The abortion pill is marketed as not all that different from Tylenol: Pop a pill, problem solved. That’s the pitch, and it’s a good one. But it’s false. It masks the real dangers of this pill, dangers that have been known—and hidden—from the beginning.
The true history of what was originally known as RU-486 reveals a dangerous drug that, despite major safety concerns, was pushed for financial and political gain.
The drug that wasn’t meant to do this
One detail almost no one remembers is that RU-486 wasn’t invented to end pregnancies. The chemists at the French company Roussel-Uclaf were testing compounds in 1980 in the hope of finding something useful to decrease levels of cortisol, the stress hormone produced from the adrenal glands.
Abortion wasn’t on anyone’s mind. That is, until endocrinologist Étienne-Émile Baulieu noticed that one of the many synthetic drugs they had developed also blocked progesterone, vital for fetal development.
Baulieu pushed the company to explore its use as an abortifacient. This drug was named Roussel-Uclaf 38486, which was first shortened to RU-486, then later became known as Mifepristone. The company agreed. That’s how a drug built to treat adrenal gland problems got redirected, mid-development, into a new and deadly purpose.
Of course, a drug designed to decrease cortisol doesn’t stop doing that simply because it also causes early-term abortions. A monkey toxicology study confirmed it: Mifespristone also affects the adrenal glands.
This problem was never solved. Indeed, no attempt to solve it was even made. What changed was what the drug company was trying to sell: a treatment for overactive adrenal glands had become a pill to end pregnancy.
Roussel-Uclaf moved fast. Too fast. After just seventeen months of animal research, RU-486 entered human trials in October 1981. The French company wanted to beat competitors to market.
The first small human trial—there were only 11 subjects—was carried out in Geneva. It resulted in three failures out of eleven. Mifepristone’s dangerous history had begun.
Nobody could agree on whether it even worked
Despite the poor results of the Geneva trial, additional trials were held in France, Sweden, Australia, the Netherlands, England, Finland, China, and the US. The results were wildly different. One study found complete abortion in 54 percent of cases. Another reported 60 percent. Still others 80 or 90 percent.
It was plain that Mifepristone was neither as well-understood or as reliable as abortion advocates claimed.
To raise the success rate, researchers added a second drug to the abortion pill(s) regimen: prostaglandins. These are hormone-like compounds that are used to induce labor. The theory was that they would potentially reduce the severe bleeding issues that women had experienced in the previous Mifepistone-only trials.
Prostaglandins already carried a troubled safety record of their own, however, serious enough that the European Women’s Health Movement had protested against their use back in the late 1970s.
Researchers combined the two drugs anyway. And they did so without first determining how the two drugs would interact—another major safety pitfall.
The World Health Organization, always on the lookout for ways to reduce the number of people on the planet, got on board anyway. In 1984, a WHO-backed trial reported a 94 percent ‘success’ rate with the two-drug combination. The two-drug approach was immediately declared the better option.
It soon became evident that the research hadn’t caught up to that conclusion.
Banned, unbanned, and later disowned
The story took another dramatic turn in 1988.
In September, the French Ministry of Health licensed Roussel-Uclaf to market RU-486. But barely a month later, on October 26th, Chairman Édouard Sakiz announced that the company was suspending the distribution and sale of the deadly drug. Reportedly, pro-lifers had threatened to organize boycotts against the company if it continued to make the drug available.
The New York Times reported that Sakiz was privately telling investors that he hoped the company would be able to reverse course. Two days later French Health Minister Claude Évin came to the rescue, ordering the company to resume distribution of RU-486, declaring that the pill was “the moral property of women.” The drug’s supporters quickly adopted the phrase as their rallying cry.
RU-486 returned to the French market in February 1989. Its use was restricted to hospitals and licensed abortion centers and was to be used in tandem with a prostaglandin. Still, even with those restrictions, the number of chemical abortions rapidly increased over the next year reaching tens of thousands.
The underlying research base, however, lagged well behind the rollout.
The evidence never caught up
Early in 1990, an international panel reviewed outcomes for 30,000 women who had taken the drug. It issued a blunt warning about the severe side effects that were occurring: bleeding serious enough to require emergency surgery, blood transfusions, and in some cases cardiovascular complications.
But French regulators didn’t pull the drug off the market. Instead they merely updated the informed consent forms given to patients to include these severe—and concerningly common—side effects.
The main source of these safety/efficacy studies was Roussel-Uclaf itself, either directly or through its affiliates. This was an obvious conflict of interest: The same company that has developed and profited from the drug should not have been relied upon as the primary source of the safety data used to evaluate it.
Then came another twist in the tale. In January 1991, France’s own government council reprimanded French Health Minister Claude Évin for exceeding his authority by ordering the drug placed back on the market. Évin responded by denying that he had ever issued such an order.
The drug had been licensed, withdrawn, publicly reinstated as a result of official arm-twisting, and then disowned by the same official. None of those reversals followed new safety data. They reflected political decisions, not medical ones.
Where abortion is concerned, the rules go out the window
This series of mishaps was no accident. They show how the drive to increase the number of abortions trumps all other considerations. A drug developed for one purpose was repurposed for abortion heedless of safety concerns. Rushed into human trials, it produced wildly inconsistent results from one country to the next. It was paired with a second class of drugs, prostaglandins, which had its serious side effects. The interaction of the two drugs was left unstudied. When adverse outcomes began to multiply alarmingly, the response wasn’t to pause or restrict use. It was to add a warning to paperwork most patients never read.
The studies that were published came largely from the company with the most to gain from minimizing adverse outcomes. Every turning point in the drug’s checkered history, from its introduction to its withdrawal, from its reinstatement to its disavowal, tracked political pressure rather than new clinical evidence.
None of this slowed down the campaign launched by the abortion, feminist and population control movements to bring RU-486 to the rest of the world.
Rather, the French episode set the pattern other countries would follow: Approve the drug, market it as liberation, and pronounce any pushback as an attack on women’s rights. That same pattern emerged in the United States. The cast of characters had changed, but the underlying struggle between public health and politics, between what the science supported and what women were told, was the same.
That’s where this story goes next.
