Chpt20 (page 148)

CHAPTER 20
VERY EARLY ABORTIONS
These fall into two general categories: thosethat prevent implantation at one week of lifeand those which kill a developing baby daysor weeks after implantation. Before Implantation:
Which methods do this? In varying degree, the methods that prevent implantation, and therefore killa baby at one week of life, include the intra-uterinedevice (IUD), Norplant, Depo Provera, Progesterone-only pills, low-dose contraceptive combination pills,and the morning-after pills. Let’s take them one at atime.
How about Norplant?
This is an implant under the skin of her forearm that lasts five years. In the first half of that time, its effect isto almost always suppress ovulation. In the last half ofthat time, break-through ovulation is the rule. How-ever, very few pregnancies survive. Clearly, this sec-ond half is commonly effective through micro-abor-tions and prevention of implantation.
What about Depo Provera?
As with Norplant, there is some variance from woman to woman, but in a far higher percent of casesDepo Provera suppresses ovulation. Break-throughovulation, however, does occur as attested to by full-term pregnancies recorded with women who were re-ceiving this shot every three months.
What of the IUD?
The intrauterine device, commonly referred to as an IUD or coil (in Europe), is a small plastic or metal de-vice that is inserted through the vagina and into thecavity of the uterus. The purpose of this is to “prevent”pregnancy.
Is an IUD a contraceptive or an abortive agent?
Until recently, almost all scientific papers had agreed that its effect was to prevent the implantation ofthe tiny new human being into the nutrient lining of theuterus; an abortive action.
The U.S. Food and Drug Administration stated in an official report that its effectiveness is “in direct propor-tion to the quantity and quality of the inflammatory re-action to various types of IUDs”.and states that there“is one common thread . . . ” They all “interfere insome manner with the implantation of the embryo inthe uterine cavity.” Second Report on IUDs, Dec. 1978, U.S. Dept. of HEW, Food & Drug Administration Document 017-012-00276-5 “The inhibition of implanation of the embryo re- mains a major, if not the dominant, mechanism of ac-tion of IUDs” J. Spinnato, “Mechanism of Action of IUDs . . .” Am. J. OB & GYN, 3/97, Vol. 176, No. 3, pp. 503-6 A detailed report in a Planned Parenthood publica- tion in 1989 claimed that a high percentage of its action was the prevention of fertilization.
IUDs are Contraceptives, not Abortifacients: A Comment on Research and Belief, I. Sivin, Studies in Family Planning, The above report, however, has not been duplicated and therefore has not presented enough evidence tochange the conventional wisdom that the IUD is almostalways an abortive agent.
What of Progesterone-only pills?
These fall into the same category as the Progester- one-only implant, Norplant, and the Progesterone-onlyinjection, Depo Provera.
How does the morning-after pill work?
This medication has an antinidatory effect on the en- dometrium (that is, a hardening of the lining of theuterus), which prevents implantation of the tiny newhuman being (blastocyst stage).
If, for example, a rape victim had ovulated just be- fore the assault and fertilization had occurred, then theuse of such medication after the event would clearly beabortive.
There is a possibility that it can act in a sterilizing fashion. The large hormone dose could rapidly affectthe ovary and prevent an ovulation that might haveoccurred one to three days after the intercourse. Ifsperm were still present and active in the woman’s gen-ital tract, she might be fertilized one to three days afterthe event. In this case, some have suggested that suchtreatment (as for an assault rape victim) might actuallyprevent a pregnancy, but this has not been proven.
“Effective Hormone Emergency Contraception” March 2002, Volume 36, Number 3 Page 465-470 Kahlenborn, et al., amply document that the so- called emergency contraceptive pill would more logi-cally be termed, emergency abortion pill. We had al-ways known that if she ovulated before she had inter-course, and the next day took this pill, that it wasridiculous to think that it could prevent a fertilizationthat had occurred 12 hours earlier. This study showsthat even if it’s taken prior to ovulation, it has a signif-icant failure rate.
They also thoroughly document the abortive effect, that while ovulation and fertilization can occur, this pillprevents implantation at one week of life and thereforeis legitimately called an abortifacient.
What about the standard contraceptive pill?
There are over 30 “contraceptive” pills on the market, each differing a little from the others. They“prevent” pregnancy through three separate functions.
1. They thicken the mucous plug at the cervix. If this is the primary effect, then it truly is contraceptivebecause it prevents sperm from entering.
2. They prevent release of the ovum. If this is the primary effect, then the function is “temporary” sterili-zation.
3. They render the lining of the womb hostile to the implantation of the tiny new human at one week of life.
This effect is abortifacient.
The earlier high-estrogen pills largely prevented ovu- lation. The newer low-estrogen pills allow “break-through” ovulation in up to 20% or more of the monthsused. Such a released ovum is fertilized 10% or more ofthe time. Most of these tiny new lives which result donot survive. The reason is that, at one week of life, thistiny new boy or girl cannot implant in the womb lining(see number 3 above) and dies. These are micro-abor-tions.
