Mifepristone is safe and reliable, so why the ban?

Australian authorities have had little success in keeping illicit drugs such as heroin and ecstasy out of the country, but a pharmaceutical providing a safe alternative to surgical abortion has been successfully deemed contraband. The importation of mifepristone, or RU486 as it was previously known, is a designated restricted and may not even be evaluated or listed without the prior written approval of the (relevant) minister.

The circumstances around the introduction of what is effectively a ban on the introduction of mifepristone or any other medicines that could be used as abortifacients, is a prime example of how opposition to a woman’s right to privacy and choice harms individual health, public health, scientific research and medical advances.

Women in France, New Zealand, Sweden, the United States and Great Britain have access to mifepristone but Australian women are denied that choice thanks to the efforts of former conservative Tasmanian Senator Brian Harradine. In 1996 he, and other anti-abortion crusaders in the Federal Parliament, managed to persuade those in the two major parties to specifically ban mifepristone, using spurious heath risk arguments.

Even then, mifepristone had been safely used in France for a decade. It works by blocking progesterone - a hormone necessary for the establishment and maintenance of pregnancy. Prior to and since its introduction, in an attempt to scare women and restrict access to the medication, anti-choice forces have made unfounded claims that mifepristone endangers the lives and health of women. Yet the evidence clearly shows that mifepristone is safer than the already safe surgical abortion procedure, and both are more than 12 times safer than carrying a pregnancy to full term and birth.

Medical, as opposed to surgical abortion, is preferred by many women overseas because, as well as being safe, it is non-invasive, avoids surgical and anaesthetic risks and can occur very early in pregnancy. It is also more private, less costly and experience overseas shows it would likely replace 50 per cent of the surgical abortions currently being conducted here. It would be particularly useful for the many women in rural areas where terminations are no longer provided by GPs or hospitals.

The World Health Organisation,the Australian Medical Association, the Royal Australian College of Obstetricians and Gynaecologists and the Public Health Association of Australia all now agree that mifepristone should be made available under medical supervision. The Royal College of Obstetricians and Gynaecologists in the United Kingdom recommend the non-surgical in preference to surgical abortion for women with pregnancies of 49 days or less.

The Health Minister says the risk is that the termination may take place at home. Of course. This is the advantage of a medical abortion and, provided there is access to emergency care in the rare event of complications, this is perfectly safe. The vast majority of women who use this process for early pregnancy termination will not see products of conception because they are so small and passed along with accompanying blood loss.

Women who have medical terminations will experience bleeding, and often nausea, cramping, vomiting and so on. But more than 99 per cent of women using mifepristone do not report any adverse drug reaction. In fact reactions to drugs, such as over-the-counter pain relief medicines, like Tylenol are hundreds of times more common than are problems with mifepristone.

Anti-reproductive choice, high moral ground defenders of religious views on the matter of abortion, held sway in the federal parliament in 1996 and probably still does but it ought to be increasingly difficult to defend the RU486 ban when abortion is legal in Australia and after two million women worldwide have now used this alternative safely and effectively.

We can expect the anti-choice movement to use lies and half truths and purport to be protecting the welfare of women if their aim is to stop abortion. Some even argue that access to mifepristone would make it “too easy” for women and increase overall numbers of abortions. Experience overseas is that the availability of mifepristone made no difference to termination rates.

Should it seem as if the government is moving towards letting women have this choice, there will undoubtedly be calls to impose onerous and medically unnecessary restrictions on mifepristone’s availability in an attempt to make it virtually impossible for any doctor to actually prescribe the drug.

When mifepristone was being considered for use in the United States, there were demands for a registry of doctors who were prescribing the drug, specialised training and special conditions on the facilities in which the drug could be administered. While none of these were implemented at the time, there have been ongoing political attempts to introduce these excessive limits on the use of mifepristone. Given Australian anti-choice advocates' inclination to follow the well-worn paths of their US counterparts, we are likely to see the same tired suggestions here.