Abortion pill is denied to thousands of women: Fewer than 3,000 women have received RU486 to terminate pregnancy, despite the drug's success abroad, Liz Hunt reports

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THOUSANDS of women are missing out on an early termination of pregnancy with the abortion pill, RU486, because NHS hospitals are not offering it, and GPs are failing to tell patients they have a choice other than a surgical abortion.

The introduction of RU486 in July 1991 was expected to bring a substantial drop in the number of women requiring surgical abortions, reducing the trauma and giving them more control over the procedure. But fewer than 3,000 women have received it, according to the Birth Control Trust.

The trust says that more than 60,000 women should have had the option of a non-surgical termination. Experience in France, where the drug has been available since 1989, suggests that at least a quarter of women offered RU486 instead of surgical termination will take it.

Wendy Smith, a spokeswoman for the trust, said: 'RU486 has proved to be the pill almost everyone has welcomed but almost nobody can get here.' She will tell a conference in Frankfurt today that RU486, also known as mifepristone, has hit social and economic barriers in the UK.

Ms Smith said: 'It costs money to establish day care centres specifically designed for early medical abortion. Hospitals . . . are saving money in the short term by keeping old premises, old equipment and old techniques.'

None of the major London hospitals is offering women the choice of an early medical abortion over surgical procedures, Ms Smith said. She claims that in some private clinics RU486 is now more expensive than surgical methods because of strict rules governing its supply and use.

Some critics of RU486 say it has proved more distressing for women than was predicted. By taking a pill women feel actively involved. A surgical termination under general anaesthetic may be easier to cope with psychologically.

A spokesman for Roussel, the manufacturer, said RU486 use was increasing monthly, but there were 'communication problems all down the line'. Many women do not know about a medical abortion and do not ask for it; many GPs think the drug is still on trial and do not tell their patients about it, and some hospitals that stock it are not offering it as an option. Other hospitals claimed it was too expensive, he said, although an RU486 abortion costs the NHS about pounds 182 (one day visit and two out-patient visits) compared with pounds 270 for a surgical abortion.

Of 250 NHS hospitals that do abortions, between 70 and 80 have ordered the drug, and 12 private clinics have been approved for its use. London was a 'black hole' for RU486, the spokesman said.

RU486 blocks the action of progesterone, the hormone needed to maintain a pregnancy. It can be used up to the ninth week of pregnancy. Women are given a single 600mg dose of RU486 followed by a hormone which makes the womb contract and expel the contents.