Scary

If the Supreme Court overturns Roe v. Wade, freeing states to ban abortion, this common prescription drug, often known by the brand name Cytotec, could emerge as a cheap, relatively safe alternative to the practices that proliferated before Roe.
"We won't go back to the days of coat hangers and knitting needles," said Dr. Jerry Edwards, an abortion provider in Little Rock, Ark. "Rich women will fly to California; poor women will use Cytotec."

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In Brazil, where abortion is banned except in rare circumstances, misoprostol is the method of choice for up to 90 percent of all abortions, said Alessandra Chacham, a professor of sociology at the University of the State of Minas Gerais, who studies reproductive health in Brazil. In the late 1980's and early 1990's, she said, pregnant women started to spread the word, because the drug's label warned that it could cause miscarriages. Compared with illegal abortions using other methods, the rate of infection with misoprostol was 12 times lower, researchers have found. But researchers at the University of Rio de Janeiro reported that they also found that among babies born with certain birth defects, a high percentage of the mothers used misoprostol. When the government in response restricted access to misoprostol, drug smugglers created an illegal black market, Ms. Chacham said.

But American women may not be as receptive, said Norma McCorvey, who in 1973 was known as Jane Roe, the woman who brought the case that legalized abortion, but who has since argued for the reversal of the court's decision.

"When women start using these self-induced drugs, and start seeing body parts in their potty, they're going to go bananas," Miss McCorvey said. "And it's going to be horrible."

Dr. Jain said researchers still need to learn more about what happens when the drug doesn't work. Currently, if women fail to terminate a pregnancy using RU-486 and misoprostol, they still have a surgical abortion. But if abortion were illegal, many of these women might carry to term. "Data suggest it causes birth defects, including facial paralysis and limb defects," Dr. Jain said. "It's hard to quantify, but yes, there probably is a risk."

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