Abortion Rights Group Challenges Mich. Law

Warning that the abortion pill is under sneak attack, a national abortion rights group has sued to block a Michigan law that it claims would effectively ban physicians from terminating pregnancies with RU-486.

Under the law, which takes effect next month, women seeking to end a pregnancy first must review a description--written by the state--of the medical procedure that will be used. Yet the state also is expressly prohibited from writing a description of any procedure that uses medication “that has not been approved by the U.S. Food and Drug Administration for use in performing an abortion.”

RU-486 has been approved by the FDA for performing abortions. But it must be used in tandem with another drug, misoprostol, which induces the contractions that expel the embryo. Misoprostol officially is labeled as an ulcer drug; it’s approved by the FDA to prevent and treat gastric ulcers.

Abortion rights activists are concerned that abortion opponents might use the new Michigan law to keep information about misoprostol out of the state’s pamphlets--and thus out of the reach of women seeking to end their pregnancies.

“On its face, it sounds like they’re saying: ‘We just want to make sure women have safe procedures for ending pregnancies,’ ” said David Nacht, an Ann Arbor, Mich., attorney pursuing the lawsuit on behalf of the Center for Reproductive Law and Policy. “But they’re doing it with the explicit goal of limiting a woman’s right to obtain RU-486.”

Abortion opponents reject that as a deliberate--and alarmist--misinterpretation of the law.

They point out that when the FDA approved RU-486, it set forth a detailed regimen for medical abortions--and specifically mentioned misoprostol. So although misoprostol might not be labeled an abortion drug, the FDA made clear that it intends for the drug to be used to end early pregnancies.

What’s more, Michigan health officials already are working on an official description of an RU-486 abortion so that women seeking to use the drug can fulfill the informed-consent requirement.

“It’s unfortunate that the Center for Reproductive Law and Policy is deliberately distorting the intent of this law,” said Geralyn Lasher, a spokeswoman for the Michigan Department of Community Health.

“There was no attempt here to make [medical] abortions illegal by refusing to provide a summary of the procedure,” added Ed Rivet, legislative director for Right to Life of Michigan. “That’s just crazy. It would never work.”

Abortion rights advocates are not reassured. Michigan officials may be making soothing comments, they say, but they fear the law offers a blueprint for future rulings that would limit women’s access to abortions.

And not just to RU-486.

The drug methotrexate, which has been used for nearly a decade to terminate ectopic pregnancies, is approved by the FDA only for cancer-fighting chemotherapy and could be banned for use in abortions under Michigan’s law. The drug digoxin often is injected into the uterus to soften fetal tissue before a surgical abortion. But it’s FDA-approved only for treating cardiovascular disease. And misoprostol, the ulcer drug, frequently is used in second-term surgical abortions to stimulate contractions.

So activists worry that the Michigan law threatens not just drug-induced abortions, but long-standing surgical practices as well.

“Clearly, [those writing the law] are legislators with an anti-abortion agenda. We feel this is part of an overall agenda of restricting reproductive health care options for women,” said Stephanie Mueller, a spokeswoman for the National Abortion Foundation, which represents 380 clinics.

Michigan state attorneys are reviewing how the new law will affect abortion procedures that use nonapproved drugs, Lasher said. But she again insisted that abortion rights activists were intentionally misrepresenting the legislation’s goal.

“You could take the statute and read it a certain way and create these kind of obstacles, but that’s not going to happen,” Rivet agreed. “No one is going to read it this way.”

The Center for Reproductive Law and Policy argues otherwise in its suit, which was filed Feb. 12 in U.S. District Court in Detroit. It is seeking an injunction to block the law from taking effect as scheduled March 28, arguing that it “creates an undue burden on a woman’s fundamental right to terminate a pregnancy.”

The suit is just the latest salvo in the heated debate over RU-486, also known as mifepristone.

The National Abortion Federation reports heavy interest in the drug among both physicians and patients. Since RU-486 was approved in November, an average of 1,000 women a month have called an NAF hotline seeking information on the drug. The group has trained more than 2,000 health-care workers in dispensing RU-486 and anticipates that most abortion clinics will offer the drug by the end of the year.

At the same time, however, 16 states have introduced legislation to restrict the use of RU-486. If Michigan’s law--whatever its intent--succeeds in limiting medical abortions, other states may follow, abortion rights advocates warn.

Michigan’s law actually is an amendment to its existing requirement that women seeking abortions wait 24 hours, sign a consent form and review material on fetal development, adoption options and the risks of both terminating and continuing a pregnancy before they undergo the procedure.

The old system allowed abortion providers to write their own material for women to review during the waiting period. Some included caveats such as this one, posted on a clinic’s Web site: “Many people believe that this material is intended to change your mind by making you feel guilty or scaring you.”

The new law requires women to read pamphlets provided by the state. In addition to the written summaries of abortion procedures, the state will provide illustrated descriptions of fetal development and list the physical complications possible after an abortion. It also must advise that “as the result of an abortion, some women may experience depression, feelings of guilt, sleep disturbance, loss of interest in work or sex, or anger.”

Many abortion opponents maintain that, for all the sound and fury about RU-486, the new law’s real achievement is in standardizing women’s required reading. Clinics, on the other hand, long have maintained that the state’s pamphlets are biased and misleading.

“In the end,” sighed state Republican Rep. Susan Tabor, who opposes abortion, “it all comes down to the same old battleground.”