The pill, then, can have a contraceptive or temporary sterilization effect (by far the most common), or it can Its Link to Abortion and the Birth Control Pill,” One More Soul Publ, 2000, p. 315-324 You mean the effect is to abort?
Yes! “The morphological changes observed in the endometrium of oral contraceptive users have func-tional significance and provide evidence that reducedendometrial receptivity does indeed contribute to thecontraceptive efficacy of OCs.” In other words, be-cause the endometrial lining is not receptive to thehuman being, who must implant in order to continueliving, the human being will die.
Somkuti, et al., “The Effect of Oral Contraceptive Pills on Markers of Endometrial Receptivity,” Fertility and Sterility, W. Larimore, et al. Post Fertilization Effects of Oral Contraceptives and Their Relationship to Informed Consent, Arch. Fam. Med., Vol. 9, Feb. 2000, pg. 126-133.
Post-Implantation:
The best known example of this is the French abor- How does RU 486 work?
RU 486 kills a developing baby after his or her heart It blocks a vital nutrient hormone, Progesterone. The embryonic baby, who had implanted into the nutrientlining of the mother’s womb at least two weeks earlier,can be compared to a grape on a vine. If the stem ispinched, preventing the nourishing sap from reachingthe grape, it will wither, die and drop off. Just so, if thisdrug is used, it causes the embryonic baby to witherand die. A second drug, prostaglandin, is used to expelthe dead baby from her womb.
Counting from the first day of her last normal men- strual period, it is effective only from the fifth throughthe seventh week. Some claim success, but with de-creasing effectiveness, into the 9th week.
RU 486 alone is effective from 60 to 80% of the time. If Prostaglandin is added, the abortion rate risesto 95%.
Couzinet et al., “Termination of Early Pregnancy by RU-486 (Mifepristone), New Eng. J. of Med., O. Ylikorkala et al., Outpatient Abortion With RU-486, OB-GYN, vol 74, no. 4, Oct. 1989 M. Rodger et al., Blood Loss . . . After RU-486 and Prostaglandin.,” Contraception, vol. 40, no. 4, Oct. 1989.
How is it used?
During the US clinical trials on RU 486, women who had one of the following conditions or diseaseswere prohibited from taking the drug: Under 18 years of age, more than 35 years of age, smoked over 10 cigarettes a day and had another car-diovascular risk factor, liver disease, respiratory dis-ease, kidney disease, adrenal disease, cardiovasculardisease, blood clots, hypertension (high blood pres-sure), anemia, insulin-dependent diabetes, known al-lergy to prostaglandins (Cytotec), using an intrauterinedevice (IUD), breast-feeding, receiving anticoagula-tion therapy, receiving long-term cortisone therapy,masses or cysts in female organs, infection in femaleorgans, ectopic (tubal) pregnancies, signs that shemight abort spontaneously These patient precautions were also followed during the clinical trials on RU 466 in France.
First Visit: She must have a thorough history, physi- cal exam and blood count. She needs an ultrasoundexam to confirm the age of her baby and to rule out atubal pregnancy. She must sign permission and, insome states or nations, wait 1 or more days.
Second Visit: She takes the pills.
Third Visit: She is given the prostaglandin drug.
This produces hard labor. Usually the baby parts arepassed that day.
Fourth Visit: If she has not aborted, or if there is still bleeding, she will need an ultrasound to determine ifthe uterus is empty. If not, she needs a D&C. TheFrench Ministry of Health requires that the abortion fa-cility be equipped with an EKG, IV equipment, and a“crash cart” with a defibrillator in the event of a heartattack resulting from the drugs.
There are complications?
Yes. Bleeding is the most common. In the controlled testing reported, one woman in a hundred bled so pro-fusely she either needed a D&C (surgical scraping outof her womb) and/or a blood transfusion. In an under-developed country, such a treatment would normallynot be available and, very likely, some of these womenwould bleed to death.
e.g., In a controlled trial in the state of Iowa, one woman took the pills and went home. She bled sobadly, she needed four emergency blood transfusionsto save her life.
Interruption of Preg. with RU-486 & Prostaglandin, Silvestre et al., N. Eng. J. Med., Vol. 322, 3/8/90, No. 10 Efficacy of Mifepristone & Prostaglandin in 1st Trimester Abortion, UK Multicentre Trial, Br. J. OB/Gyn, Other complications include substantial pain, tubal pregnancies, incomplete abortion, uterine rupture, e.g.,an 18-week abortion with RU 486 and prostaglandinproduced rupture of the uterus and a near fatality.
J. Norman, Br. J. Ob/Gyn, vol. 102, And psychological upset, ranging from mild to seri- ous, post-abortion syndrome and, in a few cases, deathof the woman.
