It's Time Australian Women Had Access To Medical Abortion
A senior obstetrician says Australian women should have access to medical abortion using mifepristone (formerly known as RU-486), bringing their choices in line with women in other countries.
In the current issue of the Medical Journal of Australia (MJA), Professor Caroline de Costa, of the Department of Obstetrics and Gynaecology at James Cook University, says availability of the drug in Australia might largely overcome many of the inequities of access to abortion.
"Availability of the drug is critical for many women in rural areas and women in some ethnic groups whose access to surgical abortion is limited," Professor de Costa says.
"Medical abortion should be an option for all Australian women.
"The overseas experience has shown it to be a safe, effective and acceptable alternative to surgical abortion.
"Medical abortion must be prescribed and administered by a medical practitioner with appropriate experience after discussion with the woman and after informed consent has been obtained."
In the MJA, Professor de Costa tells the story of a young mother with two children under the age of three, both delivered prematurely because of her severe pre-eclampsia, who requested termination of another pregnancy.
She was from a rural community and her only access to a termination meant travelling several hundred kilometres to a private clinic.
The cost of this was beyond her means, and she remained pregnant.
Once again, she developed pre-eclampsia, necessitating an emergency caesarean at 26 weeks.
The infant died within 24 hours, and the woman spent several days in a high-dependency unit, covered this time by the public purse.
"This woman's story could have been very different if Australian women had access to mifepristone, a drug which is safe, effective, cheap to produce, and now widely used overseas for medical abortion," Professor de Costa says.
"Medical termination with this drug is available to women in North America, the United Kingdom, much of Western Europe, Russia, China, Israel, New Zealand, Turkey and Tunisia, but not Australia.
"There is no need for the woman to remain under medical observation; the abortion process can occur at home, but the woman must have access to 24-hour emergency help if needed," she says.
In 1999, the International Federation of Obstetrics and Gynaecology stated that 'after appropriate counselling, a woman has the right to have access to medical or surgical induced abortion, and … healthcare services have an obligation to provide such services as safely as possible'. This view was supported by the World Health Organisation.
While acknowledging the desirability of reducing the high number of abortions carried out in Australia each year, Professor de Costa says, given the complex and compelling nature of human sexuality, unwanted pregnancies will continue, and Australian women will continue to seek safe, legal abortion.
"The safety of abortion has been shown to be directly related to how early in pregnancy it is performed," she says.
"The case for medical abortion in Australia should be judged not on political grounds but solely on evidence-based medical criteria.
"People have to remember that abortion is legal in Australia, which means that this emotive discussion is all about the scientific evidence for medical abortion, not the legality of it," Professor De Costa says.
The Medical Journal of Australia is a publication of the Australian Medical Association.
CONTACT: Professor Caroline DE COSTA 0407 010 015 / 07 4032 2695
Judith TOKLEY, AMA Public Affairs, 0408 824 306 / 02 6270 5471