ACCESS TO PILL A MUST
Just in case you’d thought the legalization of a pill was going to make abortion accessible across Canada, Health Canada, which approved the drug last summer, is here to tell you that when it hits markets this summer, it’s going to be a pain to get ahold of.
Mifegymiso, the clunky Canadian moniker for a combination of drugs that induce an abortion that’s similar to a miscarriage, was finally approved by Health Canada last July, after a weirdly long approvals process. This July, Canadian women — who face wildly disparate access to abortions — are expected to have the option of getting the drug to end a pregnancy within 49 days of conception. But only if they get it from a doctor. And only if that doctor stocks the drug. And only if that doctor has taken an online course about how to administer the drug.
Part of the reason Mifegymiso is so widely lauded is because it deals with issues of abortion access. Rural women, women in certain provinces, have very limited access to abortion. To get a pill that will end pregnancy, discreetly, without having to travel, is a huge step forward in allowing these women control over their bodies. The pill, if accessible, sidesteps a whole host of cultural, religious and geographic barriers to abortion.
It seems, though, that many doctors, particularly rural ones, don’t have the infrastructure to properly dispense Mifegymiso. Pharmacists (who would and who already dispense all sorts of drugs, some of them far, far more dangerous) don’t seem to be included in this, not exactly a great feat of planning on the government’s part.
“This is going to translate into poorer access for women,” says Wendy Norman at the University of British Columbia, adding that doctor-dispensed drugs don’t end up recorded in accessible databases, unlike pharmacist-distributed medications. “We lose our ability to follow and understand the best care for women.”
There are, to be sure, a handful of potential complications from taking the drug, and it’s understandable that Health Canada wants to be cautious. But this is not a revolutionary new drug, where we’re unsure what will happen. French women have been taking it for more than 25 years; it’s been available in the United States since 2000. It has “a phenomenal safety record,” Norman says.
The government should seriously consider expanding dispensing services and, potentially, prescribing as well. In some jurisdictions, midwives and nurse practitioners can prescribe the drug. For those concerned about what the family doctor might think, for example, this would lift a huge burden. Caution is understandable. An excess, which has the effect of limiting access, is not.