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Abortifacients and the Sixth Commandment

January 2004
By: Mark Blocher
Within the pro-abortion community there is a strong movement toward using prescription drugs of dubious safety to induce abortions. Pharmaceutical companies such as Searle, Pharmacia, and subsidiaries of the German conglomerate Hoechst A.G. stand to make billions of dollars in profits if so-called "medical abortions" can significantly replace many surgical abortions.

Among these relatively new drugs are two now approved for use in the United States for medical abortions. They are mifepristone (RU-486 or Mifeprex®) and methotrexate. Another drug being used is misoprostol (or Cytotec®), which has been approved for treating ulcers but not for aborting unwanted pregnancies. All three drugs have one thing in common: they kill an unborn child shortly after implantation of the embryo on the wall of a woman's uterus.

THE REALITY OF CHEMICAL ABORTION
Efforts to develop an effective chemical method of abortion date back to the early 1970s. However, it was not until the early 1980s that a drug was introduced that could be used for "safe, effective early abortion." That drug was RU-486. The drug is a steroid hormone similar in structure to the natural hormone progesterone. Invented in 1980 by Etienne-Emile Bauleiu for the French pharmaceutical company Rousel-Uclaf, RU-486 is only the first of a new generation of antiprogestins slated to provide private abortions for women.

The drug works by binding to the progesterone receptors in the pregnant woman's uterus and blocking the action of progesterone, an essential hormone for sustaining pregnancy. Without progesterone, the lining of the woman's uterus breaks down and sheds, just as it does in a normal menstrual cycle, and menstrual bleeding follows. In addition, RU-486 opens the cervix and leads to contractions that result in the dislodging and expulsion of the embryo. The RU-486 regimen works only during the first weeks of pregnancy, with the average being sixty-three days following the woman's last menstrual period. After this time, the woman's own progesterone level is apparently too great for the drug to be effective.

In early clinical trials, RU-486 was used alone and researchers found that it had a significant "failure" rate, which means it failed to produce a dead baby. In a significant number of instances, uterine bleeding averaged nine days following ingestion of the drug, and surgical abortion was required in order to complete the abortion.

Researchers then introduced a "Step 2" prostaglandin drug, misoprostol, after RU-486 was ingested to increase the successful abortion rate. Several companies, including the U.S. drug manufacturer Pharmacia, headquartered in Kalamazoo, Michigan, produce prostaglandins. Prostaglandins have been used since 1970 to induce uterine contractions. Researchers discovered that the combination of the two drugs (mifepristone and misoprostol) work effectively in roughly 85% of cases. In France, this drug combination accounts for about 30% of all abortions.

RU-486 is administered in dosages of 600 milligrams in the form of three 200mg pills. The woman is expected to ingest the pills in the presence of a nurse or doctor before leaving the clinic. Approximately half of the women begin to bleed the following day. The protocol requires the woman to return to the clinic after forty-eight hours to receive the prostaglandin analogue in order to complete the abortion. She remains at the clinic for an average of four to six hours. About 90% of women abort at the clinic following the administration of prostaglandin. The remaining 10% abort at home, work, or elsewhere. The woman will return again several days later for a physician's examination to ensure that the abortion is complete and to determine if she is experiencing any additional side effects. Bleeding lasts for an average of ten to twelve days.

Advocates for the drug point out that RU-486 is just as effective as surgical abortion, although there is a growing list of conditions being used to disqualify women from using it. Clinical trials indicate that women with the following conditions should not use RU-486: those receiving long-term corticosteroid therapy; those with blood clotting disorders, chronic adrenal gland failure, or ectopic pregnancy; and those with contraindications for prostaglandins.

WHAT DOES THE MEDICAL RESEARCH TELL US?
Dr. Ellen Wiebe's research ("Abortion induced with methotrexate and misoprostol," Canadian Medical Association Journal, 1996: Vol. 154: 165-170), found that a large percentage of RU-486 patients required more than one 600mg dosage. She further discovered that a significant number of patients continued their pregnancies after the administration of the drug due to miscalculations of gestational age. Additional research on the drug methotrexate, which is mixed with mifepristone, reveals that it can cause congenital malformations of babies carried to term after intrauterine exposure. Wiebe also reports congenital anomalies (birth defects) resulting from mifepristone use, with limb defects in three babies examined after surgical abortion. Lorraine E. Ferris and Antoni S. H. Basinski, also writing in the CMAJ, state: "The high potential for teratogenicity (congenital defects) in continued pregnancy with the use of methotrexate and misoprostol for early termination of intrauterine pregnancies raises concern that a woman may not complete the medical regimen or may not have a surgical abortion in the event that the drug treatment fails" ("Medical abortion: what does the research tell us?" CMAJ, Jan 1996; 154: 185-187).

