From grassroots petitions to high-level negotiations, the tireless work of women’s health advocates made mifepristone a reality in the United States—and a lifeline for millions.
Twenty-five years ago, the U.S. Food and Drug Administration approved the medication mifepristone (in combination with misoprostol) to end early pregnancy. At the time, there were great hopes and much optimism that this new medication would make abortion more accessible. The FDA initially placed burdensome restrictions on accessing the medication, but eventually expanded access.
Post-Dobbs, abortion pills and telehealth are a critical avenue of access for people living in states with abortion bans or restrictions. In response, the Trump administration and Republicans are now trying to restrict this access.
At the urging of antiabortion advocates and politicians, and based on a flawed and biased report put out by an antiabortion group, the Trump administration announced this week the launch of a new review of mifepristone—despite 100 peer-reviewed scientific studies proving the safety and efficacy of these medications and safe use by over 7.5 million U.S. women.
On the 25th anniversary of FDA approval of mifepristone, reproductive rights supporters are celebrating the creative, determined and courageous advocates who brought this medication to market.
One organization that played a critical role in bringing mifepristone—known as RU-486—to the United States was the Feminist Majority Foundation (FMF), today, the publisher of Ms.
This story is told in a new book, Abortion Pills: U.S. History and Politics, available open access from Amherst College Press—excerpted below (with some edits for clarity and length).
Abortion Pills: U.S. History and Politics
The French pharmaceutical company Roussel Uclaf developed mifepristone in 1980, and the French government approved use of mifepristone for abortion in 1988, but the battle for FDA approval in the United States lasted decades.
Beginning in the 1980s, U.S. women’s health advocates collaborated with researchers, healthcare providers, and public health experts to push for FDA approval of mifepristone.
When Roussel Uclaf and other drug companies refused to develop the medication for the U.S. market for fear of boycotts and threats of violence from abortion opponents, reproductive health advocates did it themselves, as their predecessors had done with birth control pills in the 1950s. They raised money from wealthy individuals and foundations to conduct the necessary research, found investors willing to create a company to market mifepristone in the United States, and applied for and finally achieved FDA approval of mifepristone.
A key advocate for RU-486 was the Feminist Majority Foundation, which launched a campaign for the medication in June 1989. Former National Organization for Women (NOW) president Eleanor Smeal and feminist Peg Yorkin, who chaired the FMF board, led the campaign. Yorkin later donated $5 million toward bringing the abortion pill to the country.
Smeal said at the time, “We intend to visit the pharmaceutical leaders, the medical health leaders to urge them to rise up against this movement that is denying the best of medical research, and the best that modern medicine can provide for the modern woman.”
Her plan gained urgency a month later when the Supreme Court ruled in Webster v. Reproductive Health Services to expand state powers to restrict privately funded abortion services in state facilities.
FMF hired Jennifer Jackman to head the Campaign for RU-486 and Contraceptive Research, which was based in Boston. “The first thing we did was put together a scientific team, and they explained to us exactly how it worked and its safety,” said Smeal. “We talked to the most preeminent doctors in the field.”
Smeal recruited Carl Djerassi, who helped develop the oral contraceptive pill. “I just called him. His wife was a feminist. He then helped me put together a team of scientists. He said he’d serve on it, and he’d help get some other scientists,” said Smeal.
… rise up against this movement that is denying the best of medical research, and the best that modern medicine can provide for the modern woman.
Eleanor Smeal
FMF sought to educate the public about RU-486 and convince Roussel Uclaf and Hoechst AG that there was widespread support for the medication in the United States. They also sought to neutralize anti-abortion threats to organize economic boycotts of the companies by showing widespread support for RU-486 in the United States. FMF ran a direct mail campaign, sending 8 million letters to women’s rights supporters with information about RU-486 and petitions to Hoechst AG and Roussel Uclaf, which they asked recipients to complete and mail back in.
To support the petition, NOW organized a “Freedom Caravan” to collect petition signatures. The caravan traveled to New Jersey, Pennsylvania, Massachusetts, Nevada, Oregon and other states, collecting signatures along the way. In less than four years, they collected 700,000 petitions. FMF also collected petitions from scientists by mailing and faxing various lists of scientists, Nobel laureates and faculty, as well as distributing the petitions at conferences.
On July 23, 1990, an FMF delegation met with Roussel Uclaf officials, bringing petitions signed by 115,000 Americans and weighing 800 pounds. The delegation included Smeal, Yorkin, NOW president Patricia Ireland, and FMF director of policy and research Jennifer Jackman, as well as prominent scientific and medical leaders, including Djerassi, the dean of Columbia School of Public Health Dr. Allen Rosenfield, and president of the American Public Health Association Dr. Myron Allukian.
When they arrived at the office of Roussel Uclaf ’s CEO Edouard Sakiz, Smeal was surprised to find out that Sakiz and Djerassi already knew each other. “They were buddies,” said Smeal. “I just knew [Djerassi] was one of the best scientists in this field in our country. As things happen worldwide, people who are doing something in the avant-garde, they know each other. As it turned out, they had worked together on research, so that was helpful.”
The first thing that happened was that Sakiz said he thought it was very important that RU-486 obtain FDA approval in the United States because the FDA had a “gold seal of approval,” and if the FDA approved a drug, then it would become a drug that would be used widely around the world.
