Out of the Clinics

May 20, 1994|By ELLEN GOODMAN

Boston -- The estimated time of arrival had been delayed again and again. By now, RU-486 had begun to sound like the flight number for a plane permanently grounded by bad weather.

Indeed, the manufacturers of the abortion pill at Roussel Uclaf acted more like meteorologists than medicine men when they talked about their product. All through the 1980s and early '90s, they blamed ''the climate'' for their stubborn refusal to let RU-486 come to America.

The political atmosphere surrounding abortion here was too turbulent, they said. The pill would produce a storm of controversy. The company could be devastated. In fact, Roussel Uclaf was in a rather strange position for any business. It had a lock on a product that it didn't want to sell. Indeed the pill had only gone to France, Great Britain and Sweden.

The Roman Catholic heads of its own parent company, Hoechst, had been directly lobbied by the pope himself against giving RU-486 to the U.S. They'd been threatened by American pro-life groups with a boycott of all their products. And they'd worried as well about liability in the lawsuit-happy States.

But last year there was, to put it mildly, a change in the political weather in Washington. The prevailing winds in the abortion debate shifted direction about 180 degrees. Two days after Bill Clinton was inaugurated he assigned the savvy and dogged secretary of Health and Human Services, Donna Shalala, the task of figuring out how to get RU-486 into this country. This week, after another full year of delays and a deadline ultimatum, an agreement was made.

So, RU-486 is finally off the ground. In words of Rep. Ron Wyden, D-Ore., ''This drug is coming to the United States.''

The manufacturer has agreed to give the American patent rights to The Population Council, a non-profit organization, in return for ridding itself of controversy and liability. The council will begin clinical trials this fall involving 2,000 women while they look for an American manufacturer. In two years American women will, in all probability, have at least as easy access to RU-486 as French women have today.

After all this time, it's hard to understand why so much controversy has focused on a method of abortion. After all, the pill onlydoes what a surgical abortion does.

Pro-lifers have been convinced that RU-486 would make abortion easy and making it easier would make it more common. But in France at least, the pill hasn't changed the rate at all.

In fact, RU-486 hasn't yet made abortion as simple as either pro-lifers fear or pro-choicers hope. ''The pill'' -- more properly described as a dose of Mifepristone followed two days later by a dose of prostaglandin -- can entail three medical visits and the abortion can come with serious cramps. It's not like swallowing an aspirin.

But RU-486 will have a profound effect on the public debate. As Planned Parenthood's Pamela Maraldo said, ''This will mark the beginning of a new era. It will go a long way toward ending the abortion wars.''

RU-486 is used in the earliest weeks of pregnancy. At four weeks, there are no ''silent screams'' and no images to blow up into poster fetuses. Public support for a woman's right to decide is greatest at this stage. Indeed RU-486 is being clinically tried now as a ''morning-after pill.''

More important, you don't need a clinic to take a pill. In the past couple of years, the pro-life movement has shifted its tactics from winning cases to closing clinics, from passing laws to harassing patients. But with RU-486, abortion will no longer have to be limited to clinics, hospitals and the handful of doctors easily targeted as ''the weak link'' of abortion.

The pill can be offered by trained physicians in a thousand offices. As Ms. Maraldo says, ''This will quiet and privatize the debate. It will take the debate off the streets and away from the clinics and bring it back to the minds of American women where it belongs.''

The pill will never entirely replace surgical abortions. Nor will it change the moral and emotional dimensions of the decision faced by a woman with an unwanted pregnancy. But it will make her choice easier to exercise.

Yes, there's a change in the weather pattern. Last week, Congress passed a law protecting access to clinics. This week, the administration got RU-486 off the runway. Think of it as a lesson in the politics of climate control.

Ellen Goodman is a syndicated columnist.

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