Early medical abortion using mifepristone should be safely available to all Australian women
Mifepristone, in conjunction with misoprostol, is extremely effective for medical abortion at any gestation and is now widely used throughout much of the world for this purpose.1-3 However, the history of the drug in Australia has been controversial. For 10 years from 1996, it was the object of federal legislation that allowed its use in Australia only with the special permission of the federal Minister for Health. Although this legislation was overturned in parliament in February 2006, mifepristone did not immediately become available in Australia — a drug company must receive approval from the Therapeutic Goods Administration (TGA) to import and market it.4 To date, this has not happened.
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- 2. Kulier R, Kapp N, Gulmezoglu AM, et al. Medical methods for first trimester abortion. Cochrane Database Syst Rev 2011; (11): CD002855. doi: 10.1002/14651858.CD002855.pub4.
- 3. Royal College of Obstetricians and Gynaecologists. The care of women requesting induced abortion. Evidence-based clinical guideline number 7. London: RCOG, 2011. http://www.rcog.org.uk/files/rcog-corp/Abortion%20guideline_web_1.pdf (accessed Aug 2012).
- 4. de Costa CM, Russell DB, de Costa NR, et al. Early medical abortion in Cairns, Queensland: July 2006 – April 2007. Med J Aust 2007; 187: 171-173. <MJA full text>
- 5. World Health Organisation Task Force on Post-ovulatory Methods of Fertility Regulation. Comparison of two doses of mifepristone in combination with misoprostol for early medical abortion: a randomised trial. BJOG 2000; 107: 524-530.
- 6. Schaff EA, Fielding SL, Westhoff C. Randomised trial of oral versus vaginal misoprostol 2 days after mifepristone 200 mg for abortion up to 63 days of pregnancy. Contraception 2002; 66: 247-250.
- 7. Fiala C, Winikoff B, Helstrom L, et al. Acceptability of home use of misoprostol in medical abortion. Contraception 2004; 70: 387-392.
- 8. Mulligan E, Messenger H. Mifepristone in South Australia — the first 1343 tablets. Aust Fam Physician 2011; 40: 342-345.
- 9. de Costa C. Medical abortion: the Australian experience. Expert Rev Obstet Gynecol 2012; 7: 25-30.
- 10. Goldstone P, Michelson J, Williamson E. Early medical abortion using low-dose mifepristone followed by buccal misoprostol: a large Australian observational study. Med J Aust 2012; 197: 282-286.
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