Little white pills that may end the abortion impasse

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Could the decades-long global impasse over abortion worldwide be overcome - by little white pills costing around 60p each?
That seems possible, for these pills are beginning to revolutionise abortion around the world, especially in poor countries. One result may be tens of thousands of women's lives saved each year.
Five-sixths of abortions take place in developing countries, where poor sterilisation and training often make the procedure dangerous. Up to 70,000 women die a year from complications of abortions, according to the World Health Organisation. But researchers are finding an alternative that is safe, cheap and very difficult for governments to restrict - misoprostol, a medication originally intended to prevent stomach ulcers.
"I feel like people must have felt when they discovered the nuclear bomb," said Dr Beverly Winikoff, president of Gynuity Health Projects, a non-profit research institution on reproductive health. "This technology is world-shaking."
This pharmaceutical approach is called "medical abortion". In Europe and the US, it typically consists of two sets of "M" pills. The first is mifepristone, formerly known as RU-486, and then a day or two later the misoprostol. Using the drugs in combination produces a miscarriage more than 95 per cent of the time in early pregnancy. But mifepristone is difficult to obtain in much of the world as it is used only to induce abortions. In contrast, misoprostol is widely available and can't easily be banned because it is also used for ulcers and can save lives of women with postpartum haemorrhages. Whatever one thinks of misoprostol for abortions, it also is a potential lifesaver.
Researchers are finding that if women take misoprostol alone, effectiveness drops to 80 to 85 per cent. That may sound low, but it's typically far better and safer than alternatives that women turn to, Dr Winikoff noted.
"Medical abortion represents a revolution in women's reproductive health," said Dana Hovig, chief executive of Marie Stopes International, which provides women's reproductive health services in 43 countries. "It saves women's lives and has potential to increase access to safe abortion."
Medical abortion causes a miscarriage that is indistinguishable from a natural one. That's important for women in countries where they risk arrest if they seek hospital aid after a botched abortion. The risks to a woman seem no greater than with a natural miscarriage, and there's no known harm to a woman who turns out not to have been pregnant after all. One serious downside is that misoprostol is suspected of causing birth defects, perhaps 1 per cent of the time, but only if it fails and the pregnancy continues to term.
It's not clear how late in pregnancy medical abortion is feasible.

Source: Nicholas Kristof, The Scotsman, 3 August 2010