The Complicated Life of the Abortion Pill

In March, a Republican lawmaker named Danny Bentley took the floor of the Kentucky House of Representatives to advocate for a bill that would strip many forms of reproductive-health care from residents of the state. A pharmacist and one of the bill’s sponsors, Bentley promised to clear up some “misconceptions” about RU-486, or mifepristone—a synthetic steroid that is the critical ingredient of the abortion pill, a two-dose regimen that allows people to safely end early-stage pregnancies without surgical intervention. Bentley claimed that RU-486 was created during the Second World War, and that it was initially called Xyglam B—an apparent reference to Zyklon B, the lethal gas used in concentration camps. “The person who developed it was a Jew,” Bentley said, adding that the inventors were likely motivated by “making money.”

The abortion pill was created in the nineteen-eighties; mifepristone was the 38,486th molecule developed by the French drug company Roussel-Uclaf, hence the name RU-486. It was never called Xyglam B or Zyklon B. Bentley’s fabulations were likely inspired by anti-abortion groups that have long tried to exploit a tenuous link between the two products: Roussel-Uclaf was owned by a German company that once belonged to another German company, a subsidiary of which helped manufacture and sell Zyklon B.

Bentley was correct, however, that RU-486 was developed by a Jewish scientist. He was born Étienne Blum, in Strasbourg, in 1926 and took the name Émile Baulieu upon joining the French Resistance in the nineteen-forties. As Étienne-Émile Baulieu, he led an extraordinary life: dodging Fascist paramilitaries; hobnobbing with art-world luminaries; enraging the Pope; and, in the course of a seven-decade career in biochemistry and neuroscience, becoming a seminal figure in the fight for reproductive rights. Last month—exactly two weeks before the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization overturned Roe v. Wade—I visited Baulieu, known as the father of the abortion pill, in his office, in Paris. He told me that he wasn’t much bothered by misrepresentations, such as Bentley’s, of his legacy. (Bentley apologized for his comments after complaints from anti-defamation organizations.) He had absorbed worse: the Vatican once denounced RU-486 as “the pill of Cain: the monster that cynically kills its brothers.” Baulieu’s policy had always been to brush it off. But he was deeply troubled by the threat to reproductive freedom in the United States. “It’s scandalous,” he said. Later, he wrote to say that the Dobbs decision “calls into question a fundamental right of women that we would have thought was legally, politically, and morally guaranteed.”

Bentley’s bill passed the Republican-dominated Kentucky legislature easily, but was temporarily blocked by an injunction in federal court. For the moment, abortion remains legal in the state; however, Republicans are supporting a ballot measure that would amend the state constitution to make it harder to challenge these laws in court.

The abortion pill—not to be confused with the morning-after pill, which delays ovulation, is typically taken in two stages. First, mifepristone blocks the body’s receptor for the hormone progesterone, thereby disrupting the gestation process in its early stages. Misoprostol then provokes contractions so that the uterus expels what’s left of the pregnancy, causing heavy bleeding and cramping. (According to Planned Parenthood, medication abortion feels, for most people, “like having an early miscarriage.”) In 2020, medication abortions accounted for an estimated fifty-four per cent of reported American abortions, making it, for the first time, the most common means for ending pregnancies in this country.

According to some experts, mifepristone has been overregulated since it was approved for use in America, particularly “given the very low rate of adverse events associated with its use.” During the pandemic, the F.D.A. suspended a rule requiring health-care professionals to dispense the medication in person—a change that the agency has since made permanent. Abortion pills can be taken at home, so those who need them may not require transportation, child care, or significant time away from work or school. They are safe, effective, and can be mailed or passed around, making them relatively difficult for authorities to trace. As my colleague Jia Tolentino has written, abortion pills are “among the reasons that we are not going back to the era of coat hangers.”

Greer Donley, a scholar of reproductive justice at the University of Pittsburgh’s law school, told me, “Historically, abortion was done by procedures, which meant that, if you could control doctors, you could really control abortion provision. But now that abortion pills exist, a state’s abortion ban is not going to have the same effect as it used to.” Baulieu’s so-called little white bombshell doesn’t remedy the injustice and inequity of the Court’s decision. But it is now the most powerful tool available to the estimated thirty-three million Americans whose reproductive autonomy the ruling attempts to negate.

I visited Baulieu at his research facility, INSERM Unit 1195 at the Hôpital Bicêtre, on the southern outskirts of Paris. The antechamber to his office was lined with brightly colored binders (“Abortion,” “Menopause,” “Ethics Committee”) and folders containing decades’ worth of press clippings (“Furor Over Award for Abort-Doc Pill, Pro-Lifers Rip ‘Human Pesticide,’ ” the New York Post wrote, in 1989). On a desk sat a glass container that had once held pâté and was now used to store paper clips.

