PARIS--- With quiet composure, the young French women reclined on couches and chairs at the Broussais Hospital waiting for a sign that the abortion pills they had taken were working.

A 21-year-old law student was reading a book when the cramps hit. She turned pale; the waves of pain were strong, but she weathered them with an analgesic from a nurse. Less than an hour later, she went into an adjacent bathroom with a bedpan. Her pregnancy ended as her uterus expelled the 5-week-old embryo. The nurse verified the bedpan contents and then sent the woman home.

During the past decade, a prescription drug regimen that induces an abortion has become an alternative to surgical abortion in France, Sweden, England and Scotland, and it is now awaiting final consideration by U.S. health officials.

But judging from the tepid European reaction, the drug mifepristone (or RU-486) is not likely to revolutionize access to abortion in the United States or to make abortion an at-home procedure women can opt for to be beyond the reach of violent protesters. After experience with 200,000 women choosing abortion by pill, the abortion pill in Europe :

Has not replaced surgery as the chief means of terminating pregnancy.

Has not increased the abortion rate -- in fact, rates have been declining.

Is not used by the majority of women who could use it, nor is it yet offered by most doctors.

Has not made abortion more "private." To the contrary, the pills are tightly controlled and given only under medical supervision at designated government clinics and hospitals.

"Don't expect too much," said David T. Baird, clinical research professor at the Royal Infirmary of Edinburgh, a large teaching hospital that was the main center in Scotland for human tests of RU-486. "I've been to meetings in the U.S., and people expect it will liberate women."

Instead, said Baird and other European clinical researchers, the pill has merely become another means of abortion -- with the distinct advantage that it can work for women in the very earliest stages of pregnancy. Until RU-486, a pregnant woman had to wait until the eighth week of pregnancy before she could have an abortion by vacuum aspiration, in which the contents of the uterus are suctioned out. Earlier than that, the embryo was too small for the vacuum method to work reliably.

Doctors Are Reluctant

In France, where it was developed and tested by the pharmaceutical firm Roussel-Uclaf, the method is chosen over surgery by about 70 percent of women who are less than five weeks pregnant, according to Elizabeth Aubeny, head of the family planning center at the Broussais Hospital and lead researcher there on human tests of RU-486. Under French law, RU-486 can only be prescribed through the fifth week of pregnancy.

But elsewhere in Europe, usage is much lower. In Scotland, where the abortion pill can be prescribed through the ninth week of pregnancy, only about 25 percent of women seeking abortions during that time choose it,according to the National Health Service. In Sweden, where the limit is seven weeks, the numbers have been climbing slowly from 7 percent of eligible women in 1993 to about 30 percent this year, according to Marc Bygdeman at Karolinska Hospital in Stockholm, where RU-486 was tested.

The main stumbling block, according to researchers, has been the reluctance of gynecologists to adopt the more complicated routine necessary to supervise patients using the pill. On the face of it, swallowing a pill might seem a simpler method of abortion than going through an operation -- and in Europe vacuum aspirations are usually performed under general anesthesia, not local anesthetics as in the United States. But the drug-induced abortion -- sometimes called a "medical abortion" -- involves taking RU-486 and then 48 hours later taking a dose of a synthetic prostaglandin, a substance naturally made by the lining of the uterus that provokes contractions.

The initial dangers of the French pill method of abortion -- there were three cases of heart attack, including one death, early on -- were related to the use of an injectable form of prostaglandin. Doctors now give a milder oral or suppository form, and there have been no adverse reactions in four years.

After taking the prostaglandin, women in Europe are required to wait under observation at the hospital or clinic for three or four hours. The French have found that 61 percent of patients abort during that time period, allowing doctors or nurses to examine the material expelled to verify that the abortion occurred. The embryo, although in an early stage,looks like a pinkish-white sea sponge.

If the woman does not abort in a few hours, she is sent home, where presumably the fetus will be expelled later. She must return to the medical center the following week for an ultrasound exam to make sure the abortion was complete. If it was not, she must immediately have surgery to remove the remaining material and prevent infection.

Even when the pill method works properly, there may be continuing bleeding for 10 days or more. All these steps mean a doctor must be prepared to provide extensive counseling, have the time and space to take care of patients for many hours and have backup ultrasound analysis and surgical care available.

The abortion pill method is very effective -- French figures show it works in 95.4 percent of pregnancies under 49 days. But that leaves 4.6 percent of women with a continuing pregnancy, incomplete abortion or excessive bleeding who will need surgery.

"It's more accepted by the women than by the doctors," said Aubeny. "For the physician it is less power. For the medical team it is more complicated. You have to . . . find a room where the woman will wait. We never know exactly at what time a woman will expel. With vacuum aspiration, everything is very clear."

Covering a `Technology Gap'

The pill method is also not simple psychologically for women. It requires personal involvement; the patient effectively administers her own abortion. There is significant pain -- although most women do not require analgesics -- and the woman sees the products of the expulsion.

"It is not for everybody," Aubeny said. "They must be comfortable with their body."

In a Scottish survey women reported the main reason for choosing abortion by pill was to avoid surgery and anesthesia and because they perceived it to be a more "natural" experience.

"They want to be aware of what's going on and be in control of the situation," Baird said. "They don't want people putting instruments inside their uterus. They see surgery as more invasive." Those who chose vacuum aspiration, he said, cited a wish to be unaware of the abortion procedure (that is, to be under general anesthesia) or to make only one visit to the hospital.

"I wanted to be conscious of what was happening," said one patient, a 17-year-old French girl with close-cropped fuzzy hair. She was resting in a reclining chair at the Broussais Hospital, with her mother at her side, awaiting the prostaglandin's effects. She was five weeks pregnant. "I don't want it to happen again," she said. "I'll pay attention next time -- it was an accident. Doing the abortion this way, I take more responsibility." It's better, she said, "not to be an ostrich about it."

Statistics show that women are requesting abortions earlier in pregnancy, Aubeny said. She and other researchers attribute this to wider use of nonprescription pregnancy test kits that allow women to know they are pregnant without having to wait for a doctor's appointment.

Early abortions using RU-486 "covered a gap in our technology" for women who make an early decision to abort, Aubeny said.

Awareness of the abortion pill's availability is not universal in Europe and may be higher in the United States, where it has been an object of controversy for so long. A nurse counselor at the Broussais Hospital, Christine Der Andreassian, fields frequent calls from women in the United States, such as a recent one from a Maryland woman who was three weeks pregnant and desperate to end the pregnancy immediately instead of having to wait another five weeks for a vacuum aspiration. The nurse explained that French law requires three months' residency before abortion services can be offered.

Aubeny predicts doctors will continue to feel pressure from women to provide RU-486, and now that the drug has been used without incident for four years, she believes it no longer has to be given under such strict monitoring conditions.

"It should be possible eventually for women to be given a choice of staying at the hospital or going back home to have the abortion," she said.