Baulieu’s revolutionary discovery of RU-486 reshaped reproductive healthcare and embodied his lifelong commitment to dignity, freedom and bodily autonomy for women.
Millions of women around the world gained safety, dignity and autonomy over their bodies thanks to Étienne-Émile Baulieu. The visionary biochemist, feminist and fearless innovator—best known for developing and championing “RU-486,” now known as mifepristone—died at his Paris home on May 30 at the age of 98.
Safely used for abortion and miscarriage treatment as well as other conditions, mifepristone has saved countless lives and offered millions of women a way to end unwanted pregnancies in the privacy and comfort of their homes. Dr. Baulieu’s legacy is science unflinchingly in service to women’s fundamental rights.
“Dr. Étienne-Émile Baulieu lived an extraordinary life that moved both science and society forward,” said former Vice President Kamala Harris, whose mother, renowned cancer researcher Dr. Shyamala Gopalan, worked alongside Baulieu. “He was instrumental in the fight for our fundamental freedoms, and he changed the lives of so many women around the world.”
Women die in botched abortions. Two hundred thousand every year. RU-486 can save them.
Étienne-Émile Baulieu
Baulieu’s Early Career
Born in Strasbourg, France, in 1926 to a Jewish family, Baulieu lost his father—also a doctor—at an early age and was raised by his mother, Thérèse (Lion) Blum, a feminist, lawyer and pianist.
His commitment to justice began early; at the age of 15, Baulieu joined the French resistance against Nazi occupation. After the war, he earned his medical degree from the Faculté de Médecine in Paris, becoming a doctor in 1955. He then pursued a Ph.D. in biochemistry at Faculté des Sciences in Paris.
While on a fellowship in the United States in the 1950s, Baulieu met Dr. Gregory Pincus, co-inventor of the birth control pill, who theorized a molecule could block the action of progesterone—a hormone that prepares the uterus to receive a fertilized egg, signals it to hold the fertilized egg and sustains the pregnancy after implantation. Baulieu returned to France with Pincus’ idea and turned it into one of the most significant reproductive innovations of the 20th century.
After earning his Ph.D. 1963, Baulieu was appointed director of the French National Institute of Health and Medical Research in Paris where he studied hormones and later became a biochemistry professor at the Faculté de Médecine de Bicêtre affiliated with Université Paris-Sud.
In 1970, Baulieu and his team of researchers at the National Institute identified the receptor molecules within uterine cells that respond to progesterone’s signals—causing the uterus to retain a pregnancy. Baulieu and other scientists then began searching for a substance—an antiprogesterone—that could bind to the receptor molecules and block progesterone’s message. In a 1989 New York Times article, Baulieu explained: “The receptors are like a keyhole, and we were trying to produce a false key.” He characterized the process as “jamming a radio signal.”
At the time, Baulieu was a part-time consultant at the French pharmaceutical company Roussel Uclaf. Working with the company’s chemists, he helped develop a compound to block progesterone by grafting a complex atom cluster onto a progesterone-like molecule—chemically different from progesterone but still able to bond to its receptor molecule.
Roussel Uclaf’s chief chemist, George Teutsch, led a team of researchers that tested over 900 substances in search of the highest binding qualities.
“Whereas Teutsch and his group were making a fake key that would fit the lock, Baulieu’s work was defining the shape of the lock,” explained Lawrence Lader, founder of the National Abortion Rights Action League.
In his 1995 book, RU 486: The Pill That Could End the Abortion Wars and Why American Women Don’t Have It, Lader described how the medication worked: “By occupying the space in the progesterone receptor without activating it, RU 486 impedes progesterone from entering the receptor. Instead of inducing the usual hormone responses, RU 486 stops them.”
He was instrumental in the fight for our fundamental freedoms, and he changed the lives of so many women around the world.
Kamala Harris
In 1980, Teutsch’s team synthesized the compound that worked. The company named the compound RU-486 for the initials of Roussel Uclaf and the lab serial number of the compound—the 38,486th compound synthesized by Roussel Uclaf. The company applied for a patent for RU-486 in 1980 and received it the next year.
