Mifegyne (Abortion Pill)

Objectives

Women have the right to freely and responsibly decide on their pregnancy status. However, until recently, our society has deprived women of these rights through laws and classifications, such as criminalizing abortion. During this time, access to information on safe abortions was prohibited and covered by a veil of ignorance. Let’s look into the most well-known abortion pill as a means of choice for women. Mifegyne is a drug that has recently been approved for use in the Republic of Korea. Many women in Korea have struggled to obtain it in the past and knowingly risked receiving punishment in order to do so.

Abortion Measures Available to Women

✔️ Mifegyne (Active Ingredient. Mifepristone)

Mifegyne is widely known as the “abortion pill” around the world. The active ingredient of the drug is mifepristone, which can lead to an artificially induced abortion by inhibiting the interaction of progesterone on the endometrium which is required to maintain pregnancy.

It is used as an abortion pill with misoprostol (a prostaglandin binding drug that causes cervical dilation and contractions).

✔️ Safety

Mifepristone was first developed in 1988 in France and has been proven effective along with misoprostol, based on the data from hundreds of thousands of people in over 1,000 clinical trials worldwide over the course of 30 years.

The safety and effectiveness of mifepristone are supported by it being listed in the WHO Model List of Essential Medicines. The success rate is 98-100% when used within the first 8 weeks, 96-100% between 8 and 9 weeks, and 93-100% between 9 and 10 weeks.

It is currently on the market in 75 countries around the world.

✔️ Side Effects

Whether an abortion is obtained by drugs or by surgery, the incidence of complications that require a visit to the emergency room is less than 1%.

The maternal mortality rate related to mifepristone (Mifeprex) in the U.S. in 2000 was 0.00063%.

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Mortality rate running a marathon > Mortality rate having an abortion

The mortality rate related to abortions in the US between 2000 and 2009 was 0.7 per 100,000 pregnancies. During the same period, the mortality rate for cosmetic surgeries was 0.8-1.7, 0-1.7 for dental treatment, and 0.6-1.2 for running a marathon, which highlights the minimal risks involved when performed legally.

Based on research involving more than 423,000 participants, there were serious but non-fatal side effects in 0.01-0.7% of cases, including hospitalization, blood transfusions, and infections.

Rupture of the uterus is a rare complication, which may occur when the uterus becomes enlarged after gestation or when surgery such as a C-section has been performed in the past. In this case, you must be prepared for such an emergency.

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Mifegyne is not recommended for those who have experienced an ectopic pregnancy, chronic adrenal insufficiency, hypersensitivity to drugs, severe uncontrolled asthma, severe cardiac/liver/renal failure, porphyria, or those taking regular anticoagulants or steroids.

✔️ Controversy

Having an abortion through drugs like Mifegyne has become controversial in the realms of the law, ethics, policy, and norms rather than medical safety.

In Korea, the criminalization of abortion is included in Article 269 of the Statutes of the Republic of Korea, and the availability of abortion treatment is limited within the scope permitted by the Mother and Child Health Act. In the same vein, the import and distribution of the abortion pill, Mifegyne, is prohibited.

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2000, Republic of Korea

After mifepristone was approved in the U.S., it was debated for implementation in the Republic of Korea. However, the strict and conservative society values blocked the arrival of mifepristone in Korea. Yeojun Yoon, a member of the National Assembly in the Grand National Party at the time, claimed that “Abortion pills create a trend that makes light of human life and encourages a promiscuous sex life amongst adolescents”.

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1988, France

Mifegyne was approved in September 1988 in France, but pharmaceutical companies decided to withdraw the drug from the market after a massive demonstration against it. However, the French government and the Ministry of Social Affairs and Health demanded they continue producing the drug for the sake of public health. The Minister of Social Affairs and Health in France at the time ordered pharmaceutical companies to resume sales and declared Mifegyne as “an ethical asset for all women”.

✔️ After the Ruling that “Criminalizing Abortion is Unconstitutional”

On April 11, 2019, the Constitutional Court of Korea ruled that the “criminalization of abortion” is not conforming to the constitution, as it criminally punishes pregnant women and their doctors and endangers women’s lives.

The National Assembly must pass an amendment for the constitutionality of abortions by December 31, 2020, and if the amendment is not passed within this deadline, the crime of abortion against pregnant women and doctors who practiced abortion will no longer be effective.

On October 7, 2020, the Ministry of Justice and Ministry of Health and Welfare pre-announced the amendment of the Mother and Child Health Act and legislations related to the crime of abortion. The key detail is to decriminalize abortion up to 14 weeks into a pregnancy. There was a controversy over the restrictions, as abortion was allowed up until 24 weeks of pregnancy, the second trimester, only due to socioeconomic reasons or if the pregnancy was caused by sexual assault. The legalization of abortion drugs such as “Mifegyne” is also expected to be legalized.

Summary

Women have the right to choose what they want to do in relation to their pregnancy.

There are medical and surgical abortions available and women should be able to choose their preferred method.

Safe access to abortions is a social justice issue.