Medical abortion: it is time to lift restrictions

de Costa, Caroline M; Black, Kirsten I; Russell, Darren B

doi:10.5694/mja2.50060

Topics

Lifting the special drug status applied to medical abortion medications will enable equitable access

In 2016, the Committee on Economic, Social and Cultural Rights (a collection of human rights experts tasked with interpreting these rights), in its groundbreaking interpretation of the right to sexual and reproductive health, asserted that abortion services are an integral part of the right to health.1

1 James Cook University, Cairns, QLD
2 University of Sydney, Sydney, NSW
3 Royal Prince Alfred Hospital, Sydney, NSW
4 Cairns Sexual Health Service, Cairns, QLD

Correspondence: Caroline.DeCosta@jcu.edu.au

Acknowledgements:

We thank Philip Goldstone for his assistance in the preparation of this article.

Competing interests:

No relevant disclosures.

1. ESCR‐Net, International Network for Economic Social and Cultural Rights. General Comment No. 22 (2016) on the right to sexual and reproductive health (article 12 of the International Covenant on Economic, Social and Cultural Rights). ESCR‐Net, 2016. https://www.escr-net.org/resources/general-comment-no-22-2016-right-sexual-and-reproductive-health (viewed Feb 2019).
2. MSHealth. Product information‐MS‐2 Step. Melbourne: MS Health, 2014. http://www.mshealth.com.au/products (viewed Feb 2019).
3. Grossman D, Goldstone P. Mifepristone by prescription: a dream in the United States but reality in Australia. Contraception 2015; 92: 186–189.
4. Chen MJ, Creinin MD. Mifepristone with buccal misoprostol for medical abortion: a systematic review. Obstet Gynecol 2015; 126: 12–21.
5. Gatter M, Cleland K, Nucatola DL. Efficacy and safety of medical abortion using mifepristone and buccal misoprostol through 63 days. Contraception 2015; 91: 269–273.
6. World Health Organization. Safe abortion: technical and policy guidelines for health systems. 2nd ed. WHO; 2012. https://www.who.int/reproductivehealth/publications/unsafe_abortion/9789241548434/en (viewed Feb 2019).
7. Summers A. Abortion and federal policy: here are the facts. ABC, The Drum 2013; 12 June. https://www.abc.net.au/news/2013-06-12/summers-abortion/4748872 (viewed Oct 2018).
8. de Costa CM. Medical abortion for Australian women: it's time. Med J Aust 2005; 183: 378–380. https://www.mja.com.au/journal/2005/183/7/medical-abortion-australian-women-its-time
9. de Costa CM, Russell DB, de Costa NR, et al. Introducing early medical abortion in Australia: there is a need to update abortion laws. Sex Health 2007; 4: 223–226.
10. Dickinson JE, Jennings BG, Doherty DA. Mifepristone and oral, vaginal, or sublingual misoprostol for second‐trimester abortion: a randomized controlled trial. Obstet Gynecol 2014; 123: 1162–1168.
11. Goldstone P, Michelson J, Williamson E. Early medical abortion using low‐dose mifepristone followed by buccal misoprostol: a large Australian observational study. Med J Aust 2012; 197: 282–286. https://www.mja.com.au/journal/2012/197/5/early-medical-abortion-using-low-dose-mifepristone-followed-buccal-misoprostol
12. Mulligan E, Messenger H. Mifepristone in South Australia — the first 1343 tablets. Aust Fam Physician 2011; 40: 342–345; quiz 351–352.
13. Lee RY, Moles R, Chaar B. Mifepristone (RU486) in Australian pharmacies: the ethical and practical challenges. Contraception 2015; 91: 25–30.
14. Hyland P, Raymond EG, Chong E. A direct‐to‐patient telemedicine abortion service in Australia: retrospective analysis of the first 18 months. Aust N Z J Obstet Gynaecol 2018; 58: 335–340.
15. Downing S, McNamee H, Penney D, et al. Three years on: a review of medical terminations of pregnancy performed in a sexual health service. Sex Health 2010; 7: 212–215.
16. Goldstone P, Walker C, Hawtin K. Efficacy and safety of mifepristone‐buccal misoprostol for early medical abortion in an Australian clinical setting. Aust N Z J Obstet Gynaecol 2017; 57: 366–371.
17. Dickinson JE, Brownell P, McGinnis K, et al. Mifepristone and second trimester pregnancy termination for fetal abnormality in Western Australia: worth the effort. Aust N Z J Obstet Gynaecol 2010; 50: 60–64.
18. Shankar M, Black K, Goldstone P, et al. Access, equity and costs of induced abortion services in Australia: a cross‐sectional study. Aust N Z J Public Health 2017; 41: 309–314.

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