To lead the first human trials of RU-486, Baulieu recruited an old friend: the Swiss doctor Walter Hermann at Geneva’s University Hospital. In the initial trials, RU-486 successfully ended early pregnancies in nine of 11 patients. Baulieu, joined with Roussel Uclaf ’s CEO Dr. Edouard Sakiz, published these results in 1982. A larger trial followed in 1986, where Hermann found an 85 percent success rate in terminating pregnancies.
Other scientists began running tests of RU-486’s safety and effectiveness. A doctor in Stockholm, Marc Bygdeman, tested RU-486 in combination with a synthetic prostaglandin, which stimulated uterine contractions, decreased bleeding and sped up the pregnancy termination. This combination of medications proved to be more than 96 percent effective.
Roussel Uclaf conducted clinical trials on this combination of medications at two multicenter studies, with 24 locations and over 2,000 participants. These studies showed a 95.5 percent success rate in the first seven weeks of gestation.
After worldwide clinical trials involving 20,000 women, Roussel Uclaf applied to the French government for approval to market the drug for abortion in October 1987.
Pressure from the Antiabortion Movement
The approval of RU-486 sparked a fierce backlash from Catholic fundamentalists in France, led by the president of the French Bishops Conference Msgr. Albert Decourtray. They organized a campaign to pressure Roussel Uclaf and one of its major shareholders Hoechst AG in Frankfurt, Germany to withdraw the application.
Protesters flooded shareholders’ meetings and made inflammatory parallels between RU-486 and cyanide gas used in Nazi concentration camps. Baulieu, who was Jewish and fought in the French Resistance, was accused of being a Nazi. At one meeting, an antiabortion protester yelled at him, “You are turning the uterus into a crematory oven.” U.S. antiabortion activists Judie Brown of the American Life League and John Willke of the National Right to Life Committee supported the protests. In an attempt to pressure Hoechst, they published a story in the National Right to Life News inaccurately claiming that a predecessor of Hoechst had manufactured the poison gas used by the Germans during World War II.
Facing mounting pressure from the antiabortion movement, Roussel Uclaf nearly withdrew its application for government approval of RU-486, but Baulieu persuaded the company’s CEO Dr. Edouard Sakiz—an old friend—and others at the company to move forward with the application. The French government approved the medication in September 1988, but then religious extremists’ backlash turned violent.
That October, extremists teargassed a theater screening the Claude Chabrol film Une Affaire de Femmes, a film about Marie-Louise Giraud, a woman guillotined in 1943 for performing 27 abortions. Shortly after, Catholic extremists firebombed a Paris movie theater showing Martin Scorsese’s film The Last Temptation of Christ, reportedly enraged by a scene depicting Jesus and Mary Magdalene having sex.
Just three days later, under the pall of religious extremists’ violence, Roussel Uclaf’s board of directors voted 16-4 to withdraw RU-486 from the market—just one month after its approval. The company announced that its decision to withdraw had nothing to do with the drug’s side effects or efficacy, but with antiabortion protests and threats of violence. Baulieu confronted Sakiz, who told him, “You’re independent. You can go out and speak freely.”
Just days after RU-486 was pulled from the market, Baulieu attended the World Congress of Gynecology and Obstetrics in Rio de Janeiro, Brazil, where nearly 10,000 physicians and researchers were gathered. There, Baulieu and others denounced Rousell Uclaf’s decision to withdraw RU-486 from the market. Baulieu called it “morally scandalous,” while the dean of Columbia University School of Public Health Allan G. Rosenfeld called it “a tragic decision.” Baulieu called for a “public mobilization to demand RU-486 be made available.” Over 2,000 attendees signed a petition organized by Rebecca Cook, a professor and women’s rights attorney, objecting to Roussel Uclaf’s actions and demanding the company reverse its actions. Paris gynecologist Elisabeth Aubeny personally delivered the petition to Roussel Uclaf.
In response to protests of Roussel Uclaf’s decision to withdraw RU-486 from the market, the French government, which owned 36 percent of Roussel Uclaf stock, threatened to transfer the patent to another company in the interest of public health. French Health Minister Claude Évin famously explained at the time, “I could not permit the abortion debate to deprive women of a product that represents medical progress. From the moment government approval for the drug was granted, RU-486 became the moral property of women, not just the property of a drug company.”
