September 28, 2000
After a background report, Gloria Feldt of Planned Parenthood and Laura Echevarria of the National Right to Life Committee discuss the Food and Drug Administration's approval of RU-486.
The Health Unit is a partnership with the Henry J. Kaiser Family Foundation.
MARGARET WARNER: For more we turn to Gloria Feldt, president of the Planned Parenthood Federation of America; and Laura Echevarria, the chief spokesperson for the National Right to Life Committee. Ms. Feldt, what is the significance of this medically for women?
GLORIA FELDT: We applaud the FDA's decision today. It is a giant step forward for women, a quantum leap in reproductive health technology and an option that American women have wanted for many years, so that we can have the same option that our sisters in Europe have had during all this time. It's been an arduous process. The scientific process has been long and arduous. But quite frankly, the political process has been even more arduous and longer. And having to overcome those hurdles of the pressures of anti-choice hard-liners who want to keep this very safe, early option from American women has been quite a battle. And we're very grateful that today the FDA has approved the early option.
MARGARET WARNER: All right, but let me just ask you about the medical side of this. For a woman who is seeking an abortion, how does this compare to the surgical alternative in terms of safety, risks, benefits?
GLORIA FELDT: Well, since it is a very early option and the earlier in pregnancy that an abortion can be done, the safer it is, it is a very, very safe alternative. Also, the fact that it's done without surgery means that there are lower to virtually no risks of infection. Now, surgical abortion is also extremely safe, and in any case, either of these options is much safer than carrying a pregnancy to term and full term and in delivery. But it's very important for women to have the information and the counseling so that they can decide which one of these procedures best fits their personal needs.
MARGARET WARNER: All right, Ms. Echevarria, how do you see this decision today?
|Tragic and sad|
LAURA ECHEVARRIA: We see it as tragic and sad that American women are going to suffer because of the use of RU-486 in the United States. Certainly their child is going to die, and that's something that's tragic right then and there of itself. But we also see that, if RU-486 is administered to American women, that certainly tragedies can result as a result of that. We know that there are side effects associated with RU-486 that can be quite severe, including nausea and vomiting and excessive bleeding. We know that in the studies, 2 percent of the women who take RU-486 hemorrhage severely enough that they require surgical intervention. And so certainly we see this as a sad day for American women and certainly for unborn children.
MARGARET WARNER: And do you find... the FDA did add certain restrictions, as we just heard the commissioner describe. What do you think of those? Does that allay the safety issues, as far as you're concerned?
LAURA ECHEVARRIA: We don't think that they go far enough. They are minimal requirements, in order to protect American women. But certainly the chance of a woman dying as a result of taking RU-486 still exists. We know that during the trials, during controlled clinical trials, that one woman in Iowa almost died as a result of taking RU-486. And certainly if that can be happen during U.S. drug trials, then it can happen if RU-486 is introduced at large to American women.
MARGARET WARNER: Ms. Feldt, what is your view on these extra restrictions and what that does in the safety area?
GLORIA FELDT: Thank you. First, let me just say that Laura has greatly overstated and misrepresented the facts. But that should come as no surprise because, after all, she does represent an organization whose goal it is to make sure that women do not have the right to safe legal abortion, and we need to remember that. The...
MARGARET WARNER: The additional requirements, did you find them appropriate?
GLORIA FELDT: Yes, actually, yeah, they really are by and large. I think that, as we use mifepristone, we may find that some of these requirements can go by the wayside. But I think, for example, it's entirely normal standard of practice for a physician to be able to either provide the surgical abortion or to be able to refer it to another doctor who can. That happens all the time when we go to our primary care physician and he or she doesn't have the specialty to be able to follow up on a medical problem that may be diagnosed. So I think by and large, they are appropriate, and that providers will be able to work within them very well.
MARGARET WARNER: Do you see, Ms. Echevarria, this drug being used for other purposes, for instance, as a preventive measure, to prevent pregnancy?
LAURA ECHEVARRIA: Well, the way it works, it blocks progesterone, and to prevent pregnancy, at this point in time, nothing has indicated that it could do that. Certainly we've never opposed its use to treat brain tumors or uterine fibroid tumors or cancers of any type. Certainly if it can provide life-saving solutions, then we would not oppose that. In this particular case, though, RU- 486 has been introduced into the United States. It will be used in the United States and has been promoted for use in the United States only as an abortive agent.
|Trigger more abortions?|
MARGARET WARNER: Let me ask you about the examples in Europe. I gather... I understand that in France, for instance, it did not trigger any more abortions. Do you think it will trigger any more abortions here?
