NEW YORK — Ten years ago, after long and bitter debate, the U.S. Food and Drug Administration approved use of the abortion pill by American women. It is hailed as safe and effective, but new turmoil may lie ahead as the pill's proponents consider using telemedicine to make it more available.
Already, a pioneering telemedicine program in Iowa has provided the pill to about 1,900 women — with a doctor able to consult with a faraway patient in a video teleconference, then unlock a container by remote control to release the pill. To the alarm of anti-abortion activists, abortion providers in other states are pondering whether similar programs would enable them to serve more women, especially in rural areas.
"There are many affiliates that are carefully considering this option, within the confines of their state laws," said Dr. Vanessa Cullins, vice president for medical affairs of the Planned Parenthood Federation of America, the nation's leading abortion provider.
RU-486 was first introduced in France in 1988, and anti-abortion activists fought for 12 years to keep it out of the United States. The FDA finally gave its approval on Sept. 28, 2000, and nearly 1.4 million American women have used the pill since then.
Marketed as Mifeprex, the pill accounts for about one-quarter of U.S. abortions performed in the first nine weeks of pregnancy and about 15 percent of all U.S. abortions. In 2008, about 184,000 American women used the pill.
The pill's manufacturer, Danco Laboratories, says it is effective about 95 percent of the time, with surgical procedures needed in most of the other cases to end pregnancy or stop heavy bleeding.
According to Danco, since 2000 there have been eight deaths from sepsis, a bloodstream infection, among women taking the pill — a death rate of roughly 1 in 168,000. That is far lower that the rate of women dying in childbirth.
Abortion opponents have asked the Iowa Board of Medicine to block the telemedicine program, saying it violates state medical standards and poses a health risk to women because it doesn't entail a face-to-face meeting with the doctor. The board has formed a review committee, but hasn't said when it might rule.
Jenifer Bowen, executive director of Iowa Right to Life, said there has been no verified health emergency among the telemedicine patients served thus far, "but we think the risk is still there."