Even after the “abortion pill” RU-486 made it possible for all doctors to provide early abortions, access to abortions did not improve as dramatically as women had hoped.

When RU-486, also called mifepristone, was approved by the FDA in 2000 for early pregnancy termination, it was expected to improve access to early abortion because pregnancies could be terminated more privately, within a few days after conception, without surgery, and with only a prescription for the medication from a woman’s personal physician, no matter where in the country she lived.

New research from across the US shows, however, that early visions of broader geographic access to abortions have not been fulfilled.

Dr. Lawrence B. Finer and Dr. Junhow Wei from the Guttmacher Institute in New York City report that in 2005, 96 percent of providers who penned prescriptions for RU-486 were located in metropolitan areas, just 3 percent were in “micropolitan” areas, with 10,000 to 50,000 inhabitants, and only 1 percent were in smaller cities and towns.

Furthermore, their research shows that RU-486 is being prescribed mainly at health care facilities that also provide surgical abortions.

In fact, of the 902 health care facilities (including doctors’ offices, clinics, and hospitals) where RU-486 was prescribed in 2007, only 5 nonsurgical providers who regularly prescribed the pill were located more than 50 miles away from a surgical clinic.

In the journal Obstetrics and Gynecology, Finer and Wei also report that roughly 158,000 RU-486 abortions were performed in 2007, accounting for 14 percent of all abortions and 21 percent of eligible early abortions, according to the article. This is up from about 55,000 in 2001.

Family practice doctors account for only 11 percent of RU-486 prescribers.

The proportion of providers in each state who prescribed the abortion pill in 2005 varied from 0 percent to 100 percent. South Dakota, Hawaii, Idaho, Oklahoma, West Virginia and the District of Columbia had the lowest proportions, and Wyoming, South Carolina, Kentucky, Louisiana, North Dakota and Kansas had the highest proportions.

Also in 2005, out of a total of 3,141 counties in the US, RU-486 prescriptions were written in only 307 (10 percent). Of the 62 million girls and women of childbearing age, an estimated 36 million (58 percent) lived in a county with an RU-486 provider.

These results, the researchers conclude, indicate that RU-486 “has not brought a major improvement in the geographic availability of abortion.”

SOURCE: Obstetrics and Gynecology, September 2009.