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Despite the many potential uses for RU 486 and its effectiveness as an abortion method, efforts to legalize it in the U.S. have met with repeated failure. Last year a pro-choice group called Abortion Rights Mobilization decided to force a court challenge of the import ban imposed on RU 486 by the Bush Administration in 1989. The organization helped Leona Benten, a pregnant 29-year-old California social worker, fly to England, obtain a dose of RU 486, then try to bring it into the U.S. through New York City's Kennedy Airport. Customs officials seized the pills. The ensuing legal battle went up to the Supreme Court, which refused to order the government to return the pills. Benten subsequently had a surgical abortion.
The Clinton Administration has not yet revoked the ban, but its significance is minor. Because distribution of the pills is tightly controlled in Europe and they cannot easily be purchased and imported, the real issue is how quickly the Administration will encourage the manufacture and marketing of the drug in the U.S.
When the pill does become available in America, abortion will not be as easy as going to the doctor and taking some of the tablets home -- at least not right away. In France, for instance, a woman is required to pay four visits over a three-week period to one of the country's 800 licensed clinics or hospitals. The first step is a gynecological exam. Doctors make sure the pregnancy is in its early stages, and a social worker or psychologist discusses with her the decision to abort. Then the woman is sent home for a weeklong "reflection" period.
When she returns, she is required to sign a government form requesting the abortion. She must also sign a Roussel form that confirms her understanding that a malformed fetus might result if she does not see the abortion through to completion. (As yet no defects have been found in the small number of babies born to women known to have taken RU 486.) At that point, the woman is given three aspirin-like RU 486 tablets, each containing 200 mg of the drug. After swallowing the pills, she again goes home.
Except in the rare instance where the RU 486 is enough to induce a quick abortion, the woman must take two 200-mg Cytotec pills within the next 48 hours. Because the timing is critical and doctors want to monitor the effects of this contraction-inducing drug, women are required to return to the clinic. They are encouraged to remain for four hours, even if the expulsion happens earlier. Eight to 10 days later, they must pay a final visit for an exam to make sure no part of the egg remains.
Even with all these steps, the procedure seems blessedly simple to most women. "Taking a pill seems far less murderous and violent to the child than using a vacuum cleaner," says a 31-year-old woman who has had both types of abortion. "You feel so helpless when they put you to sleep and you know they're going to be using their tubes and knives on you." Some women, however, become traumatized by the thought of performing an abortion with their own hand. After her experience with RU 486, Joelle Mevel, 34, vows that if there is a next time, she will choose surgery. "I spent the whole time worrying that I would see the child in the basin, that I would be able to | discern something human in the blood," she says. "I would rather have gone to sleep and awakened later knowing it was all over."