NEW YORK — Ten years ago, after long and bitter debate, the Food and Drug Administration approved use of the abortion pill by American women. It is hailed as safe and effective, but new turmoil may lie ahead as the pill’s proponents consider using telemedicine to make it more available.
A pioneering telemedicine program in Iowa has provided the pill to about 1,900 women — with a doctor able to consult with a faraway patient in a video teleconference, then unlock a container by remote control to release the pill. To the alarm of antiabortion activists, abortion providers in other states are pondering whether similar programs would enable them to serve more women, especially in rural areas.
Initially known as RU-486, the pill was introduced in France in 1988, and antiabortion activists fought doggedly for more than 12 years to keep it out of the US. The FDA finally gave its OK on Sept. 28, 2000, and nearly 1.4 million American women have used the pill since then.
Affording women more privacy than a surgical abortion, the pill marketed as Mifeprex now accounts for about one-quarter of US abortions performed in the first nine weeks of pregnancy and about 15 percent of all US abortions. In 2008, about 184,000 American women used the pill — up from 55,000 in 2001, even though the overall number of US abortions wasn’t rising.
The pill’s manufacturer, Danco Laboratories, said it is effective about 95 percent of the time, with surgical procedures needed in most of the other cases to end the pregnancy or stop heavy bleeding.
According to Danco, since approval in 2000 there have been eight deaths from sepsis, a bloodstream infection, among women taking the pill — a death rate of roughly 1 in 168,000 that’s far lower than the rate of women dying in childbirth.
Dr. David Grimes, a North Carolina obstetrician/gynecologist who formerly headed the abortion surveillance branch at the Centers for Disease Control and Prevention, said the pill’s impact has been overwhelmingly positive.
“For those women who don’t like the invasiveness of surgery, it gives them a very important option,’’ he added.