Over the past thirteen years, many Australian women have used the drug mifepristone (RU486) to bring about a medical abortion.
Rather than undergoing a surgical abortion in a clinic or hospital operating theatre, a medical abortion is induced by taking drugs prescribed by a doctor.
But while mifepristone has been available in Australia since 2006, only some women, in some parts of the country, are able to access it. As I argue today in the Medical Journal of Australia, this needs to change.
Chequered history in Australia.
Mifepristone was developed in France in the 1980s and was soon being used for medical abortion in many parts of the world. Not, however, in Australia, where two male politicians did a deal that gave no consideration to women’s health needs.
In 1996 the anti-abortion Senator Brian Harradine, who held the balance of power in the Howard government, persuaded John Howard to pass legislation banning mifepristone in Australia, in return for his supporting Howard’s Telstra-privatisation bill.
Australian women were deprived of mifepristone for ten years, until a vigorous cross-country campaign resulted in the parliament’s overturning of the Harradine legislation in 2006.
But this didn’t mean the drug immediately became widely available. The political controversy made pharmaceutical companies reluctant to manufacture or market it.
Doctors, including myself, began personal applications to the Therapeutic Goods Administration (TGA) to import and use the drug in Australia – a lengthy and complicated process.
But by 2012, more than 80 doctors across Australia were prescribing the drug, and two large Australian studies covering more than 13,000 women showed it was safe and effective.
Still no drug company would take on distribution, so rights were given to Marie Stopes International Australia (MSIA). Marie Stopes has for many years provided women’s health care but this was a new role.
The TGA required Marie Stopes to develop an online three- to four-hour instruction module for doctors, who must complete this and register to prescribe mifepristone.
Pharmacies must also register to dispense the drug. But many have declined to do so.
GPs can manage medical terminations.
No other drug has this kind of special status, which is unnecessary. Doctors study pharmacology and drug prescription in medical school, and use this knowledge every day in clinical practice.
Singling-out mifepristone, as well as continuing to stigmatise abortions and the women who seek them, has also dissuaded doctors, especially general practitioners, from registering and using the drug.