In Hausknecht’s study, 178 pregnant women–all less than 68 days along–received an injection of the anti-cancer medicine methotrexate. This drug stops the division of cells, malignant or fetal, and is used to end potentially fatal ectopic pregnancies. Five to seven days later, the women got misoprostol, a common ulcer drug, as vaginal tablets or suppositories. Misoprostol induces contractions, expelling the dead fetus in a process almost indistinguishable from a miscarriage. The one-two punch caused abortions in 171 of the 178 women,88 percent of them in a day, found Hausknecht, a gynecologist at New York’s Mount Sinai School of Medicine. Side effects were minimal: moderate pain, nausea or diarrhea in a few women.
Besides sparing a woman the “sidewalk counselors” and violence that plague clinics, the drug regimen allows her to abort “the minute she knows she’s pregnant,” says Hausknecht, without the six-week minimum typical for surgical abortion. Although medical abortion is no cheaper than surgery (it requires three visits to the doctor), 60 percent of women would choose it over a surgical abortion, the Population Council found in a recent study. The latest drug regimen is as effective and safe as RU 486, the French “abortion pill” that is finishing clinical trials in the United States. But the threat of boycotts and worse may have scared off potential manufacturers of RU 486. In contrast, methotrexate and misoprostol are too valuable against cancer and ulcers to be hounded off the market. Doctors could prescribe them for abortion today, though they risk malpractice suits if anything goes wrong. Hausknecht urges his colleagues to wait for another reason: the results of a larger clinical trial, due next year, should show for sure whether methotrexate-misoprostol is safe and effective. In the meantime, he’s keeping the vest.
