PHARMACOLOGY CHANGES THE ABORTION EQUATION

But wide dissemination of pill kit is thwarted

FEDERAL approval last week of the first emergency ``morning-after pill''
presents women with a long-sought, much delayed alternative to abortion. It
is proof of pharmacology's promise: to shift the power of choice from
Congress and the courts to the drugstore counter.

Within weeks, women will be able to obtain a prescription for a four-pill
kit that will prevent a pregnancy if taken within 72 hours of having sex.
Known as PREVEN, it will be sold at $20 a dose.

PREVEN consists of high-dose birth control pills. The formula has been known
for years and has been available to doctors and family planning clinics. But
the divisive debate over abortion has thwarted its wider dissemination. Drug
companies feared litigation and the controversy that so far has stymied the
marketing of the drug RU-486.

There's big difference between the two, however. RU-486 induces an abortion
of a fertilized egg that has attached itself to the uterus. PREVEN prevents
either ovulation or the implantation of a fertilized egg.

And so the reaction of anti-abortion groups that strongly opposed RU-486 has
been muted to PREVEN. An exception is the American Life League, whose
president insisted that ``there already is a way to prevent an unplanned
pregnancy: chastity.''

Most women, of course, disagree, and prefer contraception. And yet an
estimated half of the 2.7 million unintended pregnancies a year in America
result from failed condoms or displaced diaphragms. Now, if women realize
there's been a problem, they have something to turn to.

Eighteen months ago, the Food and Drug Administration advised physicians on
how existing birth control pills could be dispensed as morning-after
contraceptives. But according to a recent survey, only about a third of
women knew that such an option existed. The awareness among Latino and
African-American women was even less.

That's why the Food and Drug Administration saw the need to go retail and
approached manufacturers to take a drug to market. Now that Gynetics,
PREVEN's maker, has taken up the offer, Planned Parenthood is considering a
national hotline to get the word out.

Some experts say that drugs like PREVEN can eliminate as many as 800,000
abortions a year. But it's only 75 percent effective (RU-486 is 95 percent
effective). And, while it won't harm a fetus, it also won't work once the
egg attaches to the uterus. In other words, PREVEN isn't foolproof, and it's
no substitute for regular contraceptives, the cost of which is still not
covered by most health insurers.

Morning-after pills also won't displace the need for RU-486, a safe and
effective alternative to surgical abortion when taken within the first two
months of pregnancy. RU-486 has been used for years in Europe. The FDA has
approved clinical trials, but the anti-abortion movement has intimidated
manufacturers from producing it and strong-armed the Republican House to try
to ban it.

As long as women depend on small numbers of clinics for abortions, they will
be hostage to the anti-abortion movement and subject to their pressure
points. Drugs like PREVEN and RU-486 give women autonomy over basic
reproductive choices, and deny abortion opponents their vulnerable targets.

They won't end the debate over the most divisive moral issue of the past
quarter century. But they will decentralize and defuse it, much to the
relief of most Americans.

1997 - 1998 Mercury Center.

Checked-by: Don Beck