Medication or medical abortion is the use of drugs to end an early pregnancy. There are different drugs available for this but the most effective and best-known is mifepristone, also known as RU486.
Mifepristone (also sometimes called 'the abortion pill') is a medication that blocks the hormone progesterone, which is needed to sustain a pregnancy. Mifepristone has been used in combination with other medications called prostaglandins for medical abortion since 1988 in France and China and since the early 1990s in the United Kingdom and Sweden. In September 2001 mifepristone was approved for distribution in New Zealand, and is under limited but increasing availability in Australia. Millions of women worldwide have safely used mifepristone regimens for termination of pregnancy and it is named in the World Health Organisation Model List of Essential Medicines.
Mifepristone is only available in Australia for terminations on pregnancies less than nine weeks gestation. If you are further along than nine weeks and are considering abortion, you'll need to look at a surgical procedure.
If you're under nine weeks gestation, feel comfortable with having a miscarriage at home, can access a clinic that provides mifepristone and are keen to avoid a surgical procedure if possible, then a medication abortion may be a suitable option for you.
Mifepristone blocks the hormone progesterone, which is needed to sustain a pregnancy. This results in:
Mifepristone is used in combination with another medication, a prostaglandin analogue called misoprostol. Misoprostol causes the uterus to contract and helps the pregnancy tissue to pass.
Approximately 95% of women will have a complete abortion when using mifepristone/misoprostol in pregnancies less than nine weeks gestation. The remaining women will need a suction abortion either because of ongoing or excessive bleeding, an incomplete abortion (tissue remains in the uterus but there is no growing embryo), or an ongoing pregnancy (which occurs in less than 1% of cases).
Although mifepristone (or RU486) is now listed on the Pharmaceutical Benefits Scheme, it is still limited in availability. GPs are able to prescribe the drug if they undergo an online training course and find a pharmacist willing to stock a supply of the medication; it is hoped that availability will expand as more GPs take up this option.At the moment, there is no register of GPs providing mifepristone. The cost of medication abortion through termination clinics has remained largely unaffected by the PBS listing, and our Queensland clinics page includes info on which clinics offer medication abortion; for other states please call your closest provider or family planning organisation.
Mifepristone was not licensed for distribution in Australian until August 2012, and was only listed on the Pharmaceutical Benefits Scheme in August 2013. no drug company had successfully applied to import and distribute mifepristone in Australia. This meant that doctors wishing to use it needed to individually apply to the Therapeutic Goods Administration to be permitted to prescribe it, and needed access to an ethics committee to do so - a condition which automatically eliminates most GPs. Most doctors authorised to use mifepristone in Australia are based in hospitals or abortion clinics.
It is hoped that now a successful application to import the drug is approved by the TGA, doctors will be able to prescribe it as they do other medication and access to it will expand.
Clinical studies have shown that several variations in mifepristone/misoprostol treatment regimens are safe and effective, and procedures may vary from clinic to clinic. The info below is intended as a guide only; for more detail or if you have any further questions, call the clinic you're considering attending.
Side effects, such as pain, cramping, and vaginal bleeding, result from the abortion process itself and are therefore expected with a medical abortion. Other side effects of the medications themselves may include nausea, vomiting, diarrheoa, chills or fever. Complications are rare but may include excessive vaginal bleeding requiring transfusion (occurs in approximately one in five hundred cases), incomplete abortion or ongoing pregnancy which requires a suction abortion (see above).