Doctors must get mifepristone training. They must be able to date early pregnancy and uncover ectopic pregnancies that require special care. For the rare cases when mifepristone fails, they must either perform a surgical abortion or have a backup surgeon on call. Some gynecologists and family practitioners in regions where abortion access is limited are showing interest. Forty attended mifepristone training at the Women's Health Center of Duluth, Minn., where women drive hundreds of miles from parts of Minnesota, Michigan and Wisconsin to get abortions.
Nobody knows, however, how many of the physicians then ordered the drug.
Key may be how many patients ask their doctors for it, says Dr. Steven Tamarin, a New York City family practitioner who has never performed abortions because he's not a surgeon. It depends on where they get the pill. Mifepristone blocks the action of progesterone, vital for an embryo to develop. A second drug, misoprostol, causes contractions to expel the embryo. The FDA instructs women to swallow three mifepristone tablets, return to the doctor two days later to swallow two misoprostol tablets, and return again within two weeks for the doctor to check that the abortion worked.