Archive for Sunday, October 1, 2000

RU-486 won’t end abortion debate

October 1, 2000

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— Within hours of the announcement, the small line popped up on one of the talk shows that dance across the cable channels: "All Over But the Shouting."

Is that it? Does the FDA approval of RU-486 signal a full victory, a smackdown in the wrestling match over abortion?

"The big success of the anti-abortion movement has not been in changing women's minds. It's been in frightening off doctors and closing clinics."

RU-486 had been stalled for so long, that I had come to think of it as the flight number of a plane held hostage. And of course it had been held hostage ... to politics.

For a dozen years, the political turbulence had kept this drug grounded. Reagan and Bush the Elder had simply banned the drug known medically as mifepristone and popularly as "the abortion pill." But even when the climate changed with Clinton, it took more testing, more trials, more years to find a manufacturer, more time for the FDA to rule.

Now it's all over? But the shouting?

On television, a shrill spokeswoman for Concerned Women for America warned that women who used RU-486 would be gushing blood and searching for embryo parts all over supermarket floors as they miscarried. In Congress the usual suspects ratcheted up their usual sound bites. J.C. Watts said: "Do-it-yourself abortion has no place in a civilized society."

Meanwhile, those who believe in a woman's right to choose uttered a collective shout of victory. RU-486 has been touted as more than a medical alternative. It's the magic drug that would reshape the debate. Tip the balance.

After all, in the past decade, as the pro-life strategy turned from trying to make abortion illegal to trying to make it impossible, many women have had the "right" to abortion without the access. Fewer than 2,000 clinics perform abortions. There are no providers at all in 86 percent of U.S. counties.

The big success of the anti-abortion movement has not been in changing women's minds. Or even in changing the law. It's been in frightening off doctors and closing clinics.

At the same time, the public debate shifted disastrously to those rare and troubling late-term abortions. In the past several years, the "shouting" has been over what's labeled in a graphic and distorted way, "partial-birth abortion."

So many pro-choice advocates have pinned their hopes on mifepristone, though not because "the pill" is a medical panacea. Indeed, it involves two series of drugs and three doctor visits as well as a simulated miscarriage. In France today it accounts for less than half of abortions.

But mifepristone is, as the brand name implies, an "Early Option," used in the first seven weeks when an embryo is no larger than a grain of rice. There is no question that the public feels more comfortable with that early an abortion. So do women.

It also opens up the real possibility of increasing the pool of doctors who may no longer have to risk their lives to practice medicine. A third of doctors who don't provide abortions now have said they would prescribe and oversee this treatment.

And, more to the point, it can allow women what the Supreme Court says they have: the right to privacy. A woman who can go to her doctor's office for treatment doesn't have to pass the gantlet of protestors and placards outside the clinic.

So it's all over? I'm afraid that the shouting will still drive this debate.

The drug has been approved. But the remaining question about mifepristone is whether and when doctors will feel personally safe enough to prescribe it in their offices. Will they feel comfortable in states that still require a report on every abortion?

The anti-abortion forces have fought RU-486 because they know it's harder to target 20,000 doctors than 2,000 clinics. It's much harder to intimidate and humiliate those patients.

But mifepristone doesn't make the need for clinics moot. Nor does it mute the political reality that we are a Justice or two short of overturning abortion rights.

So here we are. In only four weeks, just a few days before the election, mifepristone will finally be available in America. It's not all over. But in the midst of the shouting, may I add one cautious cheer: "It's about time."




Ellen Goodman is a columnist for The Boston Globe.

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