Concerns for women after SA closes two centres for surgical abortion

ABC News, 19/09/2019

Two of South Australia’s surgical abortion services have been shut down over the past 18 months, amid community concerns about the impact on women seeking care.

In January, services were relocated from the main abortion provider in the state, the Pregnancy Advisory Centre in Adelaide’s inner-western suburbs, moving all surgical abortions to the Queen Elizabeth Hospital (QEH).

SA Health is now looking at relocating the abortion service permanently to the QEH during the hospital’s redevelopment.

 

 

It’s time to lift the restrictions on medical abortion in Australia – Professor Caroline de Costa

The Conversation, April 1, 2019 6.13am AEDT

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. Professor Caroline de Costa argues in the Medical Journal of Australia that this needs to change.

National abortion data vital to safe, accessible services

MJA InSight+, Issue 10 / 18 March 2019

EXPERTS are in the dark about the extent to which abortion is contributing to Australia’s historically low teenage birth rate, prompting renewed calls for the collection of national abortion data.

In a Perspective published by the MJA, Professor Susan Sawyer, Chair of Adolescent Health at the University of Melbourne, and Dr Jennifer Marino, research fellow at the University of Melbourne, have called for the collection of abortion data in all states and territories, with national integration and analysis. They further called for publicly funded abortion clinics in all states and territories, with a feasible plan for access for people living in remote areas.

World Medical Association updates advice on medically indicated termination of pregnancy

Australian Medical Association, October 21, 2018

Revised advice to physicians on medically indicated termination of pregnancy has been issued by the World Medical Association.

At its recent annual General Assembly in Reykjavik, the WMA reiterated that where the law allows medically indicated termination of pregnancy to be performed, the procedure should be carried out by a competent physician.

However, it agreed that in extreme cases it could be performed by another qualified health care worker. An extreme case would be a situation where only an abortion would save the life of the mother and no physician was available, as might occur in many parts of the world. This amends previous WMA advice from 2006 that only physicians should undertake such procedures.

Study: Abortion Pills Ordered Online Were Safe, But None Came With Instructions

Rewire, Oct 10, 2017

New research shows that you can buy effective abortion pills online. This is a groundbreaking finding given that cost, travel, and onerous abortion restrictions often make in-clinic, first-trimester abortions inaccessible.

In the study, published Tuesday in the peer-reviewed journal Contraception, researchers ordered abortion pills from 20 websites, none of which required a prescription. Once the pills arrived in their homes, researchers sent the pills to a lab in good standing with the FDA to test the pills’ chemical contents.

The lab confirmed that all of the mifepristone, one of the two drugs used during a medication abortion, was within 8 percent of the advertised—and World Health Organization-approved—effective amount. The other drug, misoprostol, varied more considerably in how much of it was present in the pills the researchers received. Despite this variation, the researchers determined that the misoprostol pills would still be effective in causing an abortion.

Safety of Medical Abortion Provided Through Telemedicine Compared With in Person

Obstetrics & Gynecology, September 05, 2017
doi: 10.1097/AOG.0000000000002212

ABSTRACT:

OBJECTIVE: To compare the proportion of medical abortions with a clinically significant adverse event among telemedicine and in-person patients at a clinic system in Iowa during the first 7 years of the service.

METHODS: We conducted a retrospective cohort study. We analyzed data on clinically significant adverse events (hospital admission, surgery, blood transfusion, emergency department treatment, and death) for all medical abortions performed by telemedicine or in person at a clinic system in Iowa between July 1, 2008, and June 30, 2015. Data on adverse events came from required reporting forms submitted to the mifepristone distributor. We calculated the prevalence of adverse events and 95% CIs comparing telemedicine with in-person patients. The analysis was designed as a noninferiority study. Assuming the prevalence of adverse events to be 0.3%, telemedicine provision was considered to be inferior to in-person provision if the prevalence were 0.6% or higher. The required sample size was 6,984 in each group (one-sided [alpha]=0.025, power 90%). To explore whether patients with adverse events presented to emergency departments and were not reported, we conducted a survey of the 119 emergency departments in Iowa, asking whether they had treated a woman with an adverse event in the prior year.

RESULTS: During the study period, 8,765 telemedicine and 10,405 in-person medical abortions were performed. Forty-nine clinically significant adverse events were reported (no deaths or surgery; 0.18% of telemedicine patients with any adverse event [95% CI 0.11-0.29%] and 0.32% of in-person patients [95% CI 0.23-0.45%]). The difference in adverse event prevalence was 0.13% (95% CI -0.01% to 0.28%, P=.07). Forty-two emergency departments responded to the survey (35% response rate); none reported treating a woman with an adverse event after medical abortion.

CONCLUSION: Adverse events are rare with medical abortion, and telemedicine provision is noninferior to in-person provision with regard to clinically significant adverse events.