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How Private Equity Cashed in on Medical Abortion

In 1993, a group of activists rented a warehouse in suburban Westchester County, New York. It was smaller than they’d hoped and had limited ventilation, but the two other locations they’d tried to rent belonged to universities and required jumping through too many bureaucratic hoops—the exact sort of paper trail this group was trying to avoid.

Led by renowned pro-choice activist Lawrence Lader, their goal was to replicate RU-486, the revolutionary abortion pill developed in the 1980s by French manufacturer Roussel-­Uclaf—which was unwilling to navigate American abortion politics to bring the pill stateside. Lader’s group, code-named ARM Research Council, set up shop just months after Dr. David Gunn was shot and killed outside his Florida clinic, the first US physician to be murdered by an anti-abortion activist. Perhaps unsurprisingly, no US manufacturer wanted to wade into the increasingly fraught abortion debate to bring the medication to American women, either. So with the help of lawyers and activists, Lader had smuggled RU-486 into the United States, and his group was going to try to reproduce it.

In their warehouse, they got to work building an underground drug laboratory, complete with a huge, customized ventilation hood, fire prevention devices, and specially designed sinks. The whole project “had the trappings of a CIA operation,” Lader would later write. They figured out a system for replenishing their near-constant need for dry ice from a supplier 15 miles away, and crafted a strategy to avoid detection by anti-abortion groups, the garbage collector, and their landlord. If anyone asked what they were up to, the group—which included a doctor who lived 1,000 miles away and asked to go by Dr. X; a Columbia University chemist working for free; and two assistants—agreed on a cover story: They were working on a new treatment for cancer.

Meanwhile, Roussel-Uclaf and its parent company were in a drawn-out negotiation with a Manhattan-based reproductive health nonprofit, called the Population Council, over the official patent for RU-486. The same month that the French company finally agreed to give the Council the patent, Lader’s secret lab announced that it had successfully developed its own copy of the drug, whose scientific name is mifepristone. The two groups knew of each other’s work, and Lader had even reached out to the Population Council about collaborating, but the Council had demurred.

Lader’s group knew American women could not wait the many years it would take for the Council to arrange an official manufacturing operation with full approval from the Food and Drug Administration. So, it got its own permission from the FDA to conduct limited testing, which would allow it to start distributing small batches of the drug to a network of 10 clinics. There, patients could get both mifepristone and misoprostol, a common ulcer drug, which, when taken in tandem, can cause a medication abortion. For the few who were able to try it, it was an emotional and physical relief: It meant they could have an abortion privately and without a vacuum aspiration machine, whose suction “feels like you’re getting the life sucked out of you,” as one early mifepristone recipient described it to the Boston Globe.

All the while, the Council was working to find a manufacturer willing to make the drug, win full FDA authorization, and sell it across America.

When the FDA finally approved mifepristone seven years later, the Council’s distribution venture, which came to be called Danco Labs, was ready to go. Within two months, the drug was shipped out to doctors. At the clinics brave enough to be early adopters, women began showing up from farther and farther away; in some places the medicine was double the cost of a surgical abortion, but that hardly seemed to matter. By 2020, the pill had become the most popular way to get an abortion in the United States.

Over the last two decades, mifepristone’s dramatic origin story has made its way into books and the pages of the New York Times. But the tale of who funded this effort to legally bring it to women across the country, and what benefits the funders might reap from their investments, has been mostly kept quiet. This was in part because the 1990s were the apex of anti-abortion violence, so investors required secrecy. It was also because the funding sources seemed like a minor plot point in a project that had the potential to transform reproductive health care for millions.

Read entire article at Mother Jones