Abortion Pill: Recent Increase In Popularity In the U.S

The Abortion Pill (Mifeprex, RU 486) was discovered and became popular in France in the late 1970's and early 1980's for termination of pregnancies between 3 and 7 weeks gestation.  More than 50% of women in France and other parts of Europe choose the Abortion Pill method to terminate their pregnancy over the traditional surgical Suction Curettage.  The reason that women choose the abortion pill more frequently is because women feel it is more private to have the abortion process take place in their own surroundings where they can be with their support person.  It also avoids uncomfortable surgery and sedation and allows women  a different choice. 

When the FDA approved RU 486 in the U.S. in 2000, it was initially thought that there would be a dramatic increase in the number of medical abortions performed.  This did not turn out to be the case for multiple reasons. These included the following:

1) High failure rate:
The original studies of abortion procedures . with RU 486 were done with patients between 4 to 7 weeks (28 to 49 days).  A lot of facilities in Europe still do not go past 7 weeks in performing abortions using RU 486.  This is because the success rate drops from 95 to 99% success  between 4 to 7 weeks, to 88 to 94% success rate between 4 to 9 weeks.  This does not seem like a significant difference but it is when it comes to thousands of people using this method to terminate.  Especially if the patient is greater than 7 weeks gestation.  There is close to a 100% success rate with the surgical abortion procedure. Very rarely retained tissue, heavy vaginal bleeding, or uterine infection occurs which requires a repeat Suction Curettage procedure. 

2) May take a long time to complete the procedure:
Patients are told that it could take two weeks or longer for the procedure to be completed.  Patients and Physicians alike can become impatient with the length of time it can take for the uterus to become empty after taking the RU486 followed 48 hours later with taking misoprostol which causes the uterus to contract and the fetus is expelled (pushed out of the uterus).  There are well known Physicians and clinics that perform abortions that have stopped offering the abortion pill for this reason. It takes too long, and requires too many weekly or bi-weekly trips for the patient to the office in order to make sure that all of the tissue has passed.

3) Excessive or prolonged bleeding. 
For most patients, the bleeding after starting the RU486 and inserting the misoprostol vaginally or taking it by mouth 48 hours after taking the RU486 normally lasts from 5 days to 2 weeks.  Over 90 percent of patients have stopped bleeding by 20 days but there is still a small percentage of patients that continue bleeding at 30 days (2 to 3 percent).  There is even a small percentage of patients (1%) that continue bleeding until their first menstrual cycle begins after the abortion which occurs generally 4 to 6 weeks after first taking the RU486 pill to start the abortion process.  Normally with the Suction Curettage, patients less than 6 weeks only bleed for 1 to 3 days.  For patients more than 6 weeks, but less than 9, the bleeding usually last 3 to 6 days. 

With more women becoming educated about their bodies, and becoming more aware of the various medical abortion procedures , there has been an  increase in the request and demand for the medical abortion procedure to be performed.  The failure rate is essentially the same, the incidence of retained tissue is less for patients less than 6 weeks.  For women who choose the medical abortion procedure over the surgical procedure for 6 weeks or less, there is still excessive bleeding that is associated with the medical abortion procedure.  Women who choose the medical abortion procedure are able to accept this as a small inconvenience rather than having to undergo surgery.