Later, Évin said, “I was doing what I could to make sure France did not surrender to pressure groups animated by archaic ideologies.”
In response, Roussel Uclaf reversed its decision and put RU-486 back on the market. The company’s vice chairman, Pierre Joly, stated, “We are relieved of the moral burden weighing on our group. For us, the problem is now solved.”
Since that decision in the fall of 1988, French women have had access to the abortion pill mifepristone.
Why couldn’t the natural process be reversed by altering the balance of the same hormone that caused it to begin?
Étienne-Émile Baulieu
Expanding Medication Abortion Beyond France
Baulieu didn’t stop after winning the fight in France. He became a key international advocate for government approval of RU-486 in other countries, including the United States.
Baulieu and Sakiz were determined to get RU-486 to the United States because they believed that acceptance in the U.S. was key to its spread to developing countries where death rates were highest for unsafe abortions because of the lack of facilities that could safely perform abortions using traditional methods. Antiabortion extremists responded with stalking, harassing and defaming Baulieu. In 1991, after Baulieu gave a talk on RU-486 in Toronto, abortion opponents plastered the streets with posters saying, “Wanted, Etienne Baulieu for Genocide,” featuring his photograph. Nevertheless, he refused to be silenced and persisted. Later that year, he published a book, The ‘Abortion Pill’: Ru 486, A Woman’s Choice (Simon & Schuster), in which he predicted, “RU-486 will make its American entrance: science, good sense, and freedom will triumph.”
Despite decades of intense antiabortion opposition, the U.S. Food and Drug Administration approved mifepristone for abortion in 2000. Since then, over 7.5 million women in the U.S.—and many millions more across the world—have safely used the medication to end pregnancies on their own terms. In the wake of the Supreme Court’s reversal of Roe v. Wade, mifepristone has played a critical role in maintaining access to abortion, especially in states where medical providers inside the states are banned from offering abortion care.
Baulieu was clear about his purpose: to save women’s lives. In 1989, he said bluntly in the journal Science, “Women die in botched abortions. Two hundred thousand every year. RU-486 can save them.” For millions of women, mifepristone became a life-saving method of abortion, especially in environments where medical care is inaccessible or abortion is legally prohibited.
Baulieu also believed deeply in women’s dignity and bodily autonomy. Mifepristone enabled women to end unwanted pregnancies in a less invasive and safer way—one that did not require inserting instruments into women’s bodies, risking infection or perforation of the uterus.
“Rather than disrupt a pregnancy with a sharpened spoon or a suction tube, why couldn’t the natural process be reversed by altering the balance of the same hormone that caused it to begin?” he asked in a 2022 New Yorker interview. “My intention was to give women a choice that, through a pill, respects their privacy and physical integrity and allows them to totally avoid the aggression of surgery.”
Baulieu and others championed the development of mifepristone for uses beyond abortion—including for treatment of fibroids, endometriosis, postpartum depression and cancer. He supported its use in managing miscarriages and as a way to help to dilate the cervix to reduce the need for Caesarean births. His vision for mifepristone wasn’t just to end pregnancies but to protect women’s health and reduce medical intervention that too often harmed them.
Mifepristone Goes Beyond Just Abortion
The U.S. Food and Drug Administration has approved the use of mifepristone to treat Cushing syndrome and brain tumors (meningioma). While in many countries, mifepristone is approved to treat fibroids and endometriosis, antiabortion activists in the U.S fought to block development of mifepristone for anything beyond abortion.
Baulieu also envisioned that mifepristone could be used as a contraceptive, but it has yet to be approved for this use, although clinical trials are now underway in Europe.
In a July 2022 article in the New Yorker, Étienne-Émile Baulieu gave his view on why there has been tremendous opposition to abortion pills from the antiabortion movement: “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.”
Baulieu’s contributions were recognized around the world: He served as president of the French Academy of Sciences and was a member of the National Academy of Sciences in the United States. He won many awards, including the prestigious Lasker Award in 1989 and the Grand Cross of the Legion of Honor, France’s highest distinction, in 2023— just a year before his death.
Editor’s note: This article draws on Baker’s recent book, Abortion Pills: US History and Politics (Amherst College Press), available for free through open access. You may also enjoy this interview with Baker from November 2024, or this one from January.
