Abortion Techniques
The procedure with methotrexate is similar to the one using RU 486, though administered by an intramuscular injection instead of a pill.
Originally designed to attack fast growing cells such as cancers by neutralizing the B vitamin folic acid necessary for cell division, methotrexate apparently attacks the fast growing cells of the trophoblast as well, the tissue surronding the embryo that eventually gives rise to the placenta. The trophoblast not only functions as the "life support system" for the developing child, drawing oxygen and nutrients from the mother’s blood supply and disposing of carbon dioxide and waste products, but also produces the hCG (human chorionic gonadotropin) hormone which signals the corpus luteum to continue the production of progesterone necessary to prevent breakdown of the uterine lining and loss of the pregnancy. Methotrexate initiaties the disintengration of that sustaining, protective, and nourishing environment. Deprived of the food, oxygen, and fluids he or she needs to survive, the baby dies.
Three to seven days later (depending on the protocol used), a suppository of misoprostol (the same prostaglandin used with RU 486) is inserted into a woman’s vagina to trigger expulsion of the tiny body of the child from the woman’s uterus. Sometimes this occurs within the next few hours, but often a second dose of the prostaglandin is required, making the time lapse between the initial administration of methotrexate and the actual completion of the abortion as long as several weeks. A woman may bleed for weeks (42 days in one study ), even heavily, and may abort anywhere -- at home, on the bus, at work, etc. Those found to be still pregnant in later visits (at least 1 in 25) are given surgical abortions.
Even doctors who support abortion are reluctant to prescribe methotrexate for abortion because of its high toxicity and unpredictable side effects. Those side effects commonly include nausea, pain, diarrhea, as well as less visible but more serious effects such as bone marrow depression, severe anemia, liver damage and methotrexate-induced lung disease.
The manufacturer warns in the package insert that while methotrexate has shown itself useful in treating certain types of cancer and severe cases of arthritis and psoriasis, "deaths have been reported with the use of methotrexate," and recommends that its use be limited to "physicians whose knowledge and experience includes the use of antimetabolite therapy." Though researchers performing methotrexate abortions have dismissed such concerns because of the low dosage used, other doctors in the abortion trade have disagreed, and the package insert clearly warns that "toxic effects may be related in frequency and severity to dose or frequency of administration but have been seen at all doses" (emphasis added).
