On September 28, 2000, the FDA approved the drug mifepristone, in combination with misoprostol, for usage in a medical abortion pill. Formerly known as RU-486 and now marketed as Mifeprex, the drug offers women an alternative to surgical abortion.
According to a Guttmacher Insititute report (PDF), nearly half of pregnancies among American women are unintended, with 40 percent of these pregnancies resulting in abortion. Although the number of abortions performed in United States has decreased in the past decade, the number of medical abortions using the pill has grown. In 2007, an estimated 21% of all abortions performed prior to nine weeks’ gestation used medication abortion.
As Jodi Jacobson writes:
The earlier in an unintended pregnancy an abortion occurs, the safer and less costly it is. Medication abortion is only appropriate for unintended and untenable pregnancies up to nine weeks. Availability of medication abortion has meant that an increasing share of abortions are early, and an increasing share of early abortions are done before six weeks or before nine weeks.
Besides the critical importance of safety and cost-effectiveness, medical abortion also provides an alternative to having an abortion performed in an operating room. For many women, being able to have the abortion experience in the privacy of their own home is more comfortable.
However, approval of mifepristone has not increased general access to abortion services as much as many reproductive health workers initially hoped. In 2009, Dr. Lawrence Finer of the Guttmacher Institute said:
Instead, almost a decade later, we find that women in areas that already had access to abortion now have the choice between a medication or a surgical abortion. But for most women who were not easily able to access an abortion provider before mifepristone became available, services remain difficult to obtain.
Jezebel points out one possible solution to this problem – a telemedicine program run by Planned Parenthood of the Heartland in Iowa. Women who participate in the program are able to obtain an ultrasound at any of 16 clinics, have an examination by a nurse, and talk to a doctor over a secure Internet connection. If the doctor sees no complications upon reviewing a patient’s medical records, they can unlock a box containing the pill and subsequently prescribe it. So far, almost 2,000 women have gained access to abortion services through this program.
Additionally, as author Irin Carmon states in the same post, this method makes it more difficult for anti-abortion activists to interfere with the process, increasing the safety and comfort of patients and physicians.
Ten years after its FDA approval, mifepristone has yet to substantially extend its reach beyond areas where access to abortion already existed. However, within a decade, it has become a significant part of reproductive health in the United States, and research data suggests its continued growth as an option for safely terminating unwanted pregnancy.