The unspoken effects of RU486

Rose (not her real name), 27, from South Australia, shared her experience in the new preface of RU-486: Misconceptions, Myths and Morals by Renate Klein, Janice Raymond and Lynette Dumble. She was told that the process would be easy and quick. "The worst part … was the sheer amount of time it took for me to 'terminate' my baby: every large clot of blood - which I could literally feel passing through my insides … was a reminder of the fact I was terminating a baby, for which I felt hugely saddened.

"It was three days of nausea, high temperature, sweating, cramping, lots of blood, distress and swirling emotions. I would never ever go through that again." Rose bled for another three weeks.

An unnamed 25-year-old American woman described her experience after taking RU486 at six weeks. "I was in excruciating physical pain for at least 12 hours straight and I was bleeding through my pants, but I was in so much pain I couldn't even clean myself," she says. "I vomited continuously … I couldn't speak, eat, drink, sit up, and had difficulty breathing … I thought I was going to die …

''I was told I would have emotional instability for a few weeks because of the hormonal chemical imbalance that the drug causes. I have experienced severe emotional fluctuation ever since … I would never have taken this had I been properly informed."

Norine Dworkin-McDaniel's story "I was betrayed by a pill" was published in Marie Claire in 2007. ''Nothing prepared me for the searing, gripping, squeezing pain that ripped through my belly … For 90 minutes I was disoriented, nauseated, and, between crushing waves of contractions … racing from the bed to the bathroom with diarrhoea," she wrote.

"The next night, I started bleeding. I bled for 14 days. A follow-up ultrasound confirmed I'd aborted."

Since the death of his 18-year-old daughter Holly in 2003 from an infection after an RU486 abortion, Monty Patterson has lobbied the US Congress to pass ''Holly's Law'', calling for the suspension and review of the drug.

In Australia, the Pharmaceutical Benefits Advisory Committee has agreed to a request from Marie Stopes Health, a subsidiary of Marie Stopes International, to list Mifepristone Linepharma (RU486) and the misoprostol GyMiso on the Pharmaceutical Benefits Scheme for termination up to 49 days gestation. From August 1, both drugs are available on the PBS.

Marie Stopes' record in following up women who have been prescribed the abortion drug is questionable. On March 19, 2012, it was reported that a woman had died sometime in 2010 at a Marie Stopes clinic. In a study by Marie Stopes' staffers published in the Medical Journal of Australia (September 2012), this death was callously attributed to the woman's own negligence because she didn't "seek medical advice" and died of sepsis.

In May 2012, the Therapeutic Goods Administration told a Senate committee it didn't collect information on RU486-related deaths of women overseas. As at April 30, 2011, the US Food and Drug Administration had held detailed reports on 14 US deaths and five deaths elsewhere, with two further deaths reported since then.

Noting that only one in 10 adverse events is reported, the FDA has recorded 2207 adverse events, including 612 hospitalisations, 58 ectopic pregnancies, 339 women who experienced blood loss requiring transfusions and 256 infections, 48 of which were "severe".

Here, the TGA has been informed of 132 cases of ongoing pregnancy requiring surgical abortion, 23 cases of haemorrhage requiring blood transfusion and 599 cases of incomplete abortion requiring surgery. This means about one in 30 women will need a second termination procedure. Other negative outcomes include cervical tearing and uterine perforation.

A South Australian study found women undergoing "medical" abortion had more symptoms, reported higher pain scores and had higher rates of emergency admissions. After discharge they had more nausea and diarrhoea. According to an earlier British study, women who saw the foetus were most susceptible to psychological distress, including nightmares, flashbacks, and unwanted thoughts related to the procedure.

While Health Minister Tanya Plibersek says that the drug will be an advantage for women in remote and under-resourced areas, the lack of nearby emergency facilities is a reason not to use it, medical bodies say. Regardless of one's views on abortion, women should be aware of what they might face.

Melinda Tankard Reist is a writer, speaker, media commentator, blogger and advocate for women and girls.