Early medical abortion “effective and safe”: study

A large study has found mifepristone-buccal misoprostol use for pregnancy termination up to 63 days gestation is an “effective and safe alternative” to surgical abortion

An observational cohort study has examined the use of the drug combination in more than 15,000 women who attended one of 16 Marie Stopes International clinics in Australia between March 2013 and September 2015, for an early medical abortion.

Early medical abortion (gestational age ≤ 63 days) involved administration of 200mg oral mifepristone (RU486) in-clinic followed 24-48 hours later by 800µg buccal misoprostol self-administered at home.

Decision-based counselling was also offered at the time of screening, and written informed consent was obtained by a doctor along with a discussion of the procedure and potential risks.

In the study led by Dr Philip Goldstone, Medical Director of Marie Stopes International in Australia, follow-up information was available for 87% (13,078) of women.

The medical method was found to be successful in 95.16% of women with follow-up (95% CI, 94.78-95.52%).

Success rates were highest in women with gestational age ≤35 days and decreased with increasing gestational age.

And method success was higher in younger women, with method success highest in women aged from 14 to 19 years, followed by those aged 20-24 years.

Overall, 674 serious adverse events were reported in the study, with most related to cases of method failure.

Incomplete abortion requiring surgical intervention was reported by 633 women (4.84%), while continuing viable pregnancy was reported by 99 (0.76%).

Infection (0.11%) and haemorrhage (0.13%) were rare.

There was one reported ectopic pregnancy resulting in salpingectomy, and one recorded death of a woman diagnosed with necrotising pneumonia.

This patient had a history of pulmonary embolism, and the relationship between her pregnancy termination and death was concluded to be “uncertain”.

Limitations of the study include lack of available data on efficacy and safety outcomes for women lost to follow-up, which the authors say may have introduced systematic bias into estimations of method success and complications.

However, “overall, oral mifepristone followed by buccal misoprostol was an effective and safe method of abortion up to 63 days gestation,” they conclude.

“Findings from this study provide further evidence of the efficacy and safety of mifepristone-buccal misoprostol for use up to 63 days gestation in an Australian setting.”

The results come on the back of Wednesday’s announcement that the Northern Territory Parliament has decriminalised abortion – and legalised access to RU486 – for women across the state.

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  1. Rita, Canberra

    In a humane society, there should be no place for “pills” designed intentionally to poison the environment of tiny unborn children being protected and nurtured in their mothers’ wombs. Chemical poisoning of an innocent defenseless human being is utterly barbaric. Administering poisoned medications to a little daughter or son in a mother’s womb is cruel and inhumane. Violence against children is never ‘necessary’. Their mothers’ personal and social needs can and should be met by non-violent means

    It is telling that in this report the tiny victims are dehumanized and disappeared as though these pregnancies are all childless.

    Yet ultrasound technology, together with biology, embryology, fetal surgery, and examination of the human remains of an abortion, all tell us that the victim targeted for abortion is a human being, belonging to the human family, a human being who can be identified as a daughter or son, a ‘who’ not a generic ‘thing’.

    True justice requires that elective abortions be recognized and treated not as harmless, idiosyncratic, personal ‘choices’ but as abusive practices, as human rights violations perpetrated by individuals and involving the complicity of politicians, judges, researchers and others.

    • fiquet

      You seem very concerned about the kids. Are you going to adopt, feed and raise all the un-aborted children? If not, who will?

      • Ronky

        Obviously you have never tried to get on the waiting list to adopt an Australian child. Australia has the lowest adoption rate in the world. Anti-abortion organisations keep long lists of suitable married couples who are willing to adopt at a moments notice, any child in danger of being aborted. “It’ll cost too much to raise and feed him” is no excuse to kill a child, especially in this one of the richest countries in the world.
        Opinion polls repeatedly show that a large majority of Australians are opposed to abortions being done for financial or social reasons. (And that women are even more opposed than men are.) And yet 99% of abortions are done for these reasons, because governments, fathers, grandparents, so-called health professionals and organisations supposedly intended to “help” mothers, instead put them under pressure to see abortion as the only real solution for them.

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