First marketed by the French pharmaceutical firm Roussel-Uclaf in April 1986, hence its numerical label, the "abortion pill" took the Europe by storm.

America’s pro-choice think tanks deliberated long and hard, fighting the opposition from various corners of society. Abortion, of course, has never been a purely medical issue in the United States.

It has been burdened with political, religious and legal ramifications that have divided the nation. Clinic bombings and physician murders have seemingly been tolerated by a torn society.

Now that mifepristone has arrived, some of us in the abortion trade wonder if our victory was at too high a cost. The FDA’s stamp of approval was handed down with fewer restrictions than predicted despite the enormous lobbying from both sides of the debate.

Of course, the drug will be by prescription only, and via physicians with a certain level of expertise for diagnosing a pregnancy and access to facilities that could treat the most severe complications, such as hemorrhage and infections. And certain guidelines for informed consent were mandated.

But the FDA did not dictate several more stringent restrictions that were considered, such as requiring that the drug be dispensed only by physicians trained to perform surgical abortions or that they be certified in the use of the drug and credentialed in ultrasonography.

We welcome the addition of mifepristone to our armamentarium. It provides women and their practitioners with another alternative that extends the right to choose. However, we must also be careful we are not doing the right thing for the wrong reason.

Mifepristone is not a medical or choice panacea. It enters our abortion world after 27 years in which the United States has become the abortion capital of the world.

The activists spoke, the court responded with Roe v. Wade in 1973 and the American medical community proudly and conscientiously reacted in kind. Undeniable statistics indicate that there are over a million terminations yearly.

With an infinitesimal complication rate, it is easily the safest minor surgical procedure in medical history and one of medicine’s proudest achievements.

The question arises – if it is not broken, why fix it? Amid the ruckus over choice and the proper place for mifepristone, there are three realities worthy of our attention.

First, is it really progress to issue a patient a series of not one but two different medications and have her judge on her own any potential hemorrhage and cramping over the next several days or more?

This then creates the need for at least two doctor consultations and an eventual third post-abortal exam. Surgical abortion is now often a short visit to a outpatient clinic with a professional support system and a usually two minute procedure performed under either local or quick acting general anesthesia.

The patient can generally return to her full activities within hours or the following day. And all at a cost, on the average, half that of the RU-486 regimen.

Secondly, the U.S. is the world’s only developed nation without a comprehensive health care plan for everyone, something that is available to all the women in the rest of the world where mifepristone is available.

Millions of the American women to whom this new medical breakthrough is being offered have inadequate or no health care coverage and the security that it carries.

It is naive to think that once on the market, RU-486 will not fall into the hands of illicit traders and be made obtainable, at a price, to those women without access to medical care.

For these same reasons, the drug cannot be considered for the Third World, where surgical abortions account for more deaths and sepsis than AIDS.

Thirdly, there is the politics of choice and the subterfuge mifepristone is providing the anti-choice movement. The issue being obscured is that choice is the constitutionally reaffirmed law of the land, even though we treat it as a disgrace and permit its compromise.

This yielding to the anti-choice forces could give them ammunition choice activists can’t afford.

The dilemma that is abortion, a choice between two unwanted alternatives, has not made it any easier for its proponents. It just won’t fade away; every political candidate on every level eventually feels obligated to take a stand.

Mifepristone has its place in the care of women. But to take it at face value is a folly many may not be able to handle. Primum non nocere. Do no harm. Hippocrates’ words never rang more true.

Don Sloan is a medical doctor in New York.