Hostname: page-component-848d4c4894-v5vhk Total loading time: 0 Render date: 2024-06-27T03:35:05.017Z Has data issue: false hasContentIssue false

Acceptability of Mifepristone for Early Pregnancy Interruption

Published online by Cambridge University Press:  29 April 2021

Extract

Traditionally, fertility regulating methods were devised and offered in accord with the convenience of service providers and/or with their perceptions of the convenience of the population served. Generally, the focus was on a method's safety, efficacy, and affordability. It was not until a June 1972 planning meeting of the World Health Organization Human Reproduction Unit that the concept of acceptability was adopted as an additional criterion. The purpose was “to modify technology and programs to fit people, rather than modifying people to fit technology and programs.” A WHO Task Force on the Acceptability of Fertility Regulating Methods was established in January 1973 within what has now become the WHO Special Programme of Research, Development, and Research Training in Human Reproduction. Research conducted in the subsequent 17 years has had a profound effect on the field.

It is the purpose of this article to review the current status of early pregnancy interruption with mifepristone (RU 486) combined with a prostaglandin analogue from the standpoint of its acceptability to women.

Type
Patient Perspectives
Copyright
© 1992 American Society of Law, Medicine & Ethics

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Newman, L.F., “Cultural factors in family planning”, Annals of the New York Academy of Sciences, Vol. 135, Art. 3 (1970), 833846; David, H.P., “Acceptability of Fertility Regulating Methods in Cross-Cultural Perspective”, International Journal of Psychology, 12 (1977), 297–306; David, H.P., “Acceptors and Acceptability”, Populi, 4(4) (1977), 18–24.Google Scholar
Marshall, J.F., “Acceptability of Fertility Regulating Methods: Designing Technology to Fit People”, Preventive Medicine, 6 (1977), 6573.CrossRefGoogle Scholar
Special Programme of Research, Development and Research Training in Human Reproduction, Research in Human Reproduction; Biennial Report, 1988–89, (Geneva: World Health Organization, 1990); Mundigo, A.I., “Contraceptive Choice and Reproductive Health,” paper prepared for the East West Initiative for Research in Reproductive Health, Szeged, October 1990.Google Scholar
Baulieu, E.E., “RU 486 as an Antiprogesterone Steroid; From Receptor to Contragestion and Beyond”, Journal of the American Medical Association, 262 (1989), 18081814; Baulieu, E.E., “Contragestion and Other Clinical Applications of RU 486; an antiprogestin at the receptor”, Science, 245 (1989), 1351–1357; Baulieu, E.E., Generation pilule, (Paris: Odile Jacob, 1990); Baulieu, E.E., interview in Der Spiegel, No. 39 (1991); Baulieu, E.E. with Rosenblum, M. The “Abortion Pill”; RU 486: A Woman's Choice, (New York: Simon & Schuster, 1991).Google Scholar
Couzinet, B., Strat, N. Le, Ulmann, A. et al., “Termination of Early Pregnancy by the Progesterone Agent RU 486 (Mifepristone)”, New England Journal of Medicine, 315 (1986), 15651570; Ulmann, A., Teutsch, G. and Philibert, D., “RU 486”, Scientific American, 262 (1991), 42–48.CrossRefGoogle Scholar
Costadot, R.G., “Pregnancy Termination Techniques, Risks, and Complications and their Management”, Fertility and Sterility, 45 (1987), 517.Google Scholar
Silvestre, L., Dubois, C., Rennult, M. et al., “Voluntary Interruption of Pregnancy with Mifepristone (RU 486) and a Prostaglandin Analogue”, New England Journal of Medicine, 322 (1991), 645648; Baulieu, E.E. with Rosenblum, M., supra, note 4.CrossRefGoogle Scholar
Aubeny, E. and Baulieu, E.E., “Activite contragestive de l'association au RU 486 d'une prostaglandin active par voie orale”, Comptes Rendus de L'Academie des Sciences, Series III, 312 (1991), 539545; Aubeny, E., “Current Status of RU 486 in France and the U.K.,” paper presented at the International Symposium on antiprogestins, Dhaka, October 7–8, 1991; Baulieu, E.E. with Rosenblum, M., supra, note 4.Google Scholar
Baird, D., paper presented at the Conference on Antiprogestins drugs: Ethical, Legal, and Medical Issues, Arlington, VA, December 6, 1991; Norman, J.E., Thong, K.J. and Baird, D.T., “Uterine Contractility and Induction of Abortion in Early Pregnancy by Misoprostol and Mifepristone”, The Lancet, 338 (1991), 12331236.Google Scholar
Aubeny, E. and Baulieu, E.E., supra, note 8; Baulieu, E.E. with Rosenblum, M., supra, note 4.Google Scholar
Baulieu, E.E. with Rosenblum, M., supra, note 4; Klitsch, M., “Antiprogestins and the Abortion Controversy; A Progress Report”, Family Planning Perspectives, 23 (1991), 275282.Google Scholar
