Étienne-Émile Baulieu, the French biochemist and physician who was often called the father of the abortion pill — and who was also known for his pioneering studies on the role of steroid hormones in human reproduction and aging — died on Friday at his home in Paris. He was 98.
His wife, Simone Harari Baulieu, confirmed the death on social media.
Dr. Baulieu’s early research focused on hormones, notably DHEA, one of the key hormones in the adrenal gland, as well as groundbreaking work on estrogen and progesterone. But it was his development in the early 1980s of the synthetic steroid RU-486, or mifepristone, that thrust him onto the public stage.
Unlike the morning-after pill, which is used after sex to delay ovulation, RU-486 works as a kind of “anti-hormone,” in Dr. Baulieu’s words, by blocking the uterus from receiving progesterone, thereby preventing a fertilized egg from implanting.
Taking the drug with misoprostol, a drug that causes uterine contractions, essentially triggers a miscarriage, enabling women to terminate early pregnancies without surgery.
The two-dose treatment has been proved safe and highly effective — with a success rate of about 95 percent — and is commonly used in many countries; in the United States, medication abortions accounted for more than 50 percent of all abortions in 2020. After the 2022 Supreme Court decision overturning Roe v. Wade, demand for the pills surged, and abortion opponents began seeking ways to ban the drug nationwide.
Controversy over RU-486 began as soon as its release in the 1980s. Dr. Baulieu developed the drug in partnership with the French drug company Roussel-Uclaf, where he was an independent consultant.
After RU-486 was approved for sale in France in 1988, Roussel-Uclaf was briefly forced to pull it from the market after protests from the Catholic Church and the threat of boycotts, before the French government persuaded the company to reverse its decision.
Opponents of abortion assailed RU-486 as dangerous and immoral, calling it a “death pill” and a “chemical coat hanger.” As recently as 1996, four years before the pill was officially approved for use in the United States, the Vatican called it a “serious threat to human life” and “the pill of Cain.”
From the beginning, Dr. Baulieu was a vociferous public presence in the crusade for acceptance of the abortion pill; at one point he held an impassioned news conference at the World Congress of Gynecology and Obstetrics in Rio de Janeiro to condemn Roussel-Uclaf after its decision to pull RU-486 from the market.
“His breezy, almost brash manner and hyperkinetic nature give him the air more of a populist politician than of a meticulous medical researcher,” Steven Greenhouse noted in a 1989 New York Times profile of Dr. Beaulieu.
Yet Dr. Baulieu, who had no financial stake in the abortion pill’s success, insisted that he was basically “a medical doctor who does science,” he told the journal Science in 1989. “I want to help women. I have not dedicated my life to abortion. I am not anti-children.” But, he continued, “Women die in botched abortions. Two hundred thousand every year. RU-486 can save them.”
Dr. Baulieu preferred to call the pill a “contragestive” rather than the more loaded label abortifacient, because it blocks gestation. “I resent when people present the very early interruption of pregnancy as killing a baby, morally or physically,” he told The Times in 1989. “I think it’s a crime to say that.”
In recent years, Dr. Baulieu, a former president of the French Academy of Sciences and a member of the National Academy of Sciences in the United States, returned to studies of other hormones. In 1995, he and a team of colleagues published a study that found that the sex hormone progesterone might play a surprising role in fighting certain nerve diseases.
He also grew increasingly interested in the role of hormones in aging and what he called “the longevity revolution,” with its far-reaching consequences for society. He was especially interested in how the steroidal hormone DHEA, which he studied early in his career, affects the aging process, and whether supplements might lead to longer, healthier lives.
“Healthy aging is one of the main goals of humanity,” he told the television interviewer Charlie Rose in 2007; a year later he created the Institut Baulieu, for him and his team from Inserm, the French national health institute, to study aging issues, including the treatment of Alzheimer’s disease and other dementias.
“My attitude is that we should work to keep extending life and life expectancy,” he told the magazine France-Amérique in 2022. “But the most important thing is to preserve optimum brain function in order to live as long as possible in full possession of our faculties.”
