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But mifepristone's defenders counter that carrying a baby to term is six times as dangerous as ending a pregnancy, whether surgically or medically. There are certainly risks if women were to use the drug without adequate supervision, but the FDA guidelines aim to limit that possibility: a patient will receive written instructions on taking the pills, and must sign a statement swearing that she has read them and that she will agree to a surgical abortion if the medication fails.
Though the abortion debate could now land squarely back in the middle of the presidential campaign, both candidates mainly used last week's announcement to reinforce longstanding positions. While the next President can't reverse the FDA outright, he could pick an FDA commissioner and a Health and Human Services Secretary who would raise safety questions and try to tighten distribution--with the goal of making medical abortion just as hard to get as surgical abortion.
But the real battle is still likely to be waged in the streets, for now. Antiabortion activists may not change anyone's mind about the pill--but they could have an effect if they persuade enough doctors that entering this minefield is dangerous to their health and practice. The tactic has worked well for years now; in much of the country, Roe v. Wade might as well not exist, and the only way the abortion pill changes that is if doctors everywhere decide to offer it. "There are a lot of doctors who feel very strongly that women have a right to make a choice but are unwilling to wear flak jackets to work," says Dr. Diana Dell, an ob-gyn specialist at Duke University Medical Center. "I don't know where it will go."
--Reported by Ann Blackman, Polly Forster and Dick Thompson/Washington
For a behind-the-scenes look at how the Clinton Administration insulated itself from the controversial drug-approval process, go to time.com