What is RU486?

This is an article that I wrote for the Life Network Australia website. You can see the article here.

Most people who are familiar with the abortion issue are familiar with surgical methods of abortion (such as D&E). But what you might not be as familiar with is RU486, which is essentially an abortion in a convenient pill. RU486 is also known by its more generic name, Mifepristone. RU486 can be effective on its own, but it is usually followed up with a second drug, Prostaglandin, to induce the uterus to contract and expel the shriveled corpse.


A woman is first counseled, given a physical examination and an ultrasound. Once the doctors determines it would not be dangerous or deadly to the woman, she is given the drug to take in the doctor’s presence. Two days later, on a follow-up visit, she is given the Prostaglandin. This results in powerful and painful contractions of the uterus which works to expel the baby. It can take up to two weeks for the RU486/Prostaglandin abortion to fully complete. On another follow-up visit, if the abortion hasn’t been completed by then the doctor will recommend a surgical abortion to finish the job.

How does it work?

It is important to note that RU486 is different from the morning after pill. There is some research that suggests the morning after pill may cause an early abortion (by preventing implantation of an already conceived human zygote) [1], but the pill usually works to delay ovulation or prevent the sperm from fertilizing the ovum. This is why it’s called Plan B. If other contraception fails, you take the morning after pill to try and prevent pregnancy. However, if the research is correct and it does have a chance of preventing implantation of a human zygote, then it would be unethical to use (since the zygote is a living human organism). It would essentially be a very early abortion.

While the verdict is still out on whether the morning after pill causes an early abortion, RU486 definitely does cause an abortion. Since the woman doesn’t even know she’s pregnant until about the fifth week of pregnancy, RU486 is used from the fifth week of pregnancy until the ninth week (so there’s a five-week window in which it’s effective).

The drug essentially works by shutting down the process of pregnancy, causing the child to suffocate or starve to death and detach from the uterus. She will then be flushed out with the woman’s next menstrual period, along with the decayed uterus lining. It does this by interfering with the action of progesterone, a hormone crucial to the early process of pregnancy.

Progesterone helps suppress uterine contractions which could dislodge the child, as well as stimulates the proliferation of the uterine lining which nourishes the developing child. RU486 fills the chemical receptor sites reserved for progesterone but does not transmit the progesterone signal. Failing to receive the signal, the woman’s body shuts down the preparation of the uterus and initiates the normal menstrual process.

How developed is the child by this time?

Since it is about the fifth week of pregnancy that a woman detects she’s pregnant, that means the unborn child is three weeks old (pregnancy is measured from the last menstrual period, so when a woman is X weeks pregnant, the unborn child is X-2 weeks old since conception is about two weeks after the last menstrual period).

Development in the womb is pretty rapid. Everything is in place by the eighth week of embryonic development (which is the tenth week of pregnancy). So when RU486 can first be used, the preborn human has already developed a beating heart that pumps blood (often a different bloodtype than the mother). She has also started to develop the spinal column, nervous system, brain, liver, kidneys, and intestines. The child is roughly the size of a tip of the pen by the end of this week. [2] This is at the earliest RU486 is used.

If used in the sixth week of pregnancy (fourth week of fetal development), basic facial features have begun to develop, and small buds that will become the arms and legs. Growth becomes rapid at this point. If used in the seventh week (fifth week of fetal development), nostrils form and eye lenses begin to take shape. The arms continue to grow. By the end of this week, the baby might be a little bigger than the top of a pencil eraser.

If used in the eighth week of pregnancy (sixth week of fetal development), the arms are growing longer and fingers develop. The eyes are visible and ears begin to take shape. The upper lip and nose have formed. By the end of this week, the baby is roughly ½ inch long. If taken in the ninth week of pregnancy (seventh week of fetal development), the arms develop bones and bend at the elbows, toes form, eyelids and ears begin developing. By the end of this week, your baby is about ¾ inch long. This is the latest at which RU486 is used (although it begins to lose its effectiveness at seven weeks).

If a woman uses RU486, she ends up expelling the aborted unborn human (now a shriveled corpse) into the toilet when she uses the restroom. She can see what it looks like (though if used earlier it might be too small to make out any features). You might have to look closely at it.

Complications

RU486 is hardly a safe drug. Normal side-effects are prolonged heavy bleeding, severe cramps, nausea, diarrhea, headache, skin rash, and vomiting. [3] The woman usually bleeds for ten days, but it can last up to 43 days. Five women out of a hundred bleed so severely that a D&C is required to stop the bleeding. Some women even have required blood transfusions. [4] There have been two reported heart attacks and one confirmed death. [5] [6] Though death by abortions are sometimes difficult to measure (and RU486 is no different). Complications from abortion usually set in at a later time. The official cause of death will be whatever she died from, though the actual cause of her death was the abortion she had.

Again, RU486 should not be confused with the morning after pill. The verdict is still out on whether or not the morning after pill actually causes an abortion (though chances are it sometimes does). RU486 always causes an abortion. It is used after the woman is confirmed pregnant.

[1] Some research suggests this may not be the case. There is no definitive answer as to whether it does or not.
[2] André Ulmann, Georges Teutsch, and Daniel Philbert, "RU486," Scientific American, Vol. 262, No. 6 (June 1990), pp. 18-24.
[3] Louise Silvestre, et al, “Voluntary Interruption of Pregnancy with Mifepristone (RU486) and a Prostaglandin Analogue,” New England Journal of Medicine, Vol. 322, No. 10 (March 8, 1990), pp. 645-648, and E.E. Baulieu, “RU 486 as an Antiprogesterone Steroid,” Journal of the American Medical Association, Vol. 262, No. 13, (October 6, 2009), pp. 1808-1814.
[4] Mary W. Rodger and David T. Baird, “Blood Loss Following induction of Early Abortion Using Mifepristone (RU 486) and a Prostaglandin Analogue (Gemeprost),” Contraception, Vol. 40, No. 4 (October 1989), p. 439.
[5] Dr. Y.M. Kervran, “RU 486: Rousell addresse une lettre aux gynecologues des centres d’IVG (RU 486: Rousell Addresses A Letter To Abortion Center Gynecologists),” Le Quotidien Du Medicin (Medical Daily), (April 30, 1990), p. 11.
[6] Martine Laronche, “Les contre-indications de 1’IVG par voie maedicamenteuse pourraient etre elargies (Contraindications for abortion by medication could be expanded),” Le Monde, (April 10, 1991).