Étienne-Émile Baulieu was born Étienne Blum on Dec. 12, 1926, in Strasbourg, France, to Jewish parents. His father, Léon Blum, was a doctor specializing in kidney disorders and was one of the first to test insulin in the treatment of diabetes. He died when Étienne-Émile was 3. Soon after, his mother, Thérèse (Lion) Blum, a lawyer and pianist, moved him and his two younger sisters first to Paris and then to a town near Grenoble after the outbreak of World War II.
Étienne-Émile joined the Communist Party as a teenager, and took the name Émile Baulieu when acquiring false papers after joining the French Resistance. He eventually quit the party in 1956, after the Soviet invasion of Hungary.
He pursued a medical career: He became a doctor in 1955 after studying at Faculté de Médecine in Paris and received his Ph.D. in biochemistry in 1963 at Faculté des Sciences in Paris.
Dr. Baulieu was named director of Inserm in 1963, and in 1970 he became a biochemistry professor at the Faculté de Médecine de Bicêtre, affiliated with Université Paris-Sud. He was also deeply involved in legalizing birth control in France in 1966 as part of a government committee appointed under President Charles de Gaulle.
As a young scientist on a fellowship at Columbia University in the 1950s, he met Gregory G. Pincus, the inventor of the birth control pill, who became a mentor and who inspired Dr. Baulieu to pursue research into contraception and pregnancy regulation.
His work on contraception began in the 1970s, focusing with his team of Inserm researchers on isolating the receptors within the cells of the uterus that receive progesterone, which signals the uterus to hold onto the fertilized egg. The goal was to find chemical “progesterone impostors” that “would latch onto the receptors and occupy them,” according to the 1989 Times profile, thus preventing impregnation.
“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 an interview with Lauren Collins of The New Yorker in 2022.
Clinical tests of RU-486 began in 1982 in Switzerland. The political firestorm was intense from the start. In his book “The Abortion Pill: RU-486, A Woman’s Choice” (1992, written with Mort Rosenblum), Dr. Baulieu recounted the volumes of hate mail he had received, some of which compared him to Hitler. Once, on a visit to the United States, Dr. Baulieu had to travel with a bodyguard.
He nevertheless lobbied hard for the pill’s acceptance. Despite intense pressure from opponents in France and abroad, the pill eventually gained traction after its initial approval in 1988. The U.S. Food and Drug Administration formally approved RU-486 in 2000.
“It is always tragic when politics takes the most vulnerable hostage — in this case, women,’’ Dr. Baulieu told France-Amérique. “I have never been ‘for abortion,’ but rather ‘for the right to abortion.’ I support life and women’s right to choose.”
He also expressed outrage at the Supreme Court’s Dobbs decision, which overturned Roe v. Wade. “It’s scandalous,” he told The New Yorker in 2022. The decision, he said, “calls into question a fundamental right of women that we would have thought was legally, politically and morally guaranteed.”
In 1996, Dr. Baulieu became a member of the National Consultative Ethics Advisory Committee for life sciences and health. A professor emeritus at the College of France, he received the prestigious Lasker Award for his medical research in 1989. In 2023, he was awarded the Grand Cross of the Legion of Honor, France’s highest distinction, held by just 67 other people. His other books include “The Antiprogestin Steroid RU 486 and Human Fertility Control” (1985), written with Sheldon J; Segal, and “Hormones, From Molecules to Disease” (1990), with Paul A. Kelly.
He lived in Paris with his second wife, Simone Harari Baulieu, whom he married in 2016. In addition to her, he is survived by two daughters, a son, eight grandchildren and nine great-grandchildren. His marriage to Yolande Compagnon ended in divorce.
Despite the many ups and downs in his long, ardent campaign to promote women’s reproductive rights and ensure that RU-486 was widely available to those in need, Dr. Baulieu seemed determined to focus on the bigger picture. “You can’t hold back scientific progress,” he told The Times in 1989. “You can’t put it back in the drawer.”
Ash Wu contributed reporting.
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