"The cost of RU486/PG abortion, for example, is not cheaper for women, but it is much cheaper for the hospitals and clinics..."
At a news conference on 17 May 2002, Dr Richard Hausknecht, medical director of Danco, the company which manufactures RU486 for the American market, admitted, "it (RU486) is not safer than a surgical abortion".
"As Abortifacient procedures go RU486 is not at all easy to use. In fact it is more complex to use than the technique of vacuum extraction...a woman who wants to end her pregnancy has to "live" with her abortion for at least a week using this technique. It's an appalling psychological ordeal". (Edouard Sakiz, Chairman Roussel-Uclaf August 1990)
Although the use of RU486 is growing steadily, vacuum aspiration is still the commonest method of abortion in England and Wales (16). Of the 184,993 abortions carried out in 2002, 149,262 (80.68%) were by vacuum aspiration.
Scotland
How does RU486 work? RU486 is a synthetic steroid which works by blocking the effects of progesterone, the natural hormone which is required to maintain the lining of the uterus during pregnancy. RU486 starves the womb of progesterone, the lining of the womb breaks down, and it is lost along with the developing embryo or foetus.
Up to four visits to a hospital or clinic are necessary to complete the process. The success rate of RU486 on its own is not high. Some studies have it as low as 54% (3) and RU486 is therefore often used with a prostaglandin, typically Gemeprost (a synthetic hormone-like chemical given by vagina), which induces powerful contractions of the uterus and causes the dead embryo or foetus to be expelled from the womb.
For pregnancies up to nine weeks' gestation Mifepristone (600mg) is normally taken by mouth on its own. If the embryo or foetus has not come away within 36 to 48 hours, a prostaglandin (Gemeprost) is given.
For pregnancies of 13 to 24 weeks' gestation, Mifepristone (600mg) is taken by mouth. This is followed by a prostaglandin (Gemeprost) by vagina (1mg every three hours up to 5mg). If abortion does not occur 24 hours after the start of treatment, a repeat course of Gemeprost (up to 5mg) will be given.
In both cases, if the treatment fails, the baby will be aborted by a surgical method, either vacuum aspiration or dilation and curettage.
The main contra-indications for RU486/prostaglandin abortions, which exclude women from having them are:
women who smoke
those over 35 years of age
women under 18 years of age
those who have asthma, obesity, high blood pressure, fibroids, glaucoma, ulcers, colitis, arthritis, epilepsy, kidney disease, pulmonary and cardio-vascular disorders, and suspected ectopic pregnancy.
Side effects Use of RU486/prostaglandin may cause any of the following: haemorrhage requiring blood transfusion, severe pain requiring strong pain killers, incomplete abortion, rupture of the uterus, vaginal bleeding, abdominal cramping, nausea, vomiting, diarrhoea, headache, muscle weakness, dizziness, flushing, chills, backache, difficulty in breathing, chest pain, palpitations, rise in temperature and fall in blood pressure.