& This is What Planned Parenthood Claims Is Safe When Done as a Telemed Proceedure
The "audit" of nearly 7000 abortions performed in South Australia in 2009 and last year found that 3.3 per cent of women who used mifepristone in the first trimester of pregnancy - when most elective terminations occur - later turned up at hospital emergency departments, against 2.2 per cent who had undergone surgery.
Federal regulator the Therapeutic Goods Administration says 11,173 prescriptions have been issued for mifepristone since its introduction in 2006. About 100,000 abortions a year are carried out in Australia.
South Australia has one of the strongest take-ups and more than a fifth of terminations done there are with the abortion pill. In their study, published by the GPs' journal Australian Family Physician, Adelaide-based doctors Ea Mulligan and Hayley Messenger reviewed most of the 9000-odd terminations carried out in the state in 2009 and last year.
They found the incidence of serious complication was also higher for medical abortion during the first trimester of pregnancy. Two of the 5823 surgical patients suffered severe haemorrhage, involving the loss of more than a litre of blood. This equated to a rate of one in 3000, the study found. Four of the 947 women who had medical abortions had the same problem, lifting the rate to one in 200.
Hospital admission for infection was one in 1500 for early surgical abortion, against one in 480 for medical abortions, the study found. Dr Mulligan pointed out that the number of complications was so small it could be regarded as statistically insignificant.
But complications from second-trimester medical abortions - often done after the detection of fetal abnormality - happened in up to 33 per cent of the cases reviewed.
Dr Mulligan, a registered medical specialist and academic, said the complication rate for both forms of abortion was low.
But she conceded that Australian doctors were still on a "learning curve" with mifepristone.
"My thinking is that as we get more used to using this drug, that follow-up surgical intervention will come down ... we are kind of at the beginning of the learning curve," she told The Weekend Australian.
However, anti-abortion groups said the findings called into question the safety of medical abortion. "We always said that taking RU486 would have a very deleterious effect on women's health ... taking a pill seems very easy, but what we are seeing here is there can be quite a lot of complications," said Margaret Tighe, of Right to Life Australia.
Cherish Life Queensland president Teresa Martin said the study "blows out of the water" arguments advanced by mifepristone pioneer Caroline de Costa for wider availability of the drug.
Currently, it can be prescribed only by the 102 doctors licensed by the TGA, under strict conditions.
Professor de Costa, the Cairns-based obstetrician who set up the country's first mifepristone program after playing a lead role in overturning a ban on its importation, said the complication rates in SA were low overall.
"I would emphasise ... that these are the first figures for a procedure that is new for the people doing it and the abortion process occurs at home," Professor de Costa said.
"Therefore, it is not surprising that a small number presented to ED (emergency departments) if they were concerned ... about the amount of pain and/or bleeding."
Australian protocols generally call for a 200mg tablet of mifepristone to be administered by an authorised prescriber in a hospital or medical clinic. The process is completed, within 48 hours, with another drug called misoprostol, causing the woman to miscarry, usually at home.
Differences in the law on abortion vary by state and this plays out in the way women are treated. In SA, almost all abortions are performed in public hospitals and both mifepristone and misoprostol are administered in them.
Queensland, however, maintains a ban on elective abortion in its public health system - meaning most terminations are done at a handful of medical clinics.
While the state has twice SA's population, there are only 15 authorised prescribers of mifepristone in Queensland, one more than in SA. NSW and Victoria have 30 each and the ACT six.
Labels: Planned Parenthood, Telemed Abortions
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