ATLANTA - The revolution did not happen.
When Kay Scott recalls September 28, 2000, she remembers thinking Georgia women would soon have safer, easier access to medical abortion providers.
That was the day the Food and Drug Administration approved the controversial abortion drug mifepristone, commonly referred to by its French name RU-486, for use in the United States. One year later, Ms. Scott finds herself disappointed the drug is not offered by as many physicians and clinics as she had expected.
"It's a slow start," said Ms. Scott, who has spent 21 years as the head of Planned Parenthood of Georgia, the state's largest family planning organization, offering counseling and medical referrals for women facing unintended pregnancies.
"It was expected to open up options and get more providers interested," Ms. Scott said.
For years, there have been only four cities in Georgia with any type of abortion services: Atlanta, Augusta, Savannah and Columbus. Only Atlanta and Augusta now have confirmed providers of mifepristone, according to Planned Parenthood.
The belief last year among Georgia abortion-rights groups was that women in cities such as Athens, Brunswick and Statesboro would be able to go to a local doctor for a medical, or pill-induced, abortion, instead of driving across the state to large cities with established surgical abortion providers.
While hard data on the number of mifepristone abortions will not be available for several years, leading abortion advocates and opponents concede that the drug's use during its inaugural year has not met expectations in Georgia or throughout the nation.
"There were arguments it was going to change the landscape of abortion, and we haven't seen it," said Laura Echevarria, the director of media relations for the National Right to Life Committee, an anti-abortion advocacy group.
The National Abortion Federation, a consortium of more than 400 abortion providers, reports that only one of its five affiliates in Georgia offers the drug. NAF has no affiliates in South Carolina.
At the same time, access to abortion has diminished throughout Georgia and the rest country for years.
The number of abortion providers nationwide has declined 14 percent, down from 2,380 in 1992 to 2,042 in 1996, the year of the most recent statistics. More than 85 percent of U.S. counties - home to 32 percent of all 15 to 44-year-old women - lacked an abortion provider in 1996, according to the Alan Guttmacher Institute, a nonprofit sexual and reproductive health organization.
One problem with mifepristone is that is requires at least three visits to a physician or clinic.
Abortion advocates and opponents note that other issues play a role in the hesitancy to offer mifepristone, such as the drug's potential side effects - including heavy bleeding.
Also, medical abortions such as mifepristone tend to cost more than surgical abortions. The Alan Guttmacher Institute reports the average cost for a medical abortion is $401, while the average cost of a surgical abortion is $355.
While a surgical abortion is performed in a matter of minutes, medical abortions with mifepristone can take several days to complete, Planned Parenthood officials said.
However, optimism for the drug's future remains.
NAF and Planned Parenthood say interest from patients and physicians is on the rise. NAF's national telephone hot line receives about 300 calls each month - 30 percent of the total calls - from people wanting to learn more about mifepristone.
Planned Parenthood of Georgia reports similar interest from women.
"Women are pretty savvy and want to know more about their options," said Leola Reis, the vice president of marketing and communication for Planned Parenthood of Georgia.
The drug's Web site, www.ru486.com, reports nearly 1 million hits per month. To date, NAF has taught education seminars on the drug for more than 3,000 health-care professionals.
Reach Brian Basinger at (404) 589-8424 or firstname.lastname@example.org.