised (eight of them with excessive bleeding and one suicidal) - yet amazingly it was accepted by the US Food and Drug Administration in 2000.

Five American women have since died from serious bacterial infection and sepsis after taking RU486, including 18-year old Californian, Holly Patterson.

In September 2003, four days after taking the drug, Holly returned to hospital, complaining of severe pain and bleeding. She returned again three days later, vomiting and in great pain, and died that afternoon.

These deaths and numerous complications prompted the FDA to twice change RU486's packaging  to warn women of the potential side-effects, including nausea, abdominal pain, vomiting, excessive and prolonged bleeding, heart attack, haemorrhage, impaired future fertility, birth defects when an abortion doesn’t occur, harm to future children, and death.

It warns women not to take RU486 if “you cannot easily get emergency medical help [including blood transfusions and emergency resuscitation] in the two weeks after you take [RU486]”. The FDA has also published 676 “adverse event” reports documenting complications suffered by American women, 200 of which were life-threatening or extremely serious.

These reports can be viewed online, and even a cursory glance reveals a hoard of problems from the same “suspect medication”, including 72 cases requiring blood transfusions, 17 ectopic pregnancies and 7 serious infections.

Here’s what one 25-year old woman said in her report after being issued with the drug:

I followed [the] directions exactly, and after taking the RU486, I was in excruciating physical pain, for at least 12 hours straight and I was bleeding extremely excessively … The only thing I could do was lie on the floor and pull my hair to deal with the pain … I thought I was going to die. After about seven hours of this I really wanted to.

Holly Patterson never told her parents she had taken the drug, and when she started to get abdominal pains she told her dad they were simply menstrual cramps. It wasn’t until days later a doctor told Monty Patterson what had happened to his daughter.

"The medical community treats this as a simple pill you take, as if you're getting rid of a headache,” Monty Patterson said.

"The procedure, the follow-ups, it's all too lackadaisical. The girl gets a pill. Then she's sent home to do the rest on her own. There are just too many things that can go wrong."

The serious health risks to women taking RU486 should never been downplayed, and the drug should never be marketed to women as a medical panacea as simple and harmless as taking a Panadol.

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Article edited by Virginia Tressider.
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About the Author

Helen Ransom is a political adviser and is currently studying a Grad Dip in Theology at Catholic Theological College, Melbourne.

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