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 36 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 early medical abortion and is known to be safe and effective.
The medications used in early medical abortion are listed on the World Health Organisation 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?
From 1 August 2023 restrictions to MS-2Step have been lifted.
The changes mean that:
- there is no longer a requirement to undertake mandatory training, registration or reregistration for GPs and removal of the requirement for pharmacists to be registered to dispense MS-2Step.
- The PBS scripting process will be moved to Streamlined Authority rather than an authority script.
- With legislative changes Nurse Practitioners and Endorsed Midwives may be able to prescribe MS-2Step.
Training for MS-2Step is recommended and available here through the MS-2step website.
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.
Are you unable to offer early medical abortion?
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:
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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