In Saturday’s New York Times, Nicholas Kristof had a sympathetic article about misoprostol, an inexpensive white pill that can be used to induce abortions between 80 and 85 percent of the time. Kristof argues that misoprostol will expand abortion access in many poor countries, for a couple reasons. First, miniprostal, unlike mifepristone and other pills that can induce abortions, has other medical uses (it can also be used for ulcers and to save the lives of women with postpartum hemorrhages), making it harder to regulate. Also, the miscarriages misoprostol causes are indistinguishable from natural ones.
Kristof is quick to tout the health benefits from wider use of misoprostal in developing countries. However, there are certainly health risks as well. When misoprostal fails and the pregnancy comes to term, it increases the likelihood of birth defects. Kristof states that birth defects only occur 1 percent of the time. However, it is possible that that figure might be higher among consistent users of misoprostal. Furthermore, mifepristone (the RU-486 drug) has generally not been used as a contraceptive, because of the cost involved and the complications it causes. However, if women treat misoprostol like a contraceptive and use it consistently, it could potentially cause even greater health risks.
Kristof also argues that the widespread use of misoprostol may change the politics of abortion, on the grounds that those in the middle might be less squeamish about women taking pills at home rather than undergoing a surgical abortion. However, this seems unlikely. First, pro-life sentiment has increased in the United States since RU-486 received FDA approval in 2000. Secondly, since misoprostol only induces an abortion 80 to 85 percent of the time, it will probably get little use in industrialized countries, where RU-486 is available and a failed abortion will likely result in a more costly surgical abortion.
Not surprisingly, one thing that Kristof does not mention in this article is how widespread availability of misoprostol might affect people’s sexual activity. In a number of countries, including the United States, the availability of the birth control pill increased sexual activity, particularly outside of marriage. This led to both a higher demand and greater political support for legal abortion. A “revolution” caused by greater availability and use of misoprostol could have similar negative consequences. Pro-lifers would do well to be vigilant.
– Michael J. New is a fellow at the Witherspoon Institute and an assistant professor of political science at the University of Alabama.