By Randall K. O'Bannon, Ph.D.

Randall K. O'Bannon, Ph.D.

I didn't see columnist Nicholas Kristof at my convention workshop this year or looking over my shoulder when I was researching this months ago, but all of a sudden, the New York Times and its followers in the media are all agog over the use of misoprostol, a cheap anti-ulcer drug, to induce abortions in countries where abortion may not be legal.

Kristof's column, "Another Pill That Could Cause a Revolution," appeared in the July 31, 2010, edition of the Times and asks "Could the decades-long global impasse over abortion worldwide be overcome – by little white pills costing less than $1 each?"

Kristof's column touts the virtues of misoprostol, a prostaglandin widely used as an anti-ulcer medication in the U.S. and in many countries around the world. It also happens to be the same prostaglandin used in conjunction with RU486 (or mifepristone), the so-called "French abortion pill," which has already killed hundreds of thousands of children worldwide and has been associated with nearly a dozen known maternal deaths and at least a thousand hemorrhages, infections, and other serious complications.

As used in the U.S., women who are supposed to be less than 7 weeks pregnant and seeking an abortion take RU486 at their doctor's office, initiating the abortion process. RU486 causes the baby's life support system to shut down, depriving the developing child of needed nutrients, so that he or she essentially starves to death. But by itself, RU486 is often incapable of completing the process, so a second drug, misoprostol, is brought in to finish the abortion, initiating powerful uterine contractions to expel the tiny corpse.

What the international abortion lobby has long known, though, is that misoprostol alone is capable of chemically inducing an abortion. Not as "effectively" or "efficiently" as the mifepristone/misoprostol combination, but just as deadly to a high percentage of unborn children.

Because it is vastly cheaper – at a dollar a pill versus $90 a pill for the RU486 – and because it is often available (as an anti-ulcer drug) in countries where abortion and abortifacients are illegal, many women in countries like Brazil have used it to chemically self-induce abortions.

At one time, this appears to have been something women did by purchasing the drug on the black market. But increasingly, as Kristof and our own research points out, this is part of a concerted effort by high profile international abortion groups.

Women on Waves, the group that tried to get Polish and Irish women to board their boat to have RU486 abortions back in the 1990s, has in recent years been promoting "hotlines" where women in countries where abortion is legal can call and get information on how they can get and use misoprostol to abort (Pakistan and Peru, 2010, Chile and Argentina, 2009; www.womenonwaves.org, 8/3/10)

Kristof quotes Beverly Winikoff, the president of Gynuity Health Projects, identified as a "nonprofit research institution on reproductive health, saying, "This technology is world-shaking." Kristof doesn't tell his readers that prior to her work with Gynuity, Winikoff worked with the Population Council for 25 years, and was instrumental in bringing RU486 to the United States.

Winikoff and Gynuity are part of something called the Misoprostol Alone Working Group (MAWG), which claims to be seeking to address concerns about women using misoprostol alone to self induce outside the regular medical system. At the same time, though, members of the same group are blatantly promoting the use of misoprostol in countries where abortion is not legal.

Traci Baird, board president of the Abortion Access Project, one of the members of MAWG, notes how women in countries where abortion is illegal can use the drug without fear of getting caught. Writing in the Spring 2008 edition of A: The Abortion Magazine, Baird says "Women for whom it doesn't work can subsequently seek treatment for miscarriage or incomplete abortion, often without health-care providers seeing evidence of their previous intervention, which protects women in settings where abortion is a crime."

Bill Alexander of abortion technology promoter IPAS reveals in the same issue how misoprostol is used to get around the Uruguayan law against abortion, with the official blessing of the Uruguayan Ministry of Public Health.

Women who indicate they do not want to continue their pregnancy go to the doctor, where they are given info on all their options, including chemical abortion with misoprostol. They are not actually given the drug, but are told how to use the drug and instructed to return for a follow up. The drug is available by prescription for other uses and can be easily obtained elsewhere. After the abortion, they return to the original doctor and are checked for signs of excessive bleeding or infection.

Alexander notes that "Because the health-care team is neither providing the misoprostol nor inducing the abortion, the initiative works within the constraints of Uruguayan law." He adds further, "The Uruguayan Ministry of Public Health has officially endorsed the model as a national strategy to reduce death and injuries from unsafe abortion."

Gynuity itself has published a pamphlet "Instructions for Use: Abortion Induced with Misoprostol in Pregnancies up to 9 Weeks LMP," offering a basic "how to" for the drug, detailing indications, contraindications, dosage and administration, side effects, and precautions. It is available in English, Spanish, Arabic, French, Portugese, Russian, and Turkish (http://gynuity.org/resources/info/misoprostol-for-early-abortion/, accessed 8/3/10)

Though the pamphlet gives dosage instructions for women up to 9 weeks pregnant, it casually notes that studies have shown that misoprostol "can be used to terminate pregnancies of any gestation."

It is an issue that Winikoff returns to with Kristof. Winikoff tells Kristof that depending on the dosage and strength, chemical abortions can be done "from Day 1 to the end of pregnancy." The safety and efficacy of regimens for those later abortions "still need to be worked out" relates Kristof.

Kristof's sources admit that effectiveness for misoprostol alone, even in those earlier weeks, is only about 80% to 85 % [and even this probably reflects ideal testing conditions, rather than use in the field]. For those who do not abort, there is the possibility of the birth of a child with serious developmental malformations. Kristof puts this at one percent, but it is unclear what the source of that estimate is.

Studies appearing in medical journals in the 1990s found a rash of births of children in Brazil with missing or fused fingers or toes, full or partial facial paralysis, and various neural tube defects after widespread illegal use of misoprostol there (see NRL News, 6/9/98 and 7/8/98).

Kristof offers this as a possible way to save "tens of thousands of women's lives" every year, ignoring not only the unborn female lives lost in abortion but also the lives of mothers who may be endangered by use of this risky method.

In addition to the violent, painful cramping and other side effects, which themselves have put women in the hospital in the past, women using chemical means to abort endure extended and copious bleeding. Some hemorrhage. Others pick up infections, which have, for some, proven deadly (FN: available data is for the RU486/misosprostol combination, but the process and side effects are similar).

That these would occur in countries where these complications are unfamiliar, or worse yet, where there are few doctors or medical facilities, portends not a "gynecological revolution," as Kristof puts it, but a frightening worldwide nightmare.

What women and their children need is support and better medical care, not another dangerous abortion method. If Kristof had attended my workshop, maybe he would have learned that.

Please send all of your comments to daveandrusko@gmail.com. If you like, join those who are now following me on Twitter at http://twitter.com/daveha.