The ministry of Health and Family Welfare is planning to include a medical abortion pill in the family welfare system to reduce the risk of surgical methods of abortion. The on going trials on the abortion pill (RU486 in combination with a prostaglandin) at the All India Institute of Medical Sciences (AIIMS) here has shown that the medical termination is successful in 90 to 95 percent of women with negligible side effects. As the next step the ministry is trying to identify the strategies and frame guidelines for launching the pill in the family welfare programme as a safe alternative to surgical termination of pregnancy.

A meeting being held in this connection has suggested the need for the amendment of Medical Termination of Pregnancy Act 1971 to enable easy access to the abortion pill. The Act calls for surgical termination of pregnancy at "a place certified and approved for the purpose". However, experts feel that administration of the pill should only be under medical supervision with proper back-up facilities for blood transfusion and MTP services. This rules out self-medication and clandestine administration of the pill as has been reported from some parts of the country. In fact, amendment might be required to prevent misuse.

The pill, for which approval was granted by the Drug Controller General of India a year ago, is already available on prescription. Trials are still on for the safe protocol required for its use in the second trimester.

If successful and accepted, this method of termination of unwanted pregnancy would be a boon for women in the country, where 20,000 women die of unsafe abortions every year. According to rough estimates, there are 67 lakh cases of induced abortion in the country every year.

Studies conducted at the AIIMS, the ICMR, at a village near Pune, in Mumbai hospitals and in China, the U.K. and Romania show a common feature: The pill shows 85 to 97 per cent rate of success although the side-effects remain similar i.e. abdominal pain and bleeding (attributed to the process of abortion), vomiting and nausea (on account of pregnancy) and in some cases, diarrhoea and fever. Apparently, the side effects vary from woman to woman.

The areas of concern in India are the anaemic nature of a sizeable number of women (though loss of blood occurs in surgical method as well), lack of well-knit, equipped health facilities and apprehensions of misuse.