More on RU-486

French Clinical Experience

Clinical Experience With RU 486
Who Should Not Use RU 486?
What Are The Effects of RU 486?
What About Other Medicines?
What Else Should I Know?

Clinical Experience With RU 486

Most women in the U.S. have probably heard to RU-486 and it's abortifacient uses in Europe. It has yet to be approved by the FDA for uses in the United States. So even though we know about it, not too many people realize what is involved in using this abortion pill. Here is a description given by Dr. Aubeny, chief of a French gynecology clinic, about a typical experience with the drug.

Initially, a woman requests a pregnancy test. If a positive result is obtained, both termination and non- termination options are discussed.
If the patient opts for an abortion, she must then wait, by law, for a period of 8 days before any procedure is performed. This is called the period of reflection.
At the end of the eight days, a patient, no more than 49 days pregnant (the company- prescribed limitation on use of the drug), still demanding an abortion is given the option of a traditional surgical procedure or RU 486. RU 486, at $250 for a complete procedure, is slightly more expensive than a surgical termination, at $215. However, in either case, the French national health insurance program reimburses 80 percent of the cost.
If Ru 486 is selected, the patient then must sign a document acknowledging the substance and risks of RU 486 treatment. they are then given 3 pills, which are to be consumed at the clinic. The patient waits at the clinic for 2 hours after taking the pills, before going home, to make sure they do not get sick.
The patient returns to the clinic 2 days later to be medicated with a contraction-inducing prostaglandin. Abortion, thereafter, occurs usually within four hours. Most patients choose to wait at the clinic for this final stage.
The patient are then directed to return 8 to 10 days later. Clinical professionals check for any adverse side effects and to make sure that the abortion was complete.

Several RU 486 patients were interviewed at a hospital. Despite the fact that the drug treatment was a multi-day rather than single-day procedure, all said they chose the drug for similar reasons:

By using the drug, they felt they were in more control of, and involved in the procedure.
The drug option did not require surgery or anesthetic.
In early pregnancy termination (these were all first trimester abortion as prescribed by the limits of the protocol), they felt that Ru 486 was 1) more effective than surgical abortions, and 2) less painful.

the patients all were at the third-visit stage of the RU 486 procedure. They had taken the prostaglandin and were either awaiting the completion of the abortion, or had only recently aborted and were awaiting discharge from the clinic.

Complaints were few. They described the contractions which precede termination as being no more painful than those associated with a normal menstrual period. One patient who had terminated her pregnancy was eating her lunch within the hour.

Dr. Aubeny, working at the clinic, said that in instances where patients have had prior surgical abortion, RU 486 was the procedure of choice "in nine cases out of ten." She commented that patients are almost never hospitalized as part of the treatment.

She added that the clinic has had no problem in controlling the distribution of the drug, which is kept under lock-and-key in an unmarked storage drawer in a locked room.

"In France, it is easier to obtain morphine than RU 486," she said.

Currently, only clinics offering surgical abortion services can distribute RU 486. However, both Dr. Aubeny and her colleague, Dr. Baulieu, told subcommittee staff that clinical environment was not vital to the safe and effective administration of the drug (this is not the French Health Ministry's position).

Who should not use RU 486?

If you are not definitely pregnant.
If you have an ectopic pregnancy.
If the first day of your last period was more than 63 days ago.
If you are a moderate or heavy smoker
If you are over 35 years old.
If you have heart problems or receiving treatment for high blood pressure.
If you suffer badly from asthma, bronchitis or have diabetes.
If you suffer from other serious conditions or are taking medicines of any kind.

What are the side effects of RU 486?

After taking the drug, nothing much will happen for about 12 hours. You may feel a little sick during the first 2 hours.
After 12 hours, you may start to bleed. About half the women who have taken the treatment started to bleed before going back to the hospital to have the prostaglandin. The bleeding my be quite heavy, like a heavy period. You may also get cramps like period pains.
After given the prostaglandin, you will begin to bleed and you will suffer cramps and stomach pains which maybe quite strong. The bleeding will be heavy.
Some women have diarrhea,, sickness, hot flushes and chills after taking the prostaglandin, and also some dizziness and headaches.
Even after the bleeding has stopped, there's a slight chance that the abortion is incomplete, and a surgical operation is required to complete the process.
A few women develop some infections, and antibiotic treatment is needed.

What about other medicines?

Some other medicines may interfere with the treatment and should not be used until it is over. These include some pain relief tablets such as aspirin and ibuprofen. If you need to take other medications, your doctor should be told.

What else should I know?

It is possible for you to become pregnant again immediately after the termination is complete so you will need to start contraception within 3 to 9 days of taking the drug.

Smoking and Drinking: You should not drink alcohol or smoke once you have taken the drug, for at least 2 days after you have been given the prostaglandin.

Once the RU 486 drug has been taken, you should be aware that changing your mind is inadvisable because there is a high risk that if the pregnancy continues, the baby may be born with abnormalities.

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