Medical abortion

Clearinghouse Connector – April 2016


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Introduction

Safe access to abortion is good public health practice and plays an important role in supporting women’s health, agency and wellbeing. This Connector focuses on the introduction of medical abortion in Australia.

Available internationally since the late 1980s, medical (non-surgical) abortions have become available in Victoria since mifepristone was added to the Australian Pharmaceutical Benefits Scheme in 2013. Medical abortion offers an alternative to surgery for women in the early weeks of pregnancy. The most well-known method of medication abortion uses mifepristone in combination with another drug, misoprostol, to end a pregnancy up to nine weeks. Mifepristone is also known as RU486 or the ‘abortion pill’. 1

Access to medical abortion is associated with numerous potential benefits, including greater choice and access for women as well as lower costs. Registered GPs are able to provide medical abortions potentially improving access for women in regional and remote areas in particular.

Research is currently underway in Victoria to examine the extent to which the provision of medical abortion has really increased access to abortion for women. Ongoing barriers affecting women’s access to abortion may include stigmatisation (of patients and health professionals providing medical abortions), high costs and the multiple appointments required.


WHV thanks Dr Maggie Kirkman from the Jean Hailes Research Unit at Monash University who reviewed the psychosocial aspects of this Connector.


Overview

Unplanned pregnancy and abortion : what it means legally and socially Royal Women’s Hospital, 2011

Abortion procedures : medication Family Planning Victoria, 2015

Mifepristone (Mifepristone Linepharma) followed by misoprostol (GyMiso) for the termination of early pregnancy NPS MedicineWise, 2015

Medication abortion Children By Choice, 2013

Registration of medicines for the medical termination of early pregnancy Australia. Therapeutic Goods Administration, 2012


Introduction in Australia

Abortion law in Australia : it’s time for national consistency and decriminalisation Medical Journal of Australia, 2015

Early medical abortion using low-dose mifepristone followed by buccal misoprostol: a large Australian observational study Medical Journal of Australia, 2012

Early medical termination of pregnancy in Australia using Mifepristone (RU486) and Misoprostol [Slideshow] Marie Stopes Australia, 2013

PBS listing won’t guarantee access to RU486 : here’s why Crikey, 2013

Early medical abortion : safe and available Medical Journal of Australia, 2012

Early medical abortion : legal and medical developments in Australia Medical Journal of Australia, 2010


International models

Best practice in comprehensive abortion care Royal College of Obstetricians and Gynaecologists (UK), 2015

Medication abortion restrictions burden women and providers : and threaten U.S. trend toward very early abortion Guttmacher Policy Review, 2013

Home use of urine pregnancy tests for medical abortion follow-up The Lancet, 2015


Women’s experiences and decision-making

What it’s like to take the abortion pill : one woman’s experience with RU-486 The Age. Daily Life, 2014

Women’s experiences of having an early medical abortion at home Uppsala University, 2013

Medical versus surgical methods of early abortion: protocol for a systematic review and environmental scan of patient decision aids BMJ Open, 2015


Clinical guidelines

The use of mifepristone for medical termination of pregnancy Royal Australasian and New Zealand College of Obstetricians and Gynaecologist, 2013

Therapeutic termination of pregnancy : Queensland Maternity and Neonatal Clinical Guideline Queensland. Department of Health, 2013

Medical methods for first trimester abortion WHO Reproductive Health Library, 2016


Role of GPs

Safe access to abortion in Victoria : a win for women’s healthIntouch : Newsletter of the Public Health Association of Australia, 2016 – pp. 12-13

Conscientious objection not a license to deny treatment Australian Medical Association, 2013

Medical abortion access extended MJA Insight, 2015

How medical schools are failing to educate doctors in abortion care The Age. Daily Life, 2015

Abortion stigma : a reconceptualization of constituents, causes, and consequences Women’s Health Issues, 2011


Access in regional areas

Too much hush hush! : rural women tell their stories about access to abortion services In: Proceedings of the 13th National Rural Health Conference Australia. National Rural Health Alliance, 2015

Abortion, contraception still a problem for women in regional Victoria ABC Local Stories, 2013

Victorian rural women’s access to family planning services : survey report Rural services of the Women’s Health Association of Victoria, 2012


General access and affordability

Out-of-pocket costs in Australian healthcare : Children by Choice submission to the Community Affairs References Committee Children by Choice, 2014

Mobile phones can be used to optimize provision of medical abortion Cell Life, 2013

Why the $12 abortion pill RU486 costs Australian women $500 Daily Telegraph, 2013


Barriers and enablers

Finally, greater access to RU486 : now let’s collect abortion data The Conversation, 2013

Barriers and facilitators of access to first-trimester abortion services for women in the developed world: a systematic review Journal of Family Planning and Reproductive Health, 2015

A hard enough decision to make : anti-abortion activism outside clinics in the eyes of clinic users : a report on the comments made by BPAS services users Aston University, 2015

Risk of violence from the man involved in the pregnancy after receiving or being denied an abortion BMC Medicine , 2014


Related websites

Royal Women’s Hospital (Melbourne) Unplanned pregnancy and abortion : the facts

Family Planning Victoria Abortion procedures : medication

Children By Choice Medication abortion


Footnotes

  1. Family Planning Victoria (2015). Abortion procedures : medication. Victoria. Department of Health, Melbourne. - (Better Health Channel Factsheet). Accessed on 23/03/2016.

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