Downie, W.W., “Misuse of Misoprostol”, The Lancet, 338 (1991), 247.Google Scholar
Van Look, P.F.A., “The Use of RU 486 (mifepristone) as a Medical Abortifacient: Current Status and Future Research Needs,” paper presented at the WEMOS Conference, Amsterdam, June 1990; P.F.A. Van Look, “Post-Ovulatory Methods,” in Specialized Programme in Research, Development and Research Training in Human Reproduction, Annual technical report, 1990, (Geneva: World Health Organization, 1991), 4570; World Health Organization, “Pregnancy Termination with Mifepristone and Gemeprost: A Multicenter Comparison Between Repeated Doses and a Single Dose of Mifepristone”, Fertility and Sterility, 56 (1991), 32–40.Google Scholar
Van Look, P.F.A., “Post-Ovulatory Methods,” supra, note 13; Maurice, J., “Improvements Seen for RU-486 Abortions,” in Science, 254 (1991), 198200, and British Medical Journal, 303 (1991), 944.Google Scholar
Van Look, P.F.A., supra, note 13; Puri, C.P. and Van Look, P.F.A., “Newly Developed Progesterone Antagonists for Fertility Control,” in Agarwal, M.K. (Ed.), Antihormones in Health and Disease, (Basel: Karger, 1991), 127167.Google Scholar
Maurice, J., supra, note 14.Google Scholar
Klitsch, M., RU 486: The Science and the Politics, (New York: Alan Guttmacher Institute, 1989); Klitsch, M., supra, note 11; Charo, R.A., “A Political History of RU-486,” in Hanna, K.E. (Ed.), Bio-Medical Politics, (Washington: National Academy Press, 1991).Google Scholar
Corfman, P., personal communication, January 19, 1992.Google Scholar
Forrest, J.D., testimony before the Subcommittee on Regulation, Business Opportunities, and Energy, House of Representatives, December 5, 1991.Google Scholar
Polgar, S. and Marshall, J.F., “The Search for Culturally Acceptable Fertility Regulating Methods,” in Marshall, J.F. and Polgar, S. (Eds.), Culture, Natality, and Family Planning, (Chapel Hill: Carolina Population Center, 1978), 204218.Google Scholar
Marshall, J.F., supra, note 2.Google Scholar
Keller, A., “Contraceptive Acceptability Research: Utility and Limitations”, Studies in Family Planning, 10 (1979), 230237.Google Scholar
Templeton, A., “How Women Respond to Mifepristone; Results from Clinical Trials,” in Williams, C. (Ed.), The Abortion Pill, (London: Birth Control Trust, 1990), 2228.Google Scholar
Winikoff, B., “RU 486 User Acceptability Survey Results,” paper presented at the Conference on Antiprogestin Drugs; Ethical, Legal, and Medical Issues, Arlington, VA, December 6–7, 1991.Google Scholar
Marcos, S., cited in the Washington Post, December 10, 1991.Google Scholar
Avrech, O.M., Bukovsky, I., Golan, A. et al., “Mifepristone (RU 486) Alone or in Combination with a Prostaglandin Analogue for Termination of Early Pregnancy: A Review”, Fertility and Sterility, 56 (1991), 385390; Aubeny, E. and Baulieu, E.E., supra, note 8.Google Scholar
Grimes, D.A., Mishell, D.R. and David, H.P., “A Randomized Clinical Trial of Mifepristone (RU 486) for Induction of Delayed Menses: Efficacy and Acceptability”, Contraception 46, 1–10, 1992.Google Scholar
Adler, F., David, H.P., Major, B.N. et al., “Psychological Responses after Abortion”, Science, 248 (1990), 4144.Google Scholar
Aubeny, E., “New Perspective for Patients: Drug Induced Abortion by RU 486 and Prostaglandins,” paper presented at the conference “From Abortion to Contraception, ” Tbilisi, October 10–13, 1990.Google Scholar
Aubeny, E., supra, note 29; Der Spiegel, No. 39 (1991).Google Scholar
Girault-Laurence, J., “RU-486: The Experience of Users”, Planned Parenthood in Europe, 20(2) (1991), 21.Google Scholar
Baulieu, E.E. and Rosenblum, M., supra, note 4.Google Scholar
Urquhart, D.R. and Templeton, A.A., “Acceptability of Medical Pregnancy Termination”, The Lancet, 335 (1988), 106107.Google Scholar
Urquhart, D.R. and Templeton, A.A., “Psychiatric Morbidity and Acceptability Following Medical and Surgical Methods of Induced Abortion”, British Journal of Obstetrics and Gynaecology, 98 (1991), 396399.CrossRefGoogle Scholar
Cossey, D., cited in the Washington Post, December 10, 1991.Google Scholar
Winikoff, B., supra, note 24.Google Scholar
Program for Appropriate Technology in Health, Model Program for the Introduction of RU 486 in Developing Country Setting, (Seattle: PATH, 1991).Google Scholar
Coyaji, B., “Safe Motherhood and RU 486 in the Third World”, People, 17(3) (1990), 1315.Google Scholar
Kabir, S. and Germain, A., “Is RU 486 Likely to Be Appropriate for Women in Bangladesh?” paper presented at the International Symposium on Antiprogestins, Dhaka, October 7–8, 1991.Google Scholar
Toubia, N., “Between the Concorde and the Horse-Carriage: How Do We Cross the Development Gap with Medical Abortifacients?” Paper presented at the International Symposium on Antiprogestins, Dhaka, October 7–8, 1991.Google Scholar