Science  /  Origin Story

The Long and Winding History of the War on Abortion Drugs

While these pills are making headlines in the US, where a Texas judge tried to ban them, the story of their invention is often overlooked.

Mifepristone, the 'pill of Cain'

“Misoprostol’s patent holder had always been very resistant to its association with abortion,” explains Dr. Calkin. "But mifepristone has always been understood as an abortion drug, first and foremost.” Its inventor, endocrinologist and biochemist Étienne-Émile Baulieu, said so himself.

In a recent interview with the New York Times, the 96-year-old described being haunted by memories of his medical residency, which he completed before France passed its abortion bill in 1975. He recalled how women were admitted to the hospital he worked in after terminating pregnancies with sticks, and how surgeons would instruct their employees not to administer anaesthesia “to teach them a lesson”.

When he began brainstorming the idea for an "unpregnancy pill" nearly 50 years ago, Baulieu was convinced that it would spark a small revolution. A pill that could terminate a pregnancy and allow women to avoid getting surgery would be a leap forward for women's rights. He hoped that by the 21st century, the "abortion pill might even help eliminate abortion as an issue" altogether. So he convinced pharmaceutical company Roussel-Uclaf, for which he was consulting at the time, to let him develop a progesterone blocker.

Baulieu first synthesised mifepristone in 1980 under the name “RU-468”, “RU” referring to Roussel-Uclaf and “468” to the sequencing number of the molecule. But the rollout of the pill, from its first medical trials to its market approval, was a hard-fought battle.

“There was a trans-national effort by anti-abortion activists from France and the US … to stop its market introduction,” says Dr. Claudia Roesch, a research fellow at the German Historical Institute Washington, who studied the backlash around mifepristone. Anti-abortion protesters blocked the entrances of French embassies in the US, as well as company headquarters in the US, France and Germany.

“Protesters would even compare medical abortion to the Holocaust,” Roesch says. Roussel-Uclaf’s main stakeholder was German company Hoechst AG, which had been part of IG Farben during World War II, the company that produced the cyanide gas used by Nazis in concentration camps. "They sent gruesome images to their headquarters in Germany and the US."

Mifepristone was eventually approved for use by French health authorities in September 1988. But opposition was so intense that less than a month later, Roussel-Uclaf said it would pull the pill from the market.

Luckily the French government held a stake in the company, so French health minister at the time Claude Évin pressured the company to resume selling it. ''From the moment government approval for the drug was granted, RU 486 became the moral property of women, not just the property of the drug company,” he said in a televised address.