Invisible Abortions


July 19, 1992|By SARA ENGRAM

Leona Benten, the woman who attempted to bring a 12-pill dose of the pregnancy-ending drug RU-486 into the country, exhibited a touching naivete when she expressed surprise this week that her case had attracted so much attention.

By testing the legality of the Food and Drug Administration's ban on the importation of RU-486, the 29-year-old social worker stepped squarely into the middle of the abortion spotlight -- a hard place to stay anonymous.

Most of the world sees RU-486 as a medical breakthrough, allowing women to end pregnancies in the early stages without intrusive surgical procedures, opening new possibilities in contraceptive research and even holding promise for fighting breast cancer and other diseases. But in the United States, RU-486 is just another pawn in a titanic political struggle.

Because it ends a pregnancy after fertilization occurs (as does the IUD), it has been termed the ''abortion pill.'' But Dr. Etienne-Emile Baulieu, the French physician who developed the drug, prefers to call it a ''contragestive.'' Rather than aborting a fetus, the drug stops gestation by preventing a fertilized egg from implanting itself in the uterus.

These fine points of the reproductive process aren't conducive to sound bites and picket signs. That's one reason anti-abortion activists see the pill as such a threat. But after too many years of polarization, a close look at RU-486 may provide some enlightening perspectives on the political implications of the reproductive process.

For instance, we hear a lot about ''the moment of conception.'' But asked to define that moment, the best scientists shrink from the task, pointing out that the process of fertilization occurs over a period of several hours. Human life, from beginning to end, is a seamless web.

Can you pinpoint the exact moment a girl turns into a woman or a boy becomes a man? Certainly there are some general guidelines, but these are essentially judgment calls for which each one of us may have different criteria. In many ways, the use of the terms ''woman'' and ''man'' to denote a stage in development is symbolic.

The discussion of when life begins is also an exercise in symbolic language. After all, each sperm and each egg is indisputably alive, unique and human, even before conception. But we don't discuss granting each of them legal rights.

RU-486 works early in the reproductive process, but not as early as the birth-control pill or other forms of contraception. Yet it clearly works before a there is a fetus that looks human, and that's a disadvantage in an emotionally charged debate. The pregnancies terminated by RU-486 produce no gory pictures that can be used to tug at consciences.

If RU-486 is immoral because it works after the fertilization process, then so is the IUD. But because of product-liability judgments, the IUD is difficult to get in this country anyway. Even so, there has been little if any effort by the anti-abortion movement to condemn the IUD.

Developed by the French pharmaceutical firm Roussel Uclaf, RU-486 is currently approved for use in France, Britain and China. The Netherlands, Sweden and other European countries are likely to approve it soon. Clinical trials have been undertaken in 20 countries. To date, about 110,000 women have ended their pregnancies by taking RU-486, followed two days later by the hormone prostaglandin to increase the drug's effectiveness.

Most of these women find RU-486 more acceptable than a surgical abortion. They can avoid an intrusive procedure and they are able to administer the pills themselves, giving them a greater feeling of control over the process. But it also should be noted that since ending a pregnancy with RU-486 can take several days, some women prefer the quicker surgical procedure.

This choice is not available to American women, and even apart from the legal wrangling this week, it probably won't be in the near future. Fearful of an anti-abortion boycott, Roussel Uclaf has not even requested that RU-486 be approved for use in the United States.

The boycott threat is not an idle one; clearly RU-486 would make the work of the anti-abortion movement infinitely more complicated. If any physician could enable a woman to end a pregnancy by handing her a prescription and telling her to come back in a couple of days, we wouldn't have those compelling news clips of protesting children being arrested in front of clinics where abortions are performed.

With RU-486, abortions could occur in a woman's own home, and the means to end the pregnancy could be obtained in virtually any doctor's office. The decision and the act would be so private that protesters would have an invisible target.

Invisible and private -- just what Leona Benten wants and what opponents fear.

Sara Engram is editorial-page director of The Evening Sun.

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