Early Medical Abortion in Australia: Policies, Practices, and Issues

This report provides a comprehensive overview of early medical abortion in Australia, tracing its development from the introduction of prostaglandin analogues in the 1970s to the present day. It details the evolution of medical abortion practices, highlighting the role of mifepristone and misoprostol, and discusses the initial restrictions imposed by the Australian government. The report analyzes the impact of the Abortions Providers’ Federation of Australia and female federal parliamentarians in lifting the ban on mifepristone and facilitating its commercial import. It examines the increasing demand for early medical abortion, the subsequent listing of mifepristone under the pharmaceutical benefits scheme, and the resulting adverse effects, including cost concerns and post-abortion care challenges. The report emphasizes the need for regulatory precautions and public health interventions to address the potential negative consequences associated with unauthorized access to abortion pills and the importance of post-operative management to ensure women's health and well-being. The study concludes by stressing the importance of the role of public health authorities to avoid the adverse consequences for women.

Running head: EARLY MEDICAL ABORTION IN AUSTRALIA
Early medical abortion in Australia
Name of the student:
Name of the university:
Author Note:

1EARLY MEDICAL ABORTION IN AUSTRALIA
Unwanted pregnancies are one of the rising public health concerns in the current age and
with the advancements in the health care industry progressing a little every day, there are a lot of
choices in the market for the mothers who do want to pursue with the pregnancy, and medical
abortion is one such choice for the unwilling mothers. Medical abortion can be described as the
phenomenon of using medical drugs or pills to terminate a pregnancy in the early stage (Trussell
et al., 2014). It is also known as non surgical abortion or medication abortion as abortifacient
drugs are used to terminate a pregnancy, early and easy. The concept of early medical abortion
was introduced in the 1970s when the prostaglandin analogue drugs were introduced, and the
very first abortifacient drug introduced in the market had been mifepristone, followed by
misoprostol in the 1980s (Sanhueza Smith et al., 2014).
According to a report by the World health organization, the safe abortion policy describes the
main purpose behind the medical abortion being used in the health care is to provide the women
the access to a safe and home- based option who do not have access to surgical interventions.
However, the exploitation of the medical abortion pills has raised a concern for the entire health
care industry (Baird 2015). Taking the Australian context under consideration, the abortion pills
like mifepristone is a widely used medical abortion pill, utilized abundantly in both the clinical
settings and in home based care scenario.
The more abortion techniques like the surgical dilation and curettage are considered to be
potentially risky for the health and safety of the women who undergo it, medical abortion pills on
the other hand had been a lesser evil, as it providers a much safer abortion experience to the
women. However, taking the Australian context into consideration, the restrictive obstructions by
the Federal Goods Administration legislation have been restricting the availability of the medical
abortion until 2006 (Baird 2015). And the medical abortion drugs have been allowed commercial

2EARLY MEDICAL ABORTION IN AUSTRALIA
import only in 2012 in Australia, and mifepristone had become a government subsidized
medication only in the year of 2013. Elaborating more on the development of the concept of
medical abortion in Australia, the initiation of the use of mifepristone occurred in the late 1990s
around in The New South Wales and Victoria, and the medication was tested as both emergency
contraceptive and abortifacient in the early phase. However, the availability of the medical
abortion was obstructed in the 1996, by the conservative government of PM John Howard,
creating a new legislation mandating special condition or the use of mifepristone, effectively
banning the use of the drug commercially (Costa et al., 2015). The movements of the Abortions
Providers’ Federation of Australia had been a slow but steady work in progress in facilitating the
entry of the medication as any other normal drug in Australia. The cumulative work of both the
federation and female federal parliamentarians was successful in the lifting the ban on
mifepristone around 2006, however the import allowance for the medication took a few years to
be materialized; although time gap served to facilitate the time consuming process of physicians
becoming authorized prescribers of the drug (Doran and Nancarrow 2015). Within the 2012, 200
doctors practising in Australia become authorized prescribers of abortifacient pills, and the
process of ensuring availability of abortifacient drugs in Australia was escalated a few more
steps.
In August, 2012, a subsidiary company in the name of Marie stopes was established which
could extract the authorized registration for the two abortifacient pills from the Therapeutic
Goods Administration, for mifepristone Linepharma and misoprostol GyMiso. Since the entry of
the medical abortion pills in the year 2012, it has been abundantly used in the market and the
alarming use of this drug in the present day scenario is one of the emerging public health
priorities (Grossman and Goldstone 2015).

