From Overachiever to Nurse’s Aide, They Choose ‘Abortion Pill’ : Research: Women are among 2,100 who are taking part in a test of RU-486. Population Council will make recommendations to the FDA.

Nobody but her boyfriend knows Gretchen has come to the Planned Parenthood clinic today.

Her parents wouldn’t understand. Neither would her friends on campus, where her conservative and pro-life views are well known.

An ultrasound procedure shows she’s 54 days along in a pregnancy she doesn’t want, and she is doing just the opposite of what she advised others in similar positions. She is having an abortion.

But no doctor will put an instrument in her body.

Gretchen is among 2,100 women at a dozen clinics who are taking part in a test of the “abortion pill,” mifepristone, also known by its brand name RU-486. The Population Council, which is conducting the test, will make its recommendations to the Food and Drug Administration early next year.

The report will discuss the pill, its side effects and its efficacy. But it will not tell the stories of Gretchen, Anne or Gwen, of how they came to this clinic and why they opted for mifepristone.

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“I was very pro-life,” said Gretchen. “If you’re not mature enough to have a child, then give it up for adoption” was her message.

But it’s different now. She knows she could not give up the child if she carried the pregnancy to term.

And a baby at this time in her life is unthinkable. She’s an overachiever, carrying an accelerated class load and working 25 hours a week in a pizza joint. She’s pretty, athletic, clear-spoken and, at age 21, focused on the future.

“I’ve never been in a predicament like this before,” she said. “It’s easy to judge something when it doesn’t happen to you.”

She chose an abortion, but not the surgical kind, which scares her. She agreed to be a mifepristone research subject.

Mifepristone counteracts progesterone, causing the uterus to let go of the fetal tissue. Taken alone, it will cause a miscarriage 60% to 80% of the time. Two days later, the woman returns to the clinic and takes misoprostol, which causes uterine contractions.

Within four hours, which must be spent at the clinic, the fetal tissue will pass in all but a percent or two of cases, in which surgery completes the abortion. Two weeks later, the woman must return to the clinic for an ultrasound to confirm the abortion.

Jill June, the clinic director, said mifepristone requires so much medical supervision that it holds little hope for women to make the abortion choice alone, in private. “It does expand a woman’s choice, but it doesn’t expand it to the degree we had initially hoped,” she said.

The procedure is not for everybody, said clinic spokeswoman Deb Steilen. There is pain and bleeding, and it takes more time than a surgical abortion.

“It’s not pleasant and it’s not quick. But most are reporting a positive experience, they describe it as more natural.”

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Fearing she was pregnant, Gwen, a 22-year-old cosmetologist, went to a pro-life organization in a town about an hour away from Des Moines, seeking a pregnancy test. “I didn’t know at the time that I could get the same thing at Wal-Mart,” she said.

“They made me watch a video about abortions; it was awful, it showed almost-babies or limbs being aborted. Then there was a lady on there who said she had an abortion and it ruined her life,” Gwen said. She left and came to Planned Parenthood.

She wants children but she’s not ready for that commitment now. Only a few weeks pregnant, she, too, agreed to the mifepristone test. An advantage of a medicinal abortion is that it can be done several weeks sooner in the pregnancy.

“Surgery seems so unnatural, like something reaching in there and sucking it out. I felt the pills would be more natural. My body’s doing the work, not some tool.”

Gwen has completed the entire process. After she took the second set of pills, it took more than three hours for the cramps to push out the fetal material. The pain was sharp but not severe.

“You know how you feel when you have to go to the bathroom so bad but you have to keep it in?” she asked.

She walked out of the clinic at 1:30 p.m., 4 1/2 hours after she arrived.

Later that night, there were pains again, sharp enough for her to call the clinic doctor at home. She took some pain pills, which worked; passed more blood, and then recovered.

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Anne is 25. She had her first abortion at age 13 and wishes she hadn’t. “My parents forced me into it,” she said. “I’ve still got a place in my heart” for the unborn child. “I carry that with me.”

She waited until her 20s to start a family and has two children, age 4 and 4 months. She reaches into her wallet to show a picture.

She’s at the Planned Parenthood clinic today because she’s pregnant again--a failure, she said, of the Norplant contraceptive.

As a nurse’s aide, she doesn’t have much money. And she’s known hardship in relationships; an abusive husband was found slain three years ago. She has not remarried. But these are not the reasons she cites for this abortion.

Instead, her doctor said this pregnancy is likely to be troublesome, even dangerous to her, coming so closely on the heels of the Cesarean-section birth of her youngest child.

Anne would have risked it, though, if it weren’t for mifepristone.

After counseling, paperwork, a physical exam, warnings about which pain killers to use and avoid, and instructions on keeping a journal, an abortion doctor personally gave Anne three mifepristone pills and a paper cup full of water.

Anne said she understood everything; she took the pills and went to a resting area, where the women are required to stay for 30 minutes to make sure the pills stay down.

Afterward, she said: “I need a cigarette.”

Two days later, she returned to complete the abortion without complications.

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Gretchen’s abortion also was uncomplicated--but only medically. She remains torn between her lifelong beliefs and her decision in what she considers a personal emergency.

She said she appreciated the controls on mifepristone. The drug should not be available without medical supervision, she said. “Then you’d have abortion as a contraceptive. Too many people would abuse it.”

The pill has been controversial; anti-abortion forces are working to prevent FDA approval. They say they are worried about its effect on women’s health, though their prime concern is preventing abortions.

Gwen says it is more important to ensure that children are wanted.

“It makes me angry; I see women bringing their children in all the time. You can see they don’t want those kids; they want somebody else to take care of them. I don’t want that ever happening to me. I want a child when I’m prepared.

“There’s no reason to bring a child into the world unless he has a fighting chance.”

Anne agrees.

“I believe it should be the right of everyone to make up their own mind,” she said. “God will make the decision” if it’s right.