Medical abortions put rural women at greater risk

Medical abortions put rural women at greater risk

By Rachael Wong

Activists in South Australia are calling for abortion laws to be changed urgently, saying that the current laws are inhibiting access to abortion, particularly for regional women.

Under the current law, all abortions must take place at a “prescribed hospital”, including abortions induced by the RU486 abortion pill (up to 9 weeks of pregnancy).

RU486 is the common term for the anti-hormone Mifepristone, which blocks the effects of progesterone, a hormone needed to provide nourishment to the baby during pregnancy. This drug is administered in combination with Misoprostol, another drug administered 36-48 hours later, which relaxes the cervix and induces contractions so as to expel the baby.

Those advocating for the law change want the “prescribed hospital” clause revoked, so that women – particularly rural women – can obtain the abortion pill from their GP (including via mail after a phone consultation) and undertake the abortion themselves at home, without having to travel long distances to Adelaide.

Adelaide’s Women’s and Children’s Hospital gynaecologist and obstetrician Dr Brian Peat supports access to early medical abortions at home, stating that complications are uncommon.

“Complications are quite rare, but when they do occur they get moved [to the relevant facility] just like anybody else,” he said.

There are however, significant health risks associated with taking RU486. The Therapeutic Goods Administration states that common adverse side effects include: “nausea, vomiting, diarrhoea, dizziness, gastric discomfort, abdominal pain, headache, vaginal bleeding, uterine spasm, fatigue, chills / fever, effects related to the abortion itself include prolonged post-abortion bleeding, spotting, severe haemorrhage, endometritis, breast tenderness, heavy bleeding and fainting.” It notes that “bleeding and pain is even more intense with a medical termination”.

If the medical abortion fails to complete – which happens in at least 2-7% of cases – the woman will then need to undergo a surgical abortion.

Given the side-effects associated with medical abortion, women taking the drug at home in rural areas are at a higher risk of danger than women in urban areas, having more limited access to medical care in the case of haemorrhage, infection, or an incomplete abortion.

This is to say nothing of the psychological impact of abortion, particularly in the case of a medical abortion, which is a much more drawn out process and where the woman may have to deal with the above side-effects alone. She may also be confronted and traumatised by the experience of seeing the foetus being expelled.

To quote Edouard Sakiz, the former chairman of Roussel-Uclaf, the French company that developed RU486: “As abortifacients procedures go, RU486 is not at all easy to use… a woman who wants to end her pregnancy has to live with her abortion for at least a week using this technique. It’s an appalling psychological ordeal.”

Instead of pushing for greater access to a drug with painful, dangerous and traumatic side-effects, activists in South Australia should be demanding that rural women have greater access to high quality pregnancy care, information and support, so that they don’t feel as if abortion is their only choice when faced with a difficult or unplanned pregnancy.

Rachael Wong is the CEO of Women’s Forum Australia