Étienne-Émile Baulieu, ‘father of the abortion pill,' dies at 98
Dr. Baulieu, who specialized in hormone research at a French government lab, had already by the 1970s made one breakthrough discovery relating to a hormone and certain health risks. He next sought to explore new birth control methods, nearly two decades after the first oral contraceptive, Enovid, was approved for use in the United States
in 1960.
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Dr. Baulieu narrowed his research to sex hormones, particularly progesterone, which is essential to pregnancy because it prepares the uterus for a newly fertilized egg.
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He knew that the French drug company Roussel-Uclaf — where he was a consultant on drug development — would not invest in a sex-hormone drug linked to birth control. Instead, he nudged the company to support work on a molecular compound to block cortisone, a hormone involved in blood sugar regulation, metabolism, and suppressing inflammation.
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The key for Dr. Baulieu was that cortisone had a chemical structure similar to that of progesterone.
Dr. Baulieu suggested that a cortisone-blocking agent, called an anti-glucocorticoid, could be useful for the treatment of burns, wounds, and glaucoma. Privately, he also hoped it would act as an anti-progesterone and prove effective in terminating early pregnancies without the need for surgery.
In 1980, Roussel-Uclaf chemist Georges Teutsch synthesized RU-38486, or the 38,486th compound created at the company's labs. The compound — its molecular name shortened to RU-486 — was found to block the function of progesterone and cortisone,
as Dr. Baulieu anticipated.
He ultimately persuaded the company to pursue human abortion trials. He first, however, had to make the case that RU-486 was safe. Toxicity tests had caused three monkeys to become so ill that they had to be euthanized. Dr. Baulieu argued that the drug was working as it should, but that the monkeys were given doses that were too high.
He told the Observer, a British newspaper, that he had 'rescued RU-486 from oblivion.'
After clinical trials — first in Switzerland, then in Hungary and Sweden — Roussel-Uclaf received French approval in 1988 to market the drug to end pregnancies up to 10 weeks after a missed menstrual period. RU-486 (whose generic name is mifepristone and which was marketed as mifeprex in the United States) is followed within 48 hours by a drug known as misoprostol to induce uterine contractions. The two drugs are supposed to be prescribed by a physician and can be taken at home without medical supervision.
RU-486 was the product of a team effort, but Dr. Baulieu was seen as the drug's key architect and advocate. He became known as 'the father of the abortion pill' and was a reviled target of antiabortion activists and others.
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The Vatican in 1997 denounced RU-486 as 'the pill of Cain: the monster that cynically kills its brothers.' In Canada, a billboard once displayed Dr. Baulieu's picture and the words, 'Wanted for genocide.' In 1988, he was protected by bodyguards during a trip to the United States. But he also said he received messages of thanks from women who were able to end their pregnancies without a surgical procedure.
In France, the antiabortion sentiment was so strong that Roussel-Uclaf halted production of the drug soon after it was approved for distribution. Protests raged outside Roussel-Uclaf headquarters in Paris. 'You are turning the uterus into a crematory oven,' demonstrators yelled, alluding to the production of poison gas for Nazi Germany by a predecessor of Hoechst, the holding company that owned Roussel-Uclaf.
With drug production on hold, Dr. Baulieu traveled to Brazil for a medical conference that turned into a 'pep rally' for RU-486, the New York Times reported. By the end of the conference, the drug was reinstated by Roussel-Uclaf. Claude Évin, then health minister of France, had declared that RU-486 was 'the moral property of women.'
'Before we left Rio,' Dr. Baulieu wrote in his book, 'we opened the champagne.'
The FDA approved mifepristone (pronounced mi-fuh-PRI-stone) in 2000, more than a decade after it became available in China and in Russia and other parts of Europe. (U.S. research into the drug as an abortion medication had been banned, but it was studied as a treatment for hormonal disorders including Cushing's syndrome.) The drug's delay in the United States came from fear of boycotts against Hoechst and a heavily politicized climate around the approval process.
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Since
Roe v. Wade
and its protection of U.S. abortion rights were overturned in 2022, mifepristone has been at the center of legal questions over whether antiabortion states can block the Postal Service from delivering the drug. Mifepristone is used in more than 60 percent of abortions in the United States, according to the Guttmacher Institute, a research and policy group focusing on reproductive health.
'Ideology and machismo, alas, weigh more heavily than rationality and scientific proof,' Dr. Baulieu told the New Yorker in 2022. 'A method that makes the termination of pregnancy less physically traumatic for women and less risky to their health has always been rejected by pro-lifers: What they really seek is to harm and punish women.'
He often recounted an incident from his medical residency in Paris in the 1950s. A surgeon, scraping the uterus of a woman who had self-administered an abortion, refused to render her unconscious with general anesthesia, remarking that it would 'teach her a lesson she will remember,' he said.
As an authority on reproduction, Dr. Baulieu became part of a government committee that helped change French law in 1967 to allow the birth control pill. Later, during a visit to India in 1970, Dr. Baulieu was shaken when a woman begging for money shoved the body of her dead child at him.
'During that trip,' Dr. Baulieu recalled, 'I decided to aim my life's work toward finding some way to ease this sort of suffering.'
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