Smeal described Sakiz’s motivations: “He made it very clear that the reasons he had worked on this so hard was he thought that it would save women’s lives throughout the developing world and it would create healthier babies when they did come because the mother herself would be in better condition.”
To publicize the life-saving benefits of mifepristone, FMF made a bracelet saying how many women die from botched, illegal abortions each year. Jennifer Jackman explained the important role that these meetings played:
“That meeting was really critical because it’s how we got to know the senior people at Roussel, especially Dr. Sakiz and his right-hand person, Catherine Euvrard. We got to know them and realized that these are people who support women’s reproductive rights. They’re in this for the right reason. They were constrained institutionally because they were owned by Hoechst AG, a parent company that was quite conservative, based in Frankfurt. They wanted us to generate pressure on them to counter the anti- abortion pressure. They welcomed a campaign that would demonstrate that there was support for the drug. So we were trying to do that through showing public and scientific support.”
After meeting with officials at Roussel Uclaf, the delegation flew to Frankfurt, Germany, to meet with Hoechst AG officials, shipping the petitions to arrive for the meeting.
FMF returned to meet with company executives on Feb, 20, 1991, and again in 1992, delivering an additional 110,000 petitions, including more than 3,000 petitions from medical experts. During the 1992 trip, Smeal, Yorkin and Jackman met with women in the Bundestag, German federal Parliament, to discuss the RU-486 campaign.
Catherine Euvrard said later that the petitions were “very important” in convincing the companies to find a way for RU-486 to be marketed in the United States.
“It was concrete because you have all those petitions. It was 50-50, so why choose one over the other. Our position was just to put the drug on the market and to let women decide. It’s a personal decision of a woman,” said Euvrard later. “Thanks to FMF and other groups, we had proof that such a medicine was necessary and good.”
To put peer pressure on Roussel Uclaf, FMF also urged scientific and medical associations to pass resolutions supporting RU-486 research and condemning the Bush administration’s import alert on RU-486.
On June 27, 1990, the American Medical Association policy committee voted unanimously to support the testing of RU-486. Eight months later, the American Association for Advancement of Science followed suit. Advocates eventually secured RU-486 endorsements from almost every scientific and medical organization in the country. FMF also had a campaign to collect petitions from individual scientists. Jackman explained, “the whole idea behind the scientific outreach was to put pressure on Roussel Uclaf from the community that mattered to them, those they would see as their peers, because Roussel really was a first-rate kind of pharmaceutical company that valued scientific research.”
FMF organized direct actions as well, such as attending stockholder meetings and holding demonstrations at public events.
In April of 1992, FMF announced a “Web of Influence” campaign, publicizing the names of companies doing business with Roussel Uclaf and Hoechst, and urging people to contact these companies to tell them to ask Roussel Uclaf and Hoechst to make RU-486 available in the United States.
That same month, FMF held an RU-486 picket at Trevira Twosome race in New York City, sponsored by Hoechst Celanese and Nike. At the time, Hoechst Celanese was the 100 percent-owned subsidiary of Hoechst AG, and Nike used Hoechst-produced fibers in its sports attire.
He knew it would save countless lives of women by reducing maternal mortality rates. If it was okayed scientifically by the FDA, which has high standards, then people would realize it was a safe medicine and it would be distributed around the world.
Smeal
RU-486 was also a major focus of massive abortion rights rallies in Washington, D.C., in April 1989 and April 1992. FMF and NOW pledged to boycott the pharmaceutical companies if they did not bring the medication to the United States.
At the state government level, FMF worked to persuade legislators to pass resolutions in favor of making RU-486 available in the United States. New Hampshire passed a resolution in 1991, followed by California, Maine and Hawaii. Lawmakers in at least eight other states introduced resolutions to support RU-486. Local lawmakers also acted. New York City Mayor David Dinkins organized 30 mayors to urge the Bush administration to reverse its opposition to RU-486 and support testing of RU-486 in the United States. New York City comptroller Elizabeth Holtzman threatened to have the city’s hospital system stop buying products from companies affiliated with Roussel Uclaf and Hoechst AG.
In 1994, Roussel Uclaf transferred the patent rights to the Population Council for clinical testing for the U.S. market.
In a private letter written to Eleanor Smeal, Dr. Sakiz attributed this success to the persistence of the women’s movement. “It is mainly your own determination and that of all the Feminist Majority Foundation’s members and other pro-choice supporters that largely contributed to this successful issue,” wrote Sakiz, who by the time of the transfer had stepped down as CEO of Roussel Uclaf but still served as chair of the board of supervisors.
Smeal credited Sakiz: “He knew it would save countless lives of women by reducing maternal mortality rates. If it was okayed scientifically by the FDA, which has high standards, then people would realize it was a safe medicine and it would be distributed around the world. He was trying to get an important medical development to people in poverty who didn’t live in conditions that a surgical abortion requires—with sterilized equipment and clean water. A pill would be safer and easier to administer.”
After the transfer, since this drug would no longer be licensed or developed in the United States by Roussel Uclaf, people no longer called it RU-486, but instead referred to the medication by its scientific name: mifepristone.
To learn more about RU-486/mifepristone in the United States, read Abortion Pills: U.S. History and Politics, available free from Amherst College Press, or listen to the audiobook.
Great Job Carrie N. Baker & the Team @ Ms. Magazine Source link for sharing this story.
