Abortion pill rules loosened at clinics in Australia
Australia’s drug regulator has accepted that it is safer for women to terminate pregnancy than to give birth, clearing the way for dramatically wider use of the abortion pill, RU486.
Abortion provider Marie Stopes International last month began offering women the choice of medical and standard surgical abortions at its nine clinics in NSW, Queensland, Victoria, Western Australia and the ACT.
The Therapeutic Goods Administration authorised the service to use RU486 under special licensing to give desperately ill people access to drugs not available in this country. The only provisos were that women had to be less than nine weeks pregnant and meet eligibility criteria covering standard surgical abortions, the group said.
The TGA denied it had watered down controls on RU486 — effectively banned in Australia until three years ago — but Marie Stopes said the federal regulator had agreed to broaden its definition of the “life-threatening or otherwise serious” illnesses that could be treated with foreign drugs under the Authorised Prescriber Scheme.
“We argued that pregnancy is a condition that may be both serious and life-threatening in particular circumstances,” said Jill Michelson, the organisation’s national clinical adviser.
“What is undeniable is the fact that the risk to a pregnant woman of induced abortion is much less than the risk of continuing a pregnancy through to delivery at term.
“And we argued that continuance of pregnancy would … also involve greater risk of injury to the physical and mental health of the pregnant woman, and a substantial risk that if pregnancy were not terminated and a child were born, the child would suffer from such physical and mental abnormalities as to be seriously handicapped.”
Anti-abortion groups slammed the move, with Right to Life Australia attacking both the TGA and Marie Stopes for making RU486 more widely available. Queensland GP David van Gend, who campaigned against RU486 for a group known as the World Federation of Doctors who Respect Human Life, disputed the scientific basis of the argument advanced by Marie Stopes.
“For an abortion clinic to argue that having a baby is so dangerous that you need to save women from that … is medically highly suspect,” Dr van Gend said yesterday from his surgery in Toowoomba. “Instead, you are at a far higher risk of suiciding after aborting a baby … I suspect only selective data has been looked at to make such a puzzling conclusion on abortion.”
Cairns obstetrician Caroline de Costa, who was at the forefront of the campaign to bring RU486 into the country, culminating in historic conscience votes of federal parliament in 2005 and 2006, questioned whether Marie Stopes’ expanded use of the drug was legal under Queensland law.
Professor de Costa suspended her own RU486 program, the country’s first, after a Cairns couple was charged with criminal offences in March for allegedly procuring contraband abortion drugs in Ukraine, which police say were used by 19-year-old Tegan Simone Leach to terminate her own pregnancy. No pleas have been entered in court proceedings.
Professor de Costa said the terms of her authorised prescriber licence from the TGA restricted her to treating women with existing medical conditions or a history of serious complications during the first trimester of pregnancy. She was yesterday seeking clarification from the agency and Marie Stopes on how RU486 could be provided more generally.
“It’s all very annoying, to put it mildly,” Professor de Costa said. “If they … are able to offer it to women using another variation of law, why can’t they share it with us? We all want the same thing in terms of helping women.”
Ms Michelson agreed her organisation’s legal advice differed from that of Professor de Costa, but said the TGA had done no more than respond to the case Marie Stopes had made that pregnancy could be “both a serious and life-threatening condition, and the risk of doing an abortion is much less than providing a full-term pregnancy”.