Early medical abortion involves using the medications mifepristone and misoprostol to end a pregnancy up to 63 days of gestation.
In Australia, the medications are marketed as MS2Step under licence from MS Health. MS2Step is available under the Pharmaceutical Benefits Scheme.
Combined use of mifepristone and misoprostol:
- prevents progesterone from supporting the pregnancy
- softens and dilates the cervix
- increases uterine contractility.
The medications are self-administered 24 to 48 hours apart to induce the abortion; the effects are similar to a spontaneous miscarriage.
Combining these two medicines is a well-established method for medical abortion and is known to be safe and effective.
The medications used in EMA are listed on the World Health Organization Model List of Essential Medicines. Efficacy is between 95.1% and 97.7%.
The majority of post-procedure presentations represent minor complications; severe complications are rare.
Who can be a provider?
To become an EMA provider, medical practitioners gain prescribing rights and pharmacists gain dispensing rights based on successful completion of free online training through MS Health.
Registered GPs who provide medical abortion are considered ‘non-procedural’ by medical insurers but are advised to confirm this with their insurance providers.
Medicare benefits are available for non-directive pregnancy support counselling services. See more information on the Department of Health website.
EMA care may also be provided by a team of healthcare workers. For example:
- Medical practitioners oversee and supervise clinical management, obtain informed consent and gain an authority prescription to prescribe MS2Step.
- Nurse practitioners, nurses and midwives have a recognised role to assess, plan and manage EMA care in a task sharing arrangement with the medical practitioner.
- Pharmacists dispense the medication.
Are you unable to offer EMA?
According to the Abortion Law Reform Act 2008 (section 8), if a woman requests a registered health practitioner to advise on a proposed abortion, or to perform, direct, authorise or supervise an abortion for that woman, and the practitioner has a conscientious objection to abortion, the practitioner must:
inform the woman that the practitioner has a conscientious objection to abortion; and
- refer the woman to another registered health practitioner in the same regulated health profession who the practitioner knows does not have a conscientious objection to abortion.
To refer, contact 1800MyOptions on 1800 696 784 or view the online database of services at www.1800myoptions.org.au