Under new regulations, Australian doctors and nurses will be allowed to prescribe the pregnancy termination pill and all pharmacists permitted to stock it, the slashing of the red tape around who can prescribe and dispense the drug enabling medical abortions to become a real option for women who want them. It will also encourage thousands more health professionals to provide access to the two-part medication.
Current obstacles for women needed the intervention are that only about 10% of doctors and 30% of pharmacists are currently certified to deal with the pill – known as MS-2 Step in Australia, or RU486 in other countries.
The Sydney Morning Herald reports that the lifting of the current restrictions from August means health practitioners don’t have to undergo special certification and registration through the drug’s importer, the non-profit MS Health.
All pharmacies will be able to dispense MS-2 Step as they would any other medication, while nurse practitioners will be able to prescribe it for the first time once the measure is enacted by states and territories.
Nurse practitioners represent about 1% of nurses – they are endorsed by the Australian nursing board and have a master’s degree – and can work in settings as varied as sexual health clinics, community centres, Aboriginal community-controlled health organisations, small regional hospitals and mobile services for homeless people.
The abortion pill was first approved for use in Australia in 2006 after a fierce political debate that required a conscience vote in parliament to strip then-health minister Tony Abbott of his veto power over the drug. But it wasn’t until 2012 that MS Health started importing it and medical abortions became more widely available.
This week’s announcement of loosened restrictions represents the first major regulatory change since the pill was registered by the Therapeutic Goods Administration (TGA) a decade ago and is a significant step towards the current government’s election promise to deliver equitable abortion access after it dropped its 2019 policy to force public hospitals to perform surgical terminations.
Medical abortions are caused by a two-tablet course of misoprostol and mifepristone and can be taken up to nine weeks into a pregnancy.
Uptake has steadily increased since the medication was added to the Pharmaceutical Benefits Scheme in 2013, but surgical terminations, which can be performed up to 24 weeks’ gestation, depending on the state and territory, have remained more common, according to available data.
However, surgical abortions are more expensive, are not offered at many public hospitals, and rules vary, depending on the jurisdiction, meaning women often have to travel hundreds of kilometres to access one.
A 2021 study found Australia trailed comparable nations in terms of both registered prescribers and medical abortion rates; about 23% of Australian abortions were medical terminations, compared with 39% in the United States and 73% in Britain.
Philip Goldstone, the medical director of MS Health which made the application, said previous restrictions controlling who was certified had created “huge logistical barriers for patients wanting to access medical abortion services”.
“We’re hoping this will broaden access for patients in Australia. More GPs will immediately be able to prescribe medical abortion, rather than the current limited one in 10. When a patient is prescribed, they’ll be able to take it to any pharmacist, like any other medicine that’s registered in Australia,” he said.
He said MS-2 Step was unfamiliar to medical practitioners when it was first introduced in Australia. “We’ve now had a decade of experience with this medicine, we know that it’s safe and effective, and we know most health practitioners have some knowledge and awareness of the process and how to provide care for patients,” he said.
Sydney Morning Herald article – Medical abortion pill access expanded in landmark move (Open access)
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