July 9, 2009

Study Shows Quarter Of Early Abortions Use Abortion Pill

According to a study released this week by Planned Parenthood, approximately one out of every four American women who obtained an early abortion last year did so with the so-called "abortion pill" rather than through conventional surgery.

Planned Parenthood, the world's largest international provider of reproductive health services, says the study shows that a new method of taking the pill has all but eliminated health risks that had been previously associated with the medication. 

A number of health experts say they expect the number of medication-induced abortions to rise as a result of the study, as it can be done more privately and less invasively that surgical abortions.

"This is the first really huge documentation of how safe and effective medical abortion is," said Dr. Beverly Winikoff, a professor of family health at Columbia University. "The technology is very good and very well used in this country, and probably will be used more and more."

The treatment, which can only be carried out during the first 9 weeks of pregnancy, works through a two pill combination.  The first drug, Mifiprex is swallowed by the patient while at a physician's office or clinic.  The main active ingredient in the pill, mifepristone, then causes the young embryo to detach from the lining of the uterine wall.  Within 24-48 hours after the first medication, the patient then takes the second pill, misoprostol, which induces minor contractions and expels the embryo from the uterus.

Health experts are quick to point out that the treatment is not to be confused with the so-called "Plan B" prophylactic treatment, which can be taken within a few days of unprotected sex to prevent pregnancy from occurring.

Mifeprex first gained approval from the FDA in 2000.  Use of the drug has risen steadily over the past 8 years despite the decision of the its manufacturer not to market the product heavily. Last year alone, sales of Mifeprex rose by 16.5 percent as some 184,000 American women used the product in medical abortions.

The report by Planned Parenthood"”the nation's largest provider of medication-induced abortions"”was conducted at hundreds of their centers around the country between 2005 and mid-2008, and included data from some 228,000 cases.  The study found the pill to be effective in 98.5 percent of the cases and also showed that changes in how the drug is administered had significantly reduced the risk of infection from 0.1 percent to 0.006 percent of cases.

Researchers published their results in Thursday's New England Journal of Medicine.

The original course of treatment had called for vaginal insertion of the contraction-inducing misoprostol pill.  By 2005, however, 5 American and Canadian women had died of rare bacterial infections related to the treatment, stirring up a flurry of controversy both in the media and the medical community.

In 2006, Planned Parenthood chiefs responded by instructing their 300 clinics that provided the treatment to have patients take the misoprostol pill orally.   The change in administering the pill, according to researchers, has proven effective, reducing the risk of serious infections to about one-sixteenth of the original rate.

"I think that providers are going to be pretty impressed with the data," said Dr. Beth Jordan, medical director of the Association of Reproductive Health Professionals.

Jordan said that she hopes the results will encourage primary care physicians around the country to begin offering the drug to their patients, especially in light of the fact that roughly 87 percent of U.S. counties have no abortion provider.

Vicki Saporta, President of the National Abortion Federation, said in an interview that a number of abortion opponents "have been misleading people into thinking that medical abortion is unsafe."  This study, she says, should serve to allay such fears.

The current cost of the "abortion pill" treatment is around $400, only marginally cheaper than the average cost of an early term surgical abortion.

Since approval of the treatment in the U.S. in 2000, health providers have connected the treatment to six deaths, all of which resulted from sepsis, or an infection of the bloodstream. As more than 1.1 million American women have used the treatment in the past 8 years, that makes for a death rate of less than 1 in 167,000.

While some health experts have recommend that doctors also provide antibiotics to be taken with treatment to even further reduce the risk of bacterial infection, Winikoff and Saporta have both raised counter-concerns that giving a full course of antibiotic treatment to all women includes risks that could outweigh the benefits.  Potential allergic reactions to antibiotic treatments, antibiotic resistance and increased costs of the procedure are three of the primary arguments offered against the addition of antibiotics to the treatment regimen.


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