23/11/2016
But didn't know who to ask.

Words by

Tara Smith

If, like us, you hadn’t really heard of the abortion pill in Australia before today, then read on.

Turns out it does exist, and up to 23 per cent of abortions in Australia are already done this way. But when compared to our progressive European counterparts, Australia comes up short.

In countries such as Norway, Sweden and Switzerland, medical abortion accounts for at least 70 per cent of abortions. In Finland, it’s 97 per cent.

So why isn’t it a thing in Australia?

We had a lot of questions, so decided to go straight to the source. The Tabbot Foundation is Australia’s only telephone distributor of the abortion pill.

We had a chat to medical director of the foundation, Dr Paul Hyland, to go through the A-Z of the abortion pill.

How it works
There are two pills. The first contains mifepristone (also known as RU-486) which causes a breakdown of the lining of the uterus, without affecting the foetus. Put simply, it stops the lining of the uterus from growing. This takes 24-48 hours to work before the second pill is taken.

The second pill is misoprostol, which is a prostaglandin. Prostaglandins cause muscle contraction, causing the uterus to contract just like in periods or labour. This allows the uterus to expel the pregnancy. Misoprostol only takes about 30 minutes to start working.

How long has it existed?
RU-486 was created by French pharmaceutical company Roussel Uclaf in 1980.

“It’s been used in France since 1988," says Dr Hyland. "28 years it’s been around and used, yet in this country it’s only been available on the PBS for three years. Doesn’t that say something?”

Why haven’t we heard more about it?
Dr Hyland explains that: “There was a regulation put in place in 1990 by Federal Minister of Health, Brian Howe. He put a regulation in the Therapeutic Goods Act to prevent advertising any drugs that cause abortion. And that’s still in place now.”

“It’s a question of the use of the word ‘abortion’ with drugs…it’s regarded as advertising and there are laws against that. Google also has restrictions on advertising the drug’s name.”

Is it safe?
Severe complications are rare. Of the 152 million women in the US who used medical abortion between 2000 and 2012, only 612 were hospitalised. 

“This really is the most significant technological advance in women’s reproductive healthcare since the birth control pill," says Dr Hyland. "We haven’t recognised this because its availability has been suppressed for years.

“It’s been used overseas for many years. We’re far behind the times.”

Does it affect future fertility?
“Not at all," explains Dr Hyland. "Unlike surgical termination of pregnancy where the cervix is stretched, this is similar to a normal miscarriage. The first drug softens the cervix,  the second one does too but then it contracts the uterus, expelling its contents – so it’s much the same as a miscarriage.”

How effective is it?
Dr Hyland reports worldwide, an effective rate of 97 per cent (effective meaning no medical intervention).

Since launching last year, The Tabbot Foundation reported a failure rate of just 0.4 per cent in the first 1000 abortions.

Up to two per cent of patients may need surgery afterwards, due to continued bleeding or an incomplete abortion (where the uterus is not fully emptied). Again, these are worldwide figures.

Does it hurt?
“When we discharge our patients from our care, we assess how much pain they’ve had on a scale of one to five, three being a normal period," says Dr Hyland. "Most people say three, that’s with analgesia [pain relief]. Of course to minimise discomfort you have to take something, but we supply that.”

Who can access the abortion pill?

The Tabbot Foundation has a list of criteria patients must meet in order to acquire the medication. Women in South Australia and the North Territory are unable due to legal restrictions. For a woman to have a medical abortion, the gestation period must be under nine weeks. The earlier the pregnancy, the better the result in terms of discomfort, or bleeding.

“If you’re about six weeks, you’re really just looking at a delayed heavy period. And that’s what we’re trying to educate to women…You’re avoiding surgery,” Dr Hyland says.

Patients must also live within one hour of a medical facility, in case of complications.

How do you get it?
The Tabbot Foundation is a tele-distributor of the abortion pill, meaning everything is done over the phone.

After you make the call, the foundation refers you to get an ultrasound and blood test. Once tests are confirmed and a medical specialist has briefed you, you receive the abortion medication via express mail.

Why over the phone?
A lot of facilities offer the pills via video call and face-to-face consultation. So why does The Tabbot Foundation do everything over the phone?

Convenience, really.

“How many women with five kids, who have been breastfeeding all their life, have a computer with Skype?," says Dr Hyland.

"We’re also serving rural and remote areas, which is a first.

"You’ve got to have that sort of service. You’ve got to have a simplified method of allowing it to be equally available throughout the whole of Australia" he notes.

"Ultimately, abortion is a deeply personal issue where opinion varies on a personal, public and political level. Our service keeps it personal," he concludes.

"Whatever your views, the most important thing we can do is educate women to make the right choice for themselves, and make it early."

tabbot.com.au

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