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...hoped that the drug's approval also would lead substantial numbers new providers, particularly physicians in private practice, to take up medical abortion, for a number of reasons this has yet to occur. A decade of experience with nonsurgical abortion in Europe indicates that integration of the procedure into a country's medical care system is generally slow and gradual. Moreover that experience also strongly suggests that the introduction of mifepristone in the United States will not noticeably increase the countrys abortion rate but, instead, may well increase the proportion of abortions taking place very early in pregnancy.
Abortion rights activists in the United States hailed the Food and Drug Administration's (FDA) September 2000 approval of mifepristone as a "momentous step," because the drug would give American women the option of a safe, early abortion where one may not have previously existed. Whereas surgical abortion is generally not performed until about the sixth week of gestation, medical abortion can be initiated as soon as pregnancy is confirmed. Because, theoretically, mifepristone can be prescribed by a woman's private physician and the abortion completed in the privacy of a woman's home, the FDAs approval held out other hopes as well: namely that a range of providers who did not offer abortion before would begin providing medical abortion, resulting not only in women's increased geographical access to abortion, but also to a reduction in the violence directed toward abortion clinics and, ultimately, a defusing of the abortion debate.
Antiabortion activists, on the other hand, considered the FDA action an outrage. Though their public rhetoric stressed the dangers of women's use of mifepristone, their primary concern lay elsewhere. Mifepristone would only make things "more convenient for abortionists." Its availability would make abortion "too easy" for women, leading to a surge in abortion rates.
It is obviously far too early to determine what impact mifepristone will have on abortion provision in the United States. Indeed, the Centers for Disease Control and Prevention's most recent abortion surveillance data are for 1998 and do not reflect the availability of mifepristone. The Alan Guttmacher Institute (AGI) is in the process of gathering information on mifepristone as part of its survey of all known U.S. abortion providers, but these data will not be available until early 2003. In the meantime some information is available from The National Abortion Federation (NAF), the professional association of abortion providers, and Planned Parenthood Federation of America (PPFA), many of whose affiliates provide abortion services. Both organizations are collecting information from members and affiliates that will shed some light on...
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