The history of abortion pills and how they work

French health the minister was furious. In September 1988, Claude Évin’s department authorized the sale of an abortion pill called RU-486. A world first. But now, just four weeks later, under pressure from anti-abortion groups, the board of the pharmaceutical company that made the pill – Roussel Uclaf – had voted 16 to 4 to pull it from the market. Some corporate executives were also opposed to the drug.

Évin summoned Roussel’s vice-president Uclaf to his office. He told her that if distribution did not resume, the French government had the power to transfer the patent to another company for the public good. Roussel Uclaf retreated. In a television interview, Évin later said, “From the moment government approval for the drug was granted, RU-486 became the moral property of women, not just the property of the pharmaceutical company. .

And so the abortion pill, now generally called mifepristone, came to the world. Today, mifepristone is often used in combination with another drug, misoprostol, and together the pair is over 95% effective in terminating a pregnancy when taken for the first 50 days. While mifepristone blocks the hormone progesterone – which regulates the lining of the womb and the maternal immune system, allowing pregnancy to take place – misoprostol stimulates the womb to expel the pregnancy.

In the 34 years since the tumultuous introduction of mifepristone in France, more than 60 countries have approved it, including the United States in 2000 and the United Kingdom in 1991 (although it has not legally become available in Northern Ireland only when abortion was decriminalized in 2019). However, mifepristone remains subject to rules governing its use in most places.

Access to these pills is not guaranteed. The landmark 1973 United States Supreme Court case that upheld a woman’s right to an abortion, known as the Roe vs. Wade, seems likely to be reversed. If so, the use of mifepristone and misoprostol for abortion may be restricted or prohibited in some US states.

Any technology related to abortion eventually becomes the subject of moral debate, says Anna Glasier, an honorary professor at the University of Edinburgh who has worked in the past with the Population Council, an NGO that has conducted trials mifepristone clinics in the United States in the 1990s.

Évin’s intervention is “a great story,” she adds, and is just one of many twists in the mifepristone story. In 2000, former Roussel Uclaf board member André Ulmann described how, even earlier in the drug’s history – before it was licensed in France – he began giving mifepristone to any gynecologist in France who wrote to him asking for it, without asking permission from his bosses. .

“By the end of 1988, we had trained the staff of more than 200 of the 800 approved abortion centers in France, and the method was already in routine use in many places before the official launch,” he writes.

The emergence of abortion-inducing pills was “absolutely revolutionary”, says Clare Murphy, CEO of Britain’s Pregnancy Advisory Service. Yet, even today, many people do not know that there are abortion pills, which are completely different from emergency contraception. Medical professionals and health experts who spoke to WIRED say that these drugs are extremely safe and have made the process of self-termination of pregnancy (which is illegal but still practiced in many places) much safer. than it was formerly.

Typically, pregnant women take a dose of mifepristone and then, 24 to 48 hours later, misoprostol, Murphy said. In the United States and the United Kingdom, health regulators have approved this method for use in the first 10 weeks of pregnancy. Those taking the drugs will notice bleeding when the pregnancy is expelled. The amount of bleeding, which partly depends on the time since conception, can be significant. Common side effects include cramping, nausea, and vomiting. Allergic reactions or more serious side effects are considered very rare.

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