A Pill to Make Abortions Private


March 02, 1993|By ELLEN GOODMAN

Boston. -- The company always blamed it on the weather. The European manufacturers of the abortion pill were simply, repeatedly and openly terrified by the American climate.

When anyone asked the heads of Roussel-Uclaf and its parent company, Hoechst, why they refused to make RU-486 available to American women, they would just point to the political atmosphere. In the intemperate, unpredictable American environment, they said the pill would produce a storm of controversy. They worried that the company would be devastated by a right-to-life boycott.

But my, how quickly the prevailing winds have changed.

There's a pro-choice president in the White House. A frustrated group of Americans has begun negotiating for a Chinese version of the pill. And suddenly, the same company finds our climate rather hospitable. In a shift that would make a weatherman dizzy, Roussel-Uclaf has told the Food and Drug Administration that the abortion pill should be made available here.

It may only be a matter of time before American women have access to the early, non-surgical abortion that's already been used by 120,000 French women. Indeed, if the early RU-486 research is right, Americans may have an effective morning-after pill. And abortion may finally become what it was always supposed to be: a private matter.

These days the most public threat to abortion rights isn't coming from the court or from the legislatures. The front lines now are the clinics, the parking lots around them and the sidewalks in front of them.

There's an irony in this turn of events. Early in the movement, such clinics were conceived as low-key, low-cost, neighborhood places where women could comfortably come for all their reproductive health care, including abortion. ''If the anti-choice people had designed them, they couldn't have done a better job than we did,'' says a rueful Barbara Radford, the head of the National Abortion Federation.

Clinics have become the isolated ghettos of abortion providers and the easy targets for pro-life activists. Abortion itself is segregated from the medical world and medical practice.

Over 90 percent of abortions are performed in specialized clinics. Doctors assume they can refer patients to clinics and are less often trained to perform abortions themselves. Only a quarter of gynecological residents are routinely taught the procedure.

Instead of having a clinic in every neighborhood, we have entire states, like the Dakotas, with only one clinic apiece. State restrictions are often written with clinics in mind and there are no abortion providers in 85 percent of the counties nationwide.

The buildings themselves are not user-friendly. They have become easy marks for arsonists and bomb-throwers and those -- this is the latest -- who inject putrid chemicals through the walls. Just to get in, a woman may have to run a gantlet of pickets and self-appointed ''rescuers.'' While someone in the parking lot writes down the number of her license plate so she can be harassed at home.

RU-486 could irrevocably change this for one simple reason: You don't need a clinic to swallow a pill.

Women who must now take long bus rides to distant cities, where they are required by some state laws to wait 48 hours, would only have to visit their gynecologists or family physicians. Women who must now be escorted along hostile sidewalks to a strange front door, could sit in the waiting room back home with patients getting pap smears and flu shots. Instead of one clinic in a town or state to terrorize, there would be thousands of doctors' offices, HMOs and college clinics to identify.

The pill does not make surgical abortions obsolete. It is only used in the first nine weeks of pregnancy. Four percent of the French women who took RU-486 still needed a surgical procedure. In France, the drug is still restricted to clinics, where most of the country's health care is provided.

But here, RU-486, as a morning-after pill, and an abortion pill, could become part of our decentralized medical system. As Ms. Radford puts it, ''If individual physicians start providing this pill on a regular basis, the anti-abortion people will have to go home.''

Finally, after all these years, most abortions could truly become a matter between the pregnant woman and her doctor. What a change in the weather that would be.

Ellen Goodman is a syndicated columnist.

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