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Chemical reaction

Roe v. Wade | The drug RU486 gives women the option of abortion in privacy-a lonely, painful, devastating privacy

Issue: "Pro-baby," Jan. 30, 2010

On a rainy fall Friday, the Planned Parenthood clinician gave Michele Stewart the first pill she needed to abort her seven-week pregnancy, patted her on the knee, and said, "Good luck!" Stewart had just spent two weeks-the loneliest of her life, she said-wavering on whether she should have the baby of a man who didn't want one, and she had finally decided to do what one sister advised: "Get rid of that."

Stewart chose RU486, the drug that induces abortion, because it seemed less scary than a surgical abortion with its suction machine. But the moment she swallowed that pill, she had second thoughts: "Everything in me wanted to push the pill back out."

Like Stewart, more women are choosing RU486 abortions. The number of drug-induced abortions at non-hospital facilities increased from 122,200 in 2001 to 161,000 in 2005. The drug works by inducing a miscarriage. Critics say that its appeal-that it lends itself to privacy-can take a destructive toll on women's psyches, as Stewart found.

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Stewart, 28, conceived in early September 2007 and first took "Plan B"-"the morning after" pill two days later. A month later she felt sharp pains that she assumed were menstrual cramps until she went to the doctor. He told her Plan B hadn't worked: She was pregnant and an ovarian cyst was causing the pain.

After dropping this upsetting news, he shuffled her to the emergency room for her pain, where she sat alone from 3 p.m. to 3 a.m., debating. She lived alone and supported herself but could she support a baby, too?

She got a prescription for prenatal vitamins and took them-just in case-and gave herself one week to decide what to do and one week to put her plan into action. Her boyfriend said no to a child, but her mother wanted a grandchild. One sister said, "Get rid of that," but another sister said she'd help Stewart if she kept the baby. Her friends told her, "You don't have to be bothered with it if you don't want to be bothered." Others said, "Maybe this is your chance to have a family."

"It was right at the hazy, confusing, lonely time," she said. She decided to abort, driving to the clinic on that rainy Friday and sitting down with the counselor, who asked her why she wanted an abortion and then hurried her along. She explained that RU486 requires two pills, one to kill the unborn baby and one to cause her body to expel it. Then the clinician handed her the first pill.

The first pill (mifepristone) Stewart took blocked the hormone progesterone, cutting off the supply of food and oxygen to the baby. Donna Harrison, a certified OB-GYN and president of American Association of Pro-Life Obstetricians and Gynecologists, says that there are progesterone receptors all over a woman's body, and researchers still don't know the effect of RU486 on other progesterone receptors. Mifepristone also blocks glucocorticoid receptors, Harrison said, which may interfere with the immune system's ability to block infection and may also hinder the blood vessels from shrinking to stop bleeding. More than 15 percent of the women who take RU486 experience hemorrhaging.

After taking the first pill, Stewart went home and made herself comfortable with some movies and food. She called up her boyfriend, but he refused to come, so she took the second pill (misoprostol) at 6 a.m. on Saturday, alone. The clinician had warned her about the bleeding, cramps, and nausea, but most women aren't prepared for their intensity. Half an hour after taking the pill, Stewart crumpled to the floor when the pain-sharp, like labor pains-began.

RU486 makes abortion private, which can mean lonely. Dr. Harrison said, "Here's a woman, she's by herself, she takes the misoprostol, she gets intense pain, intense cramps, intense nausea. Who's with her?" Depending on how old the baby is-although the FDA approves the drug only up to 7 weeks, some Planned Parenthood clinics advertise that they give it up to 9 weeks-the embryo may be recognizably human when the mother passes it, said Harrison: "She may easily recognize the human being here, the head, the legs."

Stewart expelled her baby, wrapped up the body, and threw it away-something she said she's always regretted.

Stewart's weakened immune system made her sick immediately after the abortion and she spent the next year fighting depression. Her mother asked, "Why did you do this?" The sister who encouraged her to keep the baby blamed herself for not offering to adopt it. Stewart took anti-depressants, anti-­anxiety drugs, and sleeping pills, went to therapy and counseling at a post-abortive ministry called Rachel's Vineyard, and read books.

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