The doctor appeared wearing gray slacks, a white button-down, and a bluish-gray sport coat. He used a walking stick, but, at ninety-five, he is otherwise in good shape. He has spent the latter part of his career studying depression and Alzheimer’s. He has also investigated the anti-aging properties of the hormone dehydroepiandrosterone (DHEA), without conclusive results, but he doesn’t rule out a positive influence. “I take it every day,” he said, leading the way to his office.

Long tipped for the Nobel Prize for his work on mifepristone, Baulieu never won it, but he has collected nearly every other honor a scientist could imagine, ranging from the Lasker Award to the presidency of the French Academy of Sciences. In 1989, during a visit to Baulieu’s office, the Times reporter Steven Greenhouse noted Baulieu’s “breezy, almost brash manner and hyperkinetic nature,” which gave him “the air more of a populist politician than of a meticulous medical researcher.” Although he has mellowed since then, Baulieu hasn’t entirely lost the savvy, self-assured persona that made him, in the words of one French journalist, one of the great “public enemies of the Catholic, anti-feminist, extreme right.” Plaques, memorabilia, and piles of books commingled in his office with bulbous sculptures by the feminist artist Niki de Saint Phalle. “I lived with her,” Baulieu said casually, taking a seat near a window that overlooked a former prison where the Marquis de Sade was once held. He didn’t mention Sophia Loren, whom he once drove around in an Austin Morris, fleeing paparazzi. (In the nineties, Vanity Fair reported, over Loren’s denials, that they became involved in an intense affair, causing Baulieu’s wife to remark, “What could he do? He fell in love.”)

Baulieu was conceived on the Nile—he knows this because his parents honeymooned there while his father, Léon Blum, a specialist in kidney disorders, was in Egypt treating King Fuad I for diabetes. During the First World War, Léon, an Alsatian, had been drafted into the German Army. Concocting a medical pretext, he asked officers to submit urine samples by mail. He used the postmarks to track their movements, which he transmitted to the French, who then recognized him with a Legion of Honor when the war was over. Léon died when Baulieu was three. His mother—a lawyer, pianist, and friend of the suffragettes who had “felt hemmed in by Alsace” and by Léon’s professional life—moved the family to Paris. “I was allowed to think about any career I wanted,” Baulieu later wrote. “Except medicine.”

When Hitler’s Army occupied France, in 1940, Baulieu was a teen-ager. He joined the Communists, distributing anti-German pamphlets and narrowly avoiding capture as he shot at German cars and delivered arms. In November, 1944, he was part of a group of ex-resistants who kidnapped Charles Marion, a Vichy official who was in prison awaiting trial, and executed him. “The prefect conducted himself with dignity, dressed in a beautiful loden coat that I never forgot,” Baulieu later recalled in “Libre Chercheur,” a book-length conversation with the journalist Caroline Fourest. As the youngest member of the group, Baulieu was assigned to shoot photos, rather than fire at Marion. He ultimately considered the killing “justifiable in the context,” but remained haunted for years by other horrors he witnessed, such as the forced shaving of women accused of collaboration.

Eventually, Baulieu felt drawn to his father’s profession. He threw himself into medical studies, eating bananas for every meal “to go faster,” and quit the Communist Party after the Soviet invasion of Hungary, in 1956. He recalled, “The best way to help society, I felt, was at the level of the individual.” Later, he loved Primo Levi’s work on the integrity of science, which he paraphrased as, “Science has an essential virtue. It respects what is.”

Baulieu’s first major discovery involved DHEA, the hormone to which his work would later return. Secreted by the adrenal glands, DHEA plays a key role in manufacturing both testosterone and estrogen, and DHEA levels can serve as an indicator for certain diseases. Other scientists, searching for a detection technique, had tried examining the oily fluids from the adrenal glands. Baulieu tried to measure it by looking at the water-soluble form, likening his method to “probing a vinaigrette: looking in the vinegar instead of the oil.” His discovery made him a tenured professor by the age of thirty. Soon, he was headed to New York, for a yearlong fellowship at Columbia University’s medical school. (He had to wait for Kennedy’s election to get a visa, given his Communist past.) While in the U.S., Baulieu got to know Gregory Pincus, the inventor of the oral contraceptive pill, who became a mentor. By night, he ran around with a group of striving New York artists: Jasper Johns, Robert Rauschenberg, Frank Stella. “Like them, I was adding form to a blank space with only vague notions of where it would lead me,” Baulieu later wrote of his research.

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