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"I know nothing about these things," she says, recalling the prospect of getting an abortion. The idea of surgery frightened her. "I was so scared. I was afraid of the risks." Her boyfriend had told her about mifepristone; she liked the sound of it. "Without surgery it would be less risky," she thought, "like having a period." But he had also offered to marry her, urged her to keep the baby. Her children said they would baby sit. She didn't think it would work. "I've already had my babies," she said.
The bleeding continued all afternoon, but the pain was not crushing. By evening it was mostly over. Like many women, she compares the experience to a bad period.
After years of steadily declining abortion rates in the U.S., pro-life advocates fear a reversal if the pill encourages women to view abortion more casually. For these activists, the point of the debate about late-term abortion was to draw tight the line between abortion and murder. Mifepristone, argue its supporters, makes abortion look more like birth control, "more like a standard medical treatment than something that has been marginalized and ghetto-ized," notes Boston University ethicist Annas. But even greater availability and a higher comfort level among patients do not mean the total number of abortions will necessarily rise. During the decade that the pill has been available in France, more and more women--now 29%--have chosen medical over surgical abortion, but the availability of the drug did not drive up the total number of abortions. On the other hand, surgical abortion in France does not carry the same stigma, the issue is not as divisive as in the U.S., and so the introduction of a medical alternative may have a greater impact here than abroad.
By focusing debate on the very earliest weeks of pregnancy, mifepristone does force pro-lifers to refine their arguments. "It's a whole new ball game for people in this movement," says Judith Brown, president of the Virginia-based American Life League. She hopes to convince people that even though the fetal material being expelled doesn't look like a baby, it is still an unborn child. "We will have to personalize the egg," she says. By the time a woman misses a period, sees her doctor and confirms the pregnancy, opponents note, there are already distinct signs of life. "Brain waves can be picked up as early as six weeks," says Laura Echevarria, communications director of the National Right to Life Committee. "We will be stepping up our efforts to educate people about the early development of the unborn child."
Abortion foes also plan to drive home the medical risks associated with the drug, especially if it is misused or winds up circulating through an Internet black market. "It can be banned state by state or by Congress," says Michael Schwartz, administrative assistant to Representative Tom Coburn, a doctor from Oklahoma who last year tried to bar the FDA from spending federal funds to develop any kind of abortion drug. Schwartz thinks it is inevitable that the drug will be prescribed for women who are more than seven weeks pregnant, that there will be a lack of patient compliance and that someone will die from it. "These are predictable consequences, even with the guidelines," he says.