How do Jews and how does Judaism view the recent approval of Mifeprex, a drug combination that can replace surgical abortion in many women?
Well, that depends on whom you ask.
Mifeprex, popularly call RU-486, can be used to terminate pregnancies for up to 49 days, counting from the beginning of a woman's last menstrual period. A woman first takes 600 milligrams of mifepristone, which reduces the hormonal stimulation of the fetus. Two days later, she takes 400 micrograms of misoprostol, a drug that causes contraction in order to expel the fetus.
Two weeks after using the drugs, the woman returns to the doctor to be sure the pregnancy was terminated; the drug is 92 to 95 percent effective. Women who take the drug will get a Food and Drug Administration-approved brochure explaining how the drug works and what side effects to expect.
"The pills are certainly simpler than surgical abortion," says Dr. Stephen Schuster, a gynecologist and clinical assistant professor at New York Hospital-Weil School of Medicine, who is also a member of the Association of Orthodox Jewish Scientists. "If the abortion is halachically permissible [permissible under Jewish law], then it's an additional alternative if a doctor feels sure that the patient will contact the medical office immediately if any serious problems develop."
Not surprisingly, Reform, Conservative and Orthodox Judaism have different ideas on the circumstances under which abortion is permitted under Jewish law.
"By approving mifepristone, the FDA has successfully placed women's fertility back in the hands of a woman and her doctor," says Rabbi David Saperstein, director of Reform Judaism's Religious Action Center. "The Reform movement has long supported a women's right to make moral decisions about her own life and her own body with privacy and without fear of government intrusion," Saperstein said. He added that women will now be able to "use their moral and religious conscience in deciding whether or not to terminate a pregnancy within the comfort of their own homes, surrounded by their families."
Sarrae Crane, spokeswoman for United Synagogue, which represents Conservative Judaism, was more tentative. "Conservative Judaism does not encourage abortion," said Crane, "but we don't believe that there should be obstacles put in a mother's way either. Abortion is a religious and medical decision, not a governmental one."
The Conservative Rabbinical Assembly Committee on Jewish Law takes the view that an abortion is justifiable if a continuation of pregnancy might cause the mother severe physical or psychological harm or when the fetus is judged by competent medical opinion as severely defective.
Rabbi Moshe Tendler, considered the leading Orthodox authority on Jewish medical ethics, and a professor at Yeshiva University, has reviewed data on the drug for the past 10 years.
Tendler says that Mifeprex must be viewed in the context of what Jewish law says about abortion, which is that abortion is permitted only when a pregnancy places the mother's life in danger, and in consultation with a rabbinical authority, says Tendler.
In those situations in which Jewish law would allow an abortion and the abortion can be performed within Mifeprex's time frame, the drugs are the preferred method, says Tendler, because the abortion is performed indirectly - by depriving the fetus of hormonal stimulation - instead of directly; that is, by surgically removing the fetus.
But Tendler is significantly concerned that Mifeprex will be viewed as a form of contraception - "it is much easier to take a few pills a few days after you become pregnant than to take a pill every day in order to avoid a pregnancy," Tendler says. But that, he says, is halachically impermissible. "Contraception per se is not a free ride when it comes to Jewish law," Tendler says. "Not for married folk and certainly not for unmarried folk."
While the drug would be the preferred method for a halachically approved abortion, it is not the preferred method if it is being used as contraception. "In that case," Tendler says, "it would be the greater of two evils."