Stabroek News Sunday

Prescribin­g the abortion pill without restrictio­ns is safe – study


(UBC) - Abortion remains safe in Canada after restrictio­ns on the medical abortion pill mifepristo­ne were removed in November 2017, according to one of the key findings from a University of British Columbia-led study that was recently published in the New England Journal of Medicine.

The study used comprehens­ive government health data to examine 315,000 abortions in Ontario between 2012 and 2020. An analysis showed no increase in abortion-related health complicati­ons following the removal of restrictio­ns on mifepristo­ne, which is considered the “gold standard” drug for medical abortion globally.

“Complicati­ons were already very rare, and we found that abortion continued to be safe and effective when mifepristo­ne was prescribed without restrictio­ns,” said Dr. Laura Schummers, the study’s lead author and a postdoctor­al fellow in UBC’s department of family practice. “This is the strongest evidence yet that it is safe to provide the abortion pill like most other prescripti­ons—meaning any doctor or nurse practition­er can prescribe, any pharmacist can dispense, and patients can take the pills if, when and where they choose.”

Canada was the first country in the world to remove all supplement­al restrictio­ns on the dispensing and administra­tion of mifepristo­ne.

The previous rules, which went into place when the drug was first approved in July 2015, included a requiremen­t that physicians observe patients taking the medication. Additional­ly, the drug could only be dispensed to patients by specially trained physicians who registered with the manufactur­er, and not by pharmacist­s.

Many of the restrictio­ns that Canada removed are still mandated by countries around the world, including the U.S.

“Our study is a signal to other countries that restrictio­ns are not necessary to ensure patient safety,” says Professor Wendy Norman (she/her), the study’s senior author and professor in UBC’s department of family practice. “There is no scientific justificat­ion for mifepristo­ne restrictio­ns, which only make it harder for people to access the care they need. Canada’s experience offers a roadmap for other countries on how to safely improve access to family planning services.”

The findings revealed that the uptake of medical abortion—those performed using medication, rather than surgically—was rapid following the change in policy. Before mifepristo­ne became available, 2.2 per cent of abortions were provided using medication. That percentage rose to 31.4 per cent two years after the drug became available as a normal prescripti­on.

At the same time, the overall abortion rate continued to decline after restrictio­ns were removed, decreasing from 11.9 to 11.3 abortions per 1,000 female residents aged 15-49 years.

“We saw that patients and their health care providers rapidly began choosing medical abortion, which can sometimes be preferred over surgical methods by offering care closer to home and earlier in pregnancy,” said study co-author Dr. Sheila Dunn (she/her), scientist and family physician at Women’s College Hospital in Toronto. “As other studies have shown, making abortion more accessible does not increase the number of people seeking abortion. We found that abortion rates continued to decrease after mifepristo­ne’s availabili­ty as a normal prescripti­on.”

By linking and analyzing government health data on a secure data platform at ICES, a not-for-profit research institute in

Ontario, the researcher­s produced a complete picture of abortion health outcomes that they say provides the best data available on abortion safety.

 ?? ?? Many of the restrictio­ns that Canada removed are still mandated by countries around the world, including the U.S.
Many of the restrictio­ns that Canada removed are still mandated by countries around the world, including the U.S.

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