Medical abortion is safe and effective in primary care

In Australia, around a quarter of pregnancies are unplanned and around one in three of these ends in abortion. In the December edition of Australian Prescriber, Family Planning NSW Medical Director Clinical Associate Professor Deborah Bateson and co-authors share insights about safely providing early medical abortion in the primary care setting.

“Early medical abortion delivered by general practitioners working in our primary care settings is a safe and effective alternative to surgical abortion for women wanting to terminate a pregnancy,” A/Prof Bateson says.

“Two medicines, mifespristone and misoprostol, can be administered as an alternative to surgical abortion up to the first nine weeks of pregnancy.

“This method is safe and effective for most people, and can be used at home. GPs are ideally placed to support their patients’ choices by providing medical abortion and follow-up care.”

The article also details the differences between medical and surgical abortions.

“Medical abortion is generally more widely available, is less costly, and offers increased privacy and autonomy for women. Contraception, if desired, can be provided at the time of a medical abortion except for an IUD which requires a short delay to make sure the abortion is complete,” A/Prof Bateson says.

“Surgical abortions occur in a clinic or hospital setting under sedation and are associated with less pain and bleeding. Women can, if they choose, have an IUD or contraceptive implant inserted while still under sedation to reduce the chance of recurrent unintended pregnancies.”

Follow-up after medical abortion is essential to confirm that it has been successful, and to exclude rare cases of complications. Follow-up care usually includes a blood test to check that pregnancy hormones have fallen as expected.

“There is a final follow-up consultation after two to three weeks, which can be done in person or using telehealth,” A/Prof Bateson says.

“This ensures the woman has no symptoms suggesting complications or ongoing pregnancy, her contraceptive needs are being met, and that she is not experiencing other physical or emotional concerns.”

Read the full article in Australian Prescriber.