The Right to Medical Abortion  

Without access to the full array of safe and effective reproductive technologies, control over one’s body is a hollow notion. Yet, as we’ve seen time and time again, advances in women’s reproductive healthcare are made to run a gauntlet of political obstacles—often lacking justification in medicine or science. So it was with mifepristone, which languished in the FDA’s approval process for four years after being deemed safe and effective in 1996. Finally, in 2000, the regulatory body approved mifepristone for marketing in the United States.

Now in the wake of the clearly unconstitutional, first-ever federal ban on abortion procedures—already barred by three federal courts from being enforced—emboldened anti-choice members of Congress are moving on to medical abortion. A bill introduced in early November in the House would suspend Food and Drug Administration (FDA) approval of mifepristone (RU-486) for six months, allowing the General Accounting Office to conduct an audit of the FDA’s approval process for the drug.

If women are to have the right to engage in sexual activity without reproduction, that right is contingent upon access to safe and effective forms of contraception and abortion. During the long struggle to bring mifepristone to the United States, it was widely called the “moral property” of women, a phrase borrowed from the French health minister who in 1988 ordered the drug returned to the market following anti-choice protests. The “moral property” phrase resonated deeply because it captured the notion that women had an inherent right to this drug, an entitlement that transcended borders, politics, and profit margins. Here was a means which had been used extensively by women in 18 other countries, to terminate a pregnancy early, safely and privately. Once again, reproductive rights advocates will need to mobilize to ensure that politics do not obstruct women’s access to their moral property.

Mifepristone as Moral Property: The Future of Reproductive Rights

The advent of medical abortion in the United States continues to have the enormous potential to expand the number of abortion providers and integrate reproductive choice into routine medicine. Like other medications, mifepristone is easily administered by family practitioners, gynecologists, and the Advanced Practice Clinicians they supervise. When ob/gyns and family practice physicians incorporate medical abortion into their practices, women are able to continue care with their own providers rather than being forced to travel to outside clinics. Women also avoid the emotional abuse hurled by anti-choice groups at abortion clinics when they receive treatment in the privacy of their own doctor’s office. Incorporating medical abortion into the practice of health care providers who do not currently provide abortion has a significant impact, considering that eighty-seven percent of counties in the U.S. lack an abortion provider—a shortage that imposes enormous obstacles for women needing care.

Developing new medical practices takes time and, like everything else related to abortion, is profoundly political. We know anecdotally that many individual providers and clinics have added medical abortion to their practices and thus expanded access but still await hard data on the number of new abortion providers. According to Planned Parenthood Federation of America, since receiving FDA approval, mifepristone has been used safely and effectively by more than 200,000 women in the United States. Whether women will continue to have the right to these medical technologies as their “moral property” now hangs in the balance.

* Rebekah Diller is Director of the New York Civil Liberties Union's Reproductive Rights Project.

* More information can be found at the New York Civil Liberties Union's Reproductive Rights Project.