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« Increasing Abortion Access in Canada? Approving RU-486, Part 2 | Main | Canadian Law Societies: Bastions of Intolerance? »

Increasing Abortion Access in Canada? Approving RU-486, Part 1

Health Canada is currently considering an application for RU-486, a prescription medication that would provide Canadian women with greater access to a non-surgical method of abortion.  What is this drug and how might it impact Canadian women? This post is the first in a series of three which will examine the drug, its effects, and the medical and political implications should Health Canada approve its use.

What is RU-486?
RU-486 is an abortion pill. RU-486 has been legalized, not without controversy, in 57 countries worldwide. In January 2014, Health Canada Deputy Minister George Da Pont confirmed that a pharmaceutical company has sought the drug’s approval for use in Canada. Practically speaking, this means that Canadian women would have yet another form of access to abortion. RU-486 would be an alternative to the standard surgical processes.  Canada has yet to legalize this method of abortion.

This abortion method is referred to as a chemical or medical abortion. The abortion is caused by a combination of two separate medications: Mifeprex and Misoprostol.

Has it Been Used in Canada?
Yes, in 2001 there was a drug trial of RU-486 in Canada. The drug trial was halted that same year after use of RU-486 resulted in the death of a woman. She suffered Toxic Shock Syndrome brought on by a bacterial infection related to her chemical (RU-486) abortion.

How Does RU-486 Work?
RU-486 works chemically to counteract the hormone crucial for sustaining pregnancy, progesterone. Mifeprex (mifepristone) binds to the progesterone receptor site in place of the progesterone hormone. It does this with twice the strength of progesterone, which enables the Mifeprex to ‘beat’ the progesterone hormone to its receptor site. The resulting failure of the progesterone to bind to the receptor sites causes placental failure. The failure of the placenta causes the developing embryonic child to lose the necessary nutrition and oxygen needed for development and survival, resulting in death.

Use of RU-486 is a multi-day process. On the first day, a woman takes three 200mg tablets of Mifeprex. On the third day, she takes two 200mg tablets of Misoprostol. Misoprostol is taken in conjunction with Mifeprex because it induces contractions. As a result, the woman experiences a forced miscarriage, a chemically induced abortion.

On the 14th day, it is recommended that the woman return to her doctor for a post-treatment appointment—to confirm that a “complete termination” has occurred. If the chemical abortion has failed, the patient would undergo a surgical termination to complete the abortion process.

What Are the Side Effects?
There are many side effects associated with RU-486. The most common of the 2,207 adverse side effects are

  • bleeding
  • nausea
  • abdominal pain
  • uterine hemorrhaging, and
  • vomiting

As the drug’s 2001 Canadian trial was short-lived, it is worthwhile to examine the experience of the American women who have used the drug.

According to a recent report by the U.S. Food and Drug Administration, between September 2000 and the end of April 2011, 612 American women needed to be hospitalized due to their use of RU-486. 339 women received a blood transfusion due to blood loss and 256 woman developed infections. Out of those 256 women, 48 of them developed “severe infections” (which often included death or hospitalization) due to RU-486.  150,000 American women experienced serious bleeding after taking RU-486. Tragically, 14 women have died in the U.S. as a result of using RU-486.

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