RU 486 beyond the controversy: implications for health care practice

RU 486 has been mired in controversy since it was first synthesized in the 1980s. This paper assumes that RU 486 will eventually be available in the United States and examines how clinicians might integrate it into practice without compromising quality of care and patient safety. The mechanisms of action of RU 486, its prostaglandin augmentors, and other first-trimester abortifacients are briefly reviewed. Significant and often misunderstood issues are discussed, including the concern that women will fail to return for the second visit, in which they receive the prostaglandin; the need for back-up facilities; women's acceptance of RU 486 as an abortifacient; and its potential to increase abortion services to the underserved. The paper argues that RU 486 has implications for positive changes in the interpersonal dimensions of health care and discusses the adaptation in the organization of care that will have to take place in order to make RU 486 available to all women who might choose to use it.