Is primary care ready for medical abortion?

Some physicians oppose RU-486's availability, others shy away for a range of reasons and even the most eager face barriers to its use.

By Victoria Stagg Elliott, AMNews staff. Nov. 17, 2003.

Mifepristone, also known as medical abortion or RU-486, can be administered safely and effectively in a family practice setting, according to a study published in the Journal of the American Board of Family Practice.

Researchers in New York City analyzed the records of women who received abortions at four community health clinics. One of the 236 women followed did not successfully abort and had to have a surgical abortion. Two had suction procedures for unknown reasons, and eight were lost to follow-up. One didn't take the medication as directed.

Thus, the positive conclusion. "If this can be safe in our setting, it can be safe anywhere," said Linda Prine, MD, lead author and a faculty member at the Beth Israel Residency in Urban Family Practice.

But just because it's safe doesn't mean it's available. Three years after the Food and Drug Administration's September 2000 approval of RU-486, reports indicate that the resulting increases in abortion access that some activists hoped for have not occurred.

For now, mifepristone is used primarily as an option offered by abortion clinics rather than something every physician can or is even willing to provide, although more doctors might be pursuing it. Right after approval, Danco Laboratories LLC, the drug's manufacturer, received orders almost exclusively from large clinics. As of last year, about 17% of its orders were to private practice physicians.