3EARLY MEDICAL ABORTION IN AUSTRALIA
Even during the prolonged wait period for the authorized access for the drug, the perception
of the Australian women about the abortifacient drugs have been growing, and the restrictions
for the drug in Australia only fed the raging demand for the pills in the women. As soon as
medication was available in the Australian market in the 2013, the outrage for early medical
abortion began in Australia (Newton et al., 2016). Even before the drug was legitimately
available in the Australian markets, women in Australia were reported to obtain it from outside
channels. Many of the underage women had also been reported being arrested in the Australian
market due to unauthorized usage of abortion pills in Australia. After it was made available in
Australian market legitimately, mifepristone was the most exploited drug accessed through
unauthorized outside channels in abundance (O’Rourke, Belton and Mulligan 2016). With the
demand for early medical abortion extremely high in the Australian women, the drug soon
became enlisted under the pharmaceutical benefits scheme. However, with the extreme demand
and availability, there have been a number of serious adverse effects of this development of early
medical abortion in Australia. First and foremost, there have been serious concerns regarding the
cost effectiveness of the medication abortion, while some regions reported it to be cheaper than
the surgical alternative, where as in some regions it was reported to cost more than the surgical
alternative altogether (Baird 2015). Along with that post abortive care for the poorer women with
limited access to better health care and lifestyle standards suffered the consequences of
unwarranted use of abortion pills by the means of over the counter unauthorized purchase. The
complete absence of coordinated action by public health departments in Australia can one of the
most vital contributing factors behind the chaos in context of medical abortion pills and its
availability (Oppegaard et al., 2017).

4EARLY MEDICAL ABORTION IN AUSTRALIA
On a concluding note, the legitimate introduction of medical abortion pills in the Australian
market has undoubtedly been a blessing for the women to successfully and safely undergo
abortion without having to resort to surgical interventions. However, the need for regulatory
precaution and post operative management is crucial, which in case of unauthorized outside
channel access of the medication will not provide. The extreme cost for authorized usage of these
pills can be the reason propelling the Australian women belonging to low economic standards to
resort to over the counter usage. Hence, there is need for interference from the public health
authorities so that the pain staking process of medical development or medication abortion does
not eventually lead to adverse consequences for the women.

5EARLY MEDICAL ABORTION IN AUSTRALIA
References:
Baird, B., 2015. Medical abortion in Australia: a short history. Reproductive health matters,
23(46), pp.169-176.
Costa, C., Douglas, H., Hamblin, J., Ramsay, P. and Shircore, M., 2015. Abortion law across
Australia–a review of nine jurisdictions. Australian and New Zealand Journal of Obstetrics and
Gynaecology, 55(2), pp.105-111.
Doran, F. and Nancarrow, S., 2015. Barriers and facilitators of access to first-trimester abortion
services for women in the developed world: a systematic review. J Fam Plann Reprod Health
Care, 41(3), pp.170-180.
Grossman, D. and Goldstone, P., 2015. Mifepristone by prescription: a dream in the United
States but reality in Australia. Contraception, 92(3), pp.186-189.
Newton, D., Bayly, C., McNamee, K., Hardiman, A., Bismark, M., Webster, A. and Keogh, L.,
2016. How do women seeking abortion choose between surgical and medical abortion?
Perspectives from abortion service providers. Australian and New Zealand Journal of Obstetrics
and Gynaecology, 56(5), pp.523-529.
O’Rourke, A., Belton, S. and Mulligan, E., 2016. Medical abortion in Australia: What are the
legal and clinical risks? Is medical abortion over-regulated?. Journal of Law and Medicine, 221.
Oppegaard, K.S., Sparrow, M., Hyland, P., García, F., Villarreal, C., Faúndes, A., Miranda, L.
and Berer, M., 2017. What if medical abortion becomes the main or only method of first
trimester abortion? A roundtable of views. Contraception.
Sanhueza Smith, P., Peña, M., Dzuba, I.G., Martinez, M.L.G., Peraza, A.G.A., Bousiéguez, M.,
Shochet, T. and Winikoff, B., 2014. Safety, efficacy and acceptability of outpatient mifepristone-

6EARLY MEDICAL ABORTION IN AUSTRALIA
misoprostol medical abortion through 70 days since last menstrual period in public sector
facilities in Mexico City. Reproductive health matters, 22(sup44), pp.75-82.
Trussell, J., Nucatola, D., Fjerstad, M. and Lichtenberg, E.S., 2014. Reduction in infection-
related mortality since modifications in the regimen of medical abortion. Contraception, 89(3),
pp.193-196.