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Having failed to prevent FDA approval of the abortion drug Mifepristone, also known as RU-486, abortion foes are opening a new front in the struggle over reproductive rights by lobbying for tougher restrictions on doctors who wish to prescribe it. On Oct. 4, Representative Tom Coburn, R-Okla., joined Senator Tim Hutchinson, R-Ark., in proposing legislation that would modify the U.S. Food & Drug Administration’s Sept. 28 approval of the drug by requiring that doctors be qualified to perform surgical abortions on patients taking RU-486. By requiring that doctors be able to perform surgical abortions, Simon Heller of the Center for Reproductive Law & Policy said the legislation would limit the use of RU-486 to abortion clinics, defeating the pro-choice lobby’s goal of expanding abortions beyond the clinic setting. Addressing how RU-486 will fit into existing abortion jurisprudence, James Bopp Jr., general counsel of the National Right to Life Committee, said current laws restricting the availability of surgical abortions — such as parental notification — will apply equally to the drug. But some abortion-law experts said the states will have a tough time further regulating RU-486. HIGHER BAR “What’s significant about RU-486 is that it doesn’t change the legal dynamic,” said Professor Jonathan Entin of Case Western Reserve University School of Law. “It changes the real-world dynamic. … [Y]ou don’t have to be in a medical facility to use it.” RU-486 is used with the drug misopristol to terminate unwanted pregnancies within seven weeks of the last menstrual period. It requires three visits to a doctor’s office over two weeks. While RU-486 blocks the hormone progesterone, which is necessary for a pregnancy, misopristol is taken afterward to induce contraction of the uterus to expel the lining. The drug carries a warning that “women may have severe bleeding and need to contact their doctor right away.” Citing these risks, Coburn, a licensed physician, proposed that doctors seeking to prescribe RU-486 be qualified to “handle complications resulting from an incomplete abortion,” and have admitting privileges at a hospital no less than one hour away. This is more strict than FDA rules giving the doctor the option of arranging for another physician to perform an abortion if necessary. At a Capitol Hill press conference, Coburn said the goal of the FDA approval of RU-486 should be “that only one person is injured with this pill, and that’s the developing fetus, not the woman who takes the pill.” But Judie A. Brown, president of the American Life League, says the bill “legitimizes chemical abortion.” She has called for hearings into the FDA approval process, a move supported by Hutchinson. Ohio State University College of Law Professor David A. Goldberger said that, under U.S. Supreme Court precedent, RU-486 is likely to be treated like a surgical abortion, but that the supremacy clause will prevent the federal rules governing the drug from being trumped by state regulations. “The state’s interest in protecting human life doesn’t depend on whether you’re first, second or third trimester any more,” added Goldberger. “Recent [Supreme Court] decisions show that the undue-burden standard has become the controlling mode of analysis. They’re going to ask the same question with RU-486.”

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