The RU-486 abortion pill
How it works; What the expelled
embryo looks like. Contraindications:
How it Works:
In the U.S. the FDA specifies that RU-486 is to be taken within 49 days
(7 weeks) after the start of the last menstrual
period. It is an antiprogestin. It binds itself to progesterone receptors on the wall of the
uterus thus blocking the effect of the woman's natural progesterone. This triggers the
shedding of the uterine wall, much like a normal period. RU-486 also opens the cervix, and
causes mild contractions which help expel the embryo. The initial dose often causes some
nausea, headache, weakness, diarrhea and/or fatigue. It is sometimes taken
at home; other times it is taken at a clinic.
One or two days later, the woman takes a prostaglandin pill, typically
misoprostol (a.k.a. Cytotec). This causes her
cervix to soften and dilate. Contractions of her uterus begin. French studies showed that in
54% of the time, the embryo is expelled within 4 hours. In another 22% of cases, it is expelled within 24 hours. She
is observed in a clinic for 4 to 6 hours. The medication causes bleeding and deep cramps.
Some days later, she returns again for an examination to confirm that the
abortion was complete.
There was general agreement by the year 2000 that the treatment works about 95% of the time.
However, after nine months of usage by the Planned Parenthood
Federation of America (PPFA), its "success rate" has been found to be
in excess of 99%. 1 It is most effective if taken during the first 7 weeks of
pregnancy. After 9 weeks, it is less effective and the side-effects are more
severe. Bleeding can last up to 9 days (compared with about 5 days for a surgical
abortion). Approximately 1% of women will have heavy bleeding which requires additional treatment.
The medication totally fails to cause an abortion in about 1% of the women; about 2 to 3% of women
experience an incomplete abortion. They require a follow-up surgical abortion.
About 0.1 to 0.2% of the women experience excessive bleeding and require a blood
transfusion. 2 Four women of the 2,100 who took part in the
initial trials lost sufficient blood to require a transfusion. 3
It is not a simple procedure; it has unpleasant side effects. But many women find it
more acceptable than an a conventional early-pregnancy elective abortion which involves
surgical intervention and perhaps a one day recovery period. In mid-1998-JUL, the Population Council in New York NY released the results of a survey of 2,121 women who had
taken RU-486. Half of the women had previously had a surgical abortion. 77% of those women
rated RU-486 "more satisfactory." 90% would prefer the pill if they had
another abortion and would recommend it to others.
Author S. Boyd cited a report published in the Journal of the American
Medical Women's Association. The report listed a number of reasons why many
women interviewed from "various races, ethnicities, education levels and
socioeconomic backgrounds" preferred RU-486 over a surgical abortion:
||It seemed more like a natural miscarriage.
||It was helpful to have a partner or friend with them during the
abortion; this is not allowed at most abortion clinics.
||Medical abortion counselors spend twice as much time with women as
do the counselors for surgical abortion, giving women more time to ask
questions and further solidify their abortion decision.
||One study participant said: "The fact that you insert
[misoprostol] yourself is a feeling like ... this is my choice ... my
decision. There's so much more power in it." 4
It is important to note that Cytotec is being used
"off label." That is, it was developed and approved for another purpose,
not for use in conjunction with RU-486 to induce an abortion . This means that
the woman cannot sue the manufacturer if she regards the medication to be the
cause of serious side effects.
What does the expelled embryo look like?
Part of the RU-486 induced abortion process is the expelling of the
developing embryo from the woman's body. This typically happens at home.
As expected, pro-lifers and pro-choicers take different views on how
upsetting this is to a woman:
||Linda Dean, executive director of the pro-life Women's Resource
Center of Southern Nevada, said: "...women can actually pass a
part of a fetus at home, when they're not in a clinic or directly under
a doctor's care at that time. And psychologically, that can be very
disturbing for women." 5
||Vicki Saporta, president and CEO of the pro-choice National
Abortion Federation, said that women who take RU-486 receive
counseling and know what to expect. "When they are prepared for it,
most of them say it's like having a heavy period." 5
In an ideal situation, the woman will realize that she may be pregnant
when the expected start of her period is delayed by a week or so. She might take
a home pregnancy test at that time, find that she is pregnant, visit her
doctor or clinic, and take the first RU486 pill. This would terminate the
pregnancy, about three weeks after conception. The embryo would be about
1/12" long, the size of a pencil point. It most closely resembles a worm
-- long and thin and with a segmented end.
If she delayed the procedure by an extra week, the embryo would have
grown to a length of about 1/5", and would resemble a tiny tadpole. The
structure that will develop into a head is visible, as is a noticeable
tail. The embryo has structures that resemble the gills of a fish in the area that
will later develop into a throat.
If she delayed the procedure by two weeks, the embryo would be about 5 weeks from conception.
That is approaching the limit beyond which RU-486 is not usually taken. Tiny arm
and leg buds have formed. Hands with webs between the fingers have formed
at the end of the arm buds. The face "has
a distinctly reptilian aspect."
Another week later, about 6 weeks from conception, It is typically about 1/2" long. The face
has two eyes on the side of its head; the front of the face has "connected
slits where the mouth and nose eventually will be."
At 7 weeks, the embryo has almost lost its tail. "The face is
mammalian but somewhat pig-like." 6 That
is the time limit beyond which RU486 is not generally used. A surgical abortion
would normally be indicated at this stage of gestation.
Accordig to Wikipedia:
"In clinical trials, nearly all women using the mifepristone/misoprostol regimen experienced abdominal pain, uterine cramping, and vaginal bleeding or spotting for an average of 9–16 days. Up to 8% of women experienced some type of bleeding for 30 days or more. Other less common side effects included nausea, vomiting, diarrhea, dizziness, fatigue, and fever. Pelvic inflammatory disease is a very rare but serious complication. Excessive bleeding and incomplete termination of a pregnancy require further intervention by a doctor (such as vacuum aspiration). Between 4.5 and 7.9% of women required surgical intervention in clinical trials. Mifepristone is contraindicated in the presence of an intrauterine device, as well as with ectopic pregnancy, adrenal failure, hemorrhagic disorders, inherited porphyria, and anticoagulant or long-term corticosteroid therapy.
The FDA prescribing information states no data are available on the safety and efficacy of mifepristone in women with chronic medical conditions, and 'women who are more than 35 years of age and who also smoke 10 or more cigarettes per day should be treated with caution because such patients were generally excluded from clinical trials of mifepristone'." 7
The following information sources were used to prepare and update the above
essay. The hyperlinks are not necessarily still active today.
- "Planned Parenthood reports widespread satisfaction among patients and
providers," Yahoo! Politics, 2001-SEP-24, at: http://politics.yahoo.com/politics/features/
- Tom Carney, "'Abortion pill' test goes awry for one patient,"
Des Moines Register, 1995-SEP-21. Online at: http://www.ru486.org/ru3.htm
- "FDA approves abortion pill in United States," MSNBC,
2000-SEP-28, at: http://www.msnbc.com/news/467301.asp
- S. Boyd, "Give us liberty: The approval of RU-486 isn't about
morals, it's about optons," Salon.com at: http://www.salon.com/mwt/feature/
- Kate Silver , "Abortion pill slips under radar," Las Vegas Weekly,
2002-MAY-16, at: http://www.lasvegasweekly.com/
- Carl Sagan, "Billions and Billions", Random House, New
York NY (1997), Pages 163-179.
- "Mifespristone," Wikipedia, as on 2015-JUL-31, at: https://en.wikipedia.org/
Copyright © 1997 to 2015 by Ontario Consultants on
Latest update: 2015-AUG-03
Author: B.A. Robinson