LAURA ECHEVARRIA: I don't think so. I think that what we're going to see is some women will choose RU-486 as opposed to surgical abortions. It is up in the air as to what result nationally we're going to have if we are going to see more abortions. But in all likelihood, we will find the same results that they have in France. I do think that, unfortunately, some women will end up suffering severe health consequences as a result of using RU-486. But certainly I don't see an increase in the number of abortions.
MARGARET WARNER: Ms. Feldt, do you think the fact that this drug and the way it's described, that it expels the embryo and it's not a fetus and it's not a baby, it's very early. Do you think that's going to change or does change the nature of the moral debate about abortion?
GLORIA FELDT: Well, I know that many people have said and maybe want to believe that mifepristone will change the whole course of the abortion debate in this country. Because, frankly, I think people are tired of arguing about abortion and would prefer to spend more time, as Planned Parenthood does, trying to prevent the need for abortion through family planning and responsible sex education. But I'm not quite so sanguine about what I think mifepristone will do to the debate here in this country because those who oppose a woman's right to choose have the same opinion of mifepristone as they have of abortion in general. And I think they will continue fighting on the political front, and they will continue their attempts to harass and to vilify abortion providers. Now, that having been said, the promise of mifepristone is that more doctors will provide mifepristone than currently provide surgical abortion procedures, and that should make it more geographically accessible to women, and it should, over a long period of time, several years, make it more likely that it will be a more private decision and that women will be more likely to get mifepristone from their OB/GYN or their family practice doctor that they normally go to.
MARGARET WARNER: Ms. Echevarria, what's your view on how the earliness of this procedure and the fact that we're talking really about embryonic life here, whether that has any impact on the moral nature of the debate? Because there are many people who have moral, deep moral objections, as your organization represents, to abortion.
LAURA ECHEVARRIA: Right. No, it doesn't make a difference. You're still talking about an abortion, regardless of how it's done. The life of an unborn child is taken. And whether...
MARGARET WARNER: Though it isn't a child yet, that's correct?
|Early stages of pregnancy|
LAURA ECHEVARRIA: We are talking about a child at this point in time when RU-486 is administered, by the time a woman realizes she's pregnant, the heart most likely already has begun to beat. That takes place between 18 and 22 days -- days -- after conception. So we're talking about an unborn child whose life is developing. On the outside end at seven weeks of pregnancy, that's about the time that brain waves can be detected. So most of the development of the child takes place in the early stages of pregnancy. The brain is developed, the heart is developed, the major organs are developed, fingers and toes. At the point when a child enters the fetal stage, that's when growth takes place, body fat is added; all of those things take place at later stages in the pregnancy. So you're talking about a developing human being genetically different from his or her parents whose life is taken as a result of the use of RU-486.
MARGARET WARNER: So Ms. Feldt it sounds as if the moral and ethical debate isn't going to change.
GLORIA FELDT: I think you're right about that, Margaret. I think the principle that a woman's life is a life first of all, that it's really a responsible thing to bring children into the world thoughtfully and carefully, and that women are capable moral decision-makers, women can look at the options and, frankly, make better decisions for themselves morally and ethically, as well as medically, than the government or any other institution of society can make for them. This is such a personal decision, and I think no one really knows what their own personal moral and ethical decisions will be about it until they're faced with that situation.
MARGARET WARNER: Ms. Echevarria, you heard Gloria Feldt earlier predict that abortion opponents will continue to be active against abortion. Do you and your organization, and other groups have hopes of turning this around. For instance, if there were a new president, as there will be and George W. Bush opposes abortion, do you still hold out hope that you can reverse this?
LAURA ECHEVARRIA: Well, certainly we know that George W. Bush opposes RU-486. There is the hope that, under a different administration, one not so politically motivated to see RU-486 in the United States, that we may very well find the FDA will review RU- 486, review the dangers associated with it, and possibly look into those dangers and a different decision would be made.
MARGARET WARNER: And Ms. Feldt, how about you? How final do you think this decision is?
GLORIA FELDT: Well, I thank Laura for making that point. As president also of the Planned Parenthood Action Fund, Planned Parenthood's political arm, I think Laura's exactly right. A pro-choice president will make sure that women continue to have the right to choose, an anti-choice president, like George W. Bush, has already pledged to try to make abortion illegal. We can count an anti-choice president to make appointments to, for example, the head of the FDA or the head of the Department of Health and Human Services who would want to try to roll back access and perhaps even prevent access to mifepristone. And the person who signs or vetoes bills is the next president -- the person who issues executive orders. There are many powers the president has, and it's important to have a pro-choice president if we're going to have the right to choose in the future.
MARGARET WARNER: All right, thanks Ms. Feldt and Ms. Echevarria, thank you both very much.