Introduction and provision of medical abortion: a tale of two countries, in which technology is necessary but not sufficient

Beverly Winikoff, Gynuity Health Projects
Danielle Hassoun, Centre de Formation aux Techniques de la Santé reproductive
Hillary Bracken, Gynuity Health Projects

The development of a method to provide early abortion using drugs instead of surgery has been called a landmark advance in reproductive health for women. Although the technology flowed from a single source (the French company, Roussel-Uclaf), the evolution of services surrounding its use has differed markedly in different national environments. This paper analyzes the structural differences that determined the fate of mifepristone abortion in the French and American medical systems. While the introduction of the technology has been a “success” in each country, the outcome for service delivery has been quite different. Variations in drug registration and regulatory processes, pharmaceutical companies, medical practice, abortion service provision and public opinion have shaped access to medical abortion. This discussion will explore the implications of these differences for women and providers, for prospects of expanding access to safe abortion services, and for the introduction of new reproductive technologies. FIRST PART OF PAPER: FRENCH, SECOND PART: ENGLISH