Providers, pills and power: the US mifepristone abortion trials and caregivers' interpretations of clinical power dynamics

In this article, we examine retrospective accounts of health care workers w ho participated in the Population Council's clinical trials of mifepristone (RU-486) between October 1994 and September 1995. We conducted focus group interviews with 78 health care providers at 17 sites around the USA, after the clinical trials of mifepristone (RU-486) were completed. We discuss pr oviders' reflections upon power dynamics between them and their clients dur ing the clinical trials, as well as the implications of these changes on th e future provision of non-surgical abortion. Caregivers tend to see mifepri stone users as more 'empowered' than women having surgical abortions, and s ee themselves as losing power over their clients' abortion experiences. The y offer nuanced and ambivalent assessments of the role of empowerment in th eir clients' motivations and experiences as mifepristone users. They tend t o view the method as responsible for generating more egalitarian clinical i nteractions (and to endorse it as such), but the variation present in their evaluations demonstrates most clearly the power of caregivers' interpretat ive work in shaping clinical interactions. In assessing their experiences w ith mifepristone, caregivers demonstrate their interpretative work 'on' cli ents, which is enmeshed with their sense of who they are as medical workers .