One of the greatest fears of clinicians "is that many patients who received the initial dosage of the abortifacient drug will not return for follow-up visits. In some cases, as much as 3% of RU-486 patients never returned for a follow-up visit. Physicians have to consider what might happen to such women.

On September 1, 2001, a woman who was participating in Dr. Wiebe's RU-486 clinical trials in Canada died from an infection following her RU-486-induced abortion. Her death came just ten days after she took RU-486. While Dr. Wiebe acknowledged that the woman's infection was related to the abortion, she denied that it was related to the use of RU-486. Eleven days later on September 12, another woman died after suffering an infection from a ruptured ectopic pregnancy five days after taking RU-486. In another case, a twenty-one-year-old woman suffered a heart attack just three days after taking RU-486.

Dr. Mark Louviere, a physician in Waterloo, Iowa, was called to the emergency room at Allen Memorial Hospital to treat a woman who was hemorrhaging and was in true shock due to loss of blood. Her pulse was racing and her blood pressure was 90/60. An examination revealed she had had an incomplete abortion or miscarriage. The baby was dead, but the uterus was unable to expel the tissue on its own. The patient's husband informed Dr. Louviere that his wife had received mifepristone and misoprostol at a Planned Parenthood clinic in Des Moines about two weeks earlier as part of Iowa's RU-486 clinical trial.

Dr. Louviere determined that the woman had lost more than half her blood. The doctor performed surgery to remove the dead baby and administered two units of blood during surgery and two units following surgery. Fortunately, the woman survived; however, the clinical researchers in Iowa refused to report this incident as a complication associated with their RU-486 trials. In fact, their report to the Food and Drug Administration, the Population Council, and the people of Iowa stated: "The clinical test of RU-486 ended in Iowa with no complications reported among the 283 women who ended unwanted pregnancies without surgery." Jill June, director of Planned Parenthood in Iowa wrote in the Des Moines Register: "I have been told repeatedly that we were viewed as among the leading institutions for the clinical trial. We're very proud of that." One wonders just how proud she and Planned Parenthood will be when the inevitable lawsuits begin piling up.

The Iowa trials used RU-486 in conjunction with misoprostol (Cytotec), an ulcer drug produced by Searle. In a letter to the nation's physicians, Searle's medical director wrote:

August 23, 2000

Re: Cytotec® (misoprostol)
Important drug warning concerning unapproved use of intravaginal or oral misoprostol in pregnant women for induction of labor or abortion

Dear Health Care Provider:
The purpose of this letter is to remind you that Cytotec administration by any route is contraindicated in women who are pregnant because it can cause abortion. Cytotec is not approved for the induction of labor or abortion... Searle has become aware of some instances where Cytotec, outside of its approved indication, was used as a cervical ripening agent prior to termination of pregnancy, or for induction of labor, in spite of the specific contraindications to its use during pregnancy.

Serious adverse effects reported following off-label use of Cytotec in pregnant women include maternal or fetal death, uterine hyperstimulation, uterine rupture or perforation requiring surgery, hysterectomy or salpingo-oophorectomy, amniotic embolism, severe vaginal bleeding, retained placenta, shock, fetal bradycardia and pelvic pain.

Searle has not conducted research concerning the use of Cytotec for cervical ripening prior to termination of pregnancy or for induction of labor, nor does Searle intend to study or support these uses. Therefore, Searle is unable to provide complete risk information for Cytotec when it is used for such purposes. In addition to the known and unknown acute risks to the mother and fetus, the effect on the later growth, development and functional maturation of the child when Cytotec is used for induction of labor or cervical ripening has not been established.

It is clear that Searle is not at all happy that its ulcer treatment drug is being used for off-label purposes. Drug companies face enough product liability threats without having to endure additional ones related to unauthorized usage.

CHEMICAL ABORTION AND THE SIXTH COMMANDMENT
The shift by the abortion rights movement toward chemical abortion is aimed at moving the issue out of public scrutiny and placing abortion's victims beyond the reach of the pro-life community. It is difficult to picket, sidewalk counsel, or protest in front of every woman's residence. The undeniable goal is to make medical abortion legal, private, and safe for the woman and as lethal as possible for the baby.

What seems to be lost on so many is that abortion by whatever means is killing, an act directly prohibited by the Sixth Commandment. Scripture makes it clear that the only killing authorized is that which is under direct divine command. Scripture expressly prohibits private killing, regardless of its form.

Christians in particular should be alert to new encroachments on the lives of pre-born children. Questioning physicians about their positions on the use of abortifacient drugs like RU-486 and their views concerning abortion generally is the least we can do. We cannot be silent while the lives, health, and well-being of tens of thousands of women are placed in jeopardy by the misguided utopian dreams and political aspirations of abortion's loudest advocates. We cannot stand idly by while the culture of death does all it can to make killing seem less like killing.

ABOUT THE AUTHOR: Mark Blocher is the director of Christian Worldview Institute. He can be reached at 616-457-2797.

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