In April, 2002, the FDA required the drug company to report that four women developed “serious illnesses”and that two more died after taking RU 486. Theseproblems included ruptured tubal pregnancies, infec-tions, and a heart attack.
Are there problems with the baby?
RU 486 and a prostaglandin will produce an abor- tion 95% of the time. The rest will be advised to have asurgical abortion. But there will be some who will re-fuse surgery and carry to term. These babies will havea significant possibility of fetal deformity. Why? Two poisonous drugs were given when the heart, limbs, etc., were being formed. This didn’t quite kill,but the effect can be to cause severe structural defor-mities as a direct toxic effect, similar to those fromThalidomide.
In the tightly controlled French experience, there has been one such tragedy. Under the far looser privatecare in North America, the number of deformed babiesshould be greater.
Two French researchers report on two women who continued their pregnancies after their RU 486 failed tocause abortion. One delivered a normal baby. “Thesecond pregnancy was terminated because of malfor-mations (sirenomelia)” [fusion of lower extremities].
J.C. Pons et al., letter to Lancet, Scrip, Sept. 26, 1991 Aren’t there therapeutic uses?
To date, there are no proven uses of RU 486 to treat any human illness. Research is underway testingwhether it will have any beneficial effect on one typeof breast cancer, on meningioma (brain tumor), Cush-ing’s Syndrome or endometriosis. No serious research is projected for any other conditions.
Note that pro-life groups have never opposed re- search with RU 486 to find therapeutic uses. To date allstudies of this drug were paid for by, or associated with,the manufacturer.
Where can I find more details?
A pamphlet, “RU 486, A Human Pesticide,” is avail- able from Hayes Publishing Company in Cincinnati –Phone (513) 681-7559.
A detailed scientific description of function, effects, efficacy, complications, etc. is available.
J. Willke, “Mifepristone – A Boom or a Bust,” Ann. Pharmacotherapy, Vol. 35, No. 3, Mar. 2002, pp 376-381 What about Methotrexate?
This also works to kill a baby after his or her heart has begun to beat. It works roughly within the sametimeframe, but in a different fashion. The RU 486essentially starves the baby which then dies and is lost.
Methotrexate is a direct poison and kills the developingbaby.
Methothrexate & Misoprostol, M. Creinin et al., JAMA, Oct. 19, 1994 Methotrexate & Misoprostol to Terminate Early Pregnancy, R. Hausknecht, N. Eng. J.M., Vol. 333, No. 9, 8/31/95, pg. 537 Is Methotrexate safe?
Definitely not. It is a cellular toxin and has been used for years to kill cancer cells. The object of cancertreatment is to kill cancer cells before the drug kills thepatient. This is a commonly used chemotherapeuticagent. Most readers have known loved ones who havehad chemotherapy. There are some serious side-effectsat times -loss of hair, inability to digest food, diarrhea,anemia and even death. All of these have been causedby methotrexate. The trick is to use a dose just largeenough to kill the sensitive embryonic baby but not large enough to do any serious damage to the mother.
It works alone?
No. It also needs a follow up dose of prostaglandin What of Prostaglandin alone?
A pill form, Cytotec or Misoprostol, has been used alone in concomitant oral and vaginal doses. Its “effec-tiveness” is in question. Used without medical supervi-sion in Brazil, it has frequently failed to produce abor-tions and has caused fetal deformity.
“The most striking manifestations . . . were growth re- tardation, underdeveloped bones, short equinovarus feet,joint rigidity and webs, hypoplasia or atrophy of limbmuscles . . .” Other researchers report cranial nerve deficiency, hydrocephalus, delayed motor and mental develop-ment and mobius anomaly.
Coelho, et al. “Misoprostol Embryotoxicity Evaluation of 15 Patients with Arthrogryposis,” Am. J. Med., Genetics, 95, 2000, pp 297-301 The maker approves?
Absolutely not. The maker of Cytotec, the Searle Co., sent a drug warning to physicians stating, “Cy-totec administration, by any route, is contraindicated inwomen who are pregnant . . . Serious adverse effectsreported following its use in pregnant women includematernal or fetal death, uterine hyperstimulation, rup-ture or perforation requiring surgical repair, hysterec-tomy, amniotic fluid embolism, severe vaginal bleed-ing, retained placenta, shock . . . ” This drug is being used for induction of labor at term. But the USFDA reports over 50 cases of uterinerupture and other serious complications, some withneonatal and maternal deaths.
Misoprostol and the Politics of Convenience, The Lancet, p 2142, 6-30-01 Label Change:
The Searle Co. (above) refused to change the label.
Then, in July, 2002, the FDA itself changed it, chang-ing Searle’s warning to merely stating that women tak-ing it should not get pregnant.

Source: http://www.lifeissues.org/abortionqanda/chapters/c20.pdf