Health Minister's RU-486 Advice Skewed, Incomplete and Ignores the Needs of the Majority of Australian Women
AMA Executive Councillor and senior obstetrician, Dr Andrew Pesce, said today that advice on the safety of the pregnancy termination drug RU-486 provided to the Health Minister by the Office of the Chief Medical Officer (CMO) appears unnecessarily confined to one hypothetical situation, not allowing a full recommendation based on the implications of restriction of the drug for all Australian women.
Dr Pesce said the RU-486 debate is about safety and choice for all Australian women, and the advice to the Minister fails to acknowledge that women in rural and remote Australia could and would only ever have access to the prescription-only drug under the supervision and advice of a doctor who would be responsible for managing the entire termination process.
"The advice to the Health Minister is correct in pointing out that it would be potentially unsafe for some women to use RU-486 if locally available facilities for monitoring and following up these women were inadequate, but the decision of the safety of such a treatment option can only be made on the basis of information and advice from a local doctor familiar with local facilities and, where necessary, surgical backup," Dr Pesce said.
"My colleague, Dr Andrew Child, was asked to provide advice for a particular group of women in a particular circumstance - an extreme and rare circumstance - and that is what he has done," Dr Pesce said.
"The fact of the matter is that a doctor with a patient in that particular rare circumstance would advise against the use of RU-486 because there was no coordination or back-up.
"Coordination and back-up is needed for any form of medical or surgical intervention, not just termination of pregnancy. This is and will always be the responsibility of the local doctor.
"The reality is that one out of every six pregnancies in Australia ends in a spontaneous abortion. Of these, around half will need an urgent surgical intervention (dilatation and curettage) to remove tissue that remains in the uterus. These women live in urban, outer-urban, rural and remote Australia.
"Most rural communities have access to this kind of surgical care but they do not always have access to surgically-induced abortion as the health services choose for a wide variety of reasons not to provide this service.
"However, for the small number of women (five per cent for early abortions and six per cent for later abortions) who would need surgical intervention following the use of RU486, these back-up services would be relatively easy to access in a safe and timely manner.
"With RU-486, the AMA is calling for the drug to be licensed for use in Australia in the same way as any other drug and that it should be subject to all the normal controls.
"In the same way as any other drug, it should be available as an option for choice by doctor and patient.
"The advice released by the Minister today is skewed to the risk in a specific situation, but the worst case scenario is not a fair way to present the reality of the risks and benefits of RU-486.
"With RU-486, I think the best advice is to put the patient first and give Australian women safe choices when they find themselves in a position to make one of the hardest decisions of their life," Dr Pesce said.