Kenneth Smith was executed in Alabama recently using a new technique of supplying 100% nitrogen gas thru a facemask while he was strapped to a gurney. (We normally breathe in a mixture of air that contains about 79% nitrogen, an inert gas, but more importantly, 20% oxygen which is necessary to maintain life.) A writer for the Tribune News Service described his last moments dramatically. “He began thrashing against the straps, his whole body and head violently jerking back and forth for several minutes. Soon, for around a minute, Smith appeared heaving and retching inside the mask.” And more, until after about ten minutes of nitrogen flow he made his last visible effort to breathe.
Gruesome? You bet! What does that have to do with a medically-induced RU486 abortion, you ask? For me, the legalized murder of the prisoner is a metaphor of sorts for the legalized murder of a human fetus, and the grisly last moments of both, I maintain, are comparable.
First, let me confess that although I was once in favor of the death penalty as a lawful method of capital punishment, my conscience over time convinced me that to be a non-hypocritical pro-lifer, I had to be consistent. I now oppose the death penalty. Second, I attempted to contact the reporter of the Tribune article to share my observation of the similarity between a medical abortion and the asphyxiation of the prisoner, but the writer never responded. Finally, the rest of this message will be a brief look at how the abortion pill(s) work, and why we must understand the physiological consequences of this form of life termination because about one half of all abortions taking place in the US are non-surgical and take place at home, usually.
RU486 is most often a two pill process. The first pill is a gonadal steroid anti-progestin called mifepristone sold under the trade name MifeprexR and manufactured in China. The second pill is administered two days later. It is the prostaglandin misoprostol sold under the trade name CytotecR. I could not find the manufacturer of the misoprostol sold in the US.
Mifepristone is taken orally at around 5-7 weeks after the last menstrual period, and it should be taken under the supervision of a doctor trained in gynecology, but depending upon the state, it may be ordered on-line by the woman and taken without any supervision. (It is NOT the same as the so-called “morning after pill” which is usually a very high dose of the estrogen/progesterone birth control pills that can be taken up to a few days after unprotected sex, and this prevents the implantation of a fertilized zygote into the uterine lining.)
To maintain a viable pregnancy and the attachment of the placenta to the uterine lining which is necessary for the developing baby to receive all of its nourishment, the hormone progesterone is produced by a small enlargement of the ovary called the corpus luteum (CL). This hormone flows to the uterus and helps maintain the life-giving connection. Some estrogen, also produced by the CL is needed for this, too. Later in pregnancy (and well after the abortion pill is approved to be administered) the placenta itself produced both progesterone and estrogen to maintain the pregnancy and other activities for the baby’s sustenance such as the development of the lactating mammary glands.
A placenta attaches itself to the uterine lining called the endometrium using finger-like projections called villi. These small intrusions are surrounded by the blood of the mother, and now the mother’s blood—carrying oxygen, nutrition, antibodies and other life-giving nourishment—transfers those to the baby while carrying away the baby’s metabolic waste products such as carbon dioxide and nitrogen-based urea. The placenta is an amazing organ, and we could spend much time discussing all that this most intimate of miracles does for us.
What does mifepristone do? Because it is chemically a molecule very similar to progesterone in structure, it latches on to progesterone receptors in the uterus, and prevents the progesterone from doing its work. Think of a lock and key, but in this case a false key that will not open the lock is jammed into the space thus preventing the good key from doing its work.
The placenta now begins to disconnect from the uterus, and you can thus imagine the consequences of the disruption: loss of nutrition, but most significant, loss of oxygen. Think now of what that will do to the fetus: inevitable asphyxiation, and if we were able to watch the response of the dying baby, my guess is that it would be very similar to the response of the dying Alabama prisoner strapped to the gurney. Use your own imagination, or recall the last time you were submerged in water and you were desperate for a breath of air.
The baby almost always dies with just the mifepristone, but a second pill which the woman takes 2 days later in this chemical abortion is the prostaglandin which causes uterine contractions and helps assure the evacuation of the uterus and expulsion of the baby with much blood and sloughed tissue as might occur in a very heavy menstruation. The pills were approved by the US FDA in 2000, but because of the incomplete vetting of the procedure and the possible effects upon the woman to include rare fatalities (the effect on the baby is always fatal!) the Supreme Court at this writing is reviewing a lower court decision to ban RU486.
For more information there are many on-line sources. The best is the National Right to Life site www.nrlc.org , but for a brief overview, the Planned Parenthood site is worth a look. Always make decisions about your health and the health of your baby after consulting a trusted Ob/Gyn. Future articles in this series will cover other aspects of the physiology of pregnancy.