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Access to medical abortion is set to be expanded in Australia. Here's what it means.

Medical abortions will become more accessible for all Australian women, as restrictions on the medications are scrapped.

Following a Senate inquiry into universal access to reproductive healthcare, the Therapeutic Goods Administration (TGA) has announced they will remove a number of restrictions around prescribing and dispensing of the medical abortion pills, mifepristone and misoprostol.

The medication was previously only allowed to be prescribed by a doctor with specialist certification and then provided by a pharmacist registered to dispense the product. From August this year, any healthcare practitioner with appropriate qualifications and training will be able to prescribe the medication, including nurse practitioners. Restrictions on pharmacists will also be lifted.

This means that Australian women, particularly those in regional and rural areas, will see vastly improved accessibility to medical abortion pills. 

It's a move that many in the reproductive healthcare and rights space are celebrating, including *Lucy, who knows firsthand what it's like to undergo a medical abortion.

Watch: the stories of women who had abortions before they were legal. Post continues below. 


Video via YouTube. 
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Lucy's story.

When Lucy was 28, she had a one-night stand but the condom split. She realised in the weeks afterwards that she was pregnant.

"It was in the run up to Christmas, so I found it difficult to get an appointment to see anyone until early January. I ended up going to an abortion clinic in the city. I had to get checked over, there was a little interview about why I didn't want to go ahead with the pregnancy, a scan to see how far along I was, and then some form signing," she tells Mamamia

Following this process, Lucy was given the first pill, which stops the pregnancy. Lucy then returned to the clinic 24 hours later to have the second pill, which induces a miscarriage. She says her reaction to the second pill was far more severe than the first and she experienced vomiting, heavy cramps and bleeding. 

"I ended up being quite close to the limit for the medication abortion due to the Christmas delay, so that may be why I experienced more blood and pain than someone who might be four weeks or something," she explains.

"Nothing happened for about a week, and then while out at the movies with a friend, the bleeding and pain began. It was quite traumatic. That being said, I was able to access it reasonably well – likely due to going to the clinic in the city as opposed to a regional area."

Of course, all experiences related to medical abortion are individual. But Lucy remains forever thankful she was able to access the service and wishes that all Australian women were given equal access and choice. 

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The revised access to medical abortion pills, explained. 

From August, the TGA will scrap restrictions on the prescription of medical abortion pills, which can be used in the first nine weeks of an unwanted pregnancy.

Essentially, the move slashes the red tape around who can prescribe or dispense the two-part medical abortion pill.

Currently, only roughly one in 10 of GPs are able to prescribe the drug and three in 10 pharmacists can dispense it.

These restrictions can be particularly stressful for women in regional or rural areas who have limited access to GPs, as the chances are low that doctors close by will be able to prescribe medical abortion pills. 

This lack of access can result also result in a significant cost barrier. Many women have spoken of being shoehorned into having just one prescriber option, meaning if that prescriber does not bulk bill, it leaves the woman being forced to pay a price she may not be able to reasonably afford.

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Assistant Health Minister Ged Kearney said the specialist training and registration for GPs – which had to be refreshed every three years – meant only a small cohort of pharmacists and doctors were able to prescribe and dispense the pills.

"This has created an enormous barrier for lots of women who need this treatment," Ms Kearney told ABC TV on Tuesday. "We know it's time-limited, of course, there's some urgency about getting the treatment early. It's really added to the stress."

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Professor Danielle Mazza is the Head of General Practice at Monash University and the Chief Investigator and Director of SPHERE Centre of Research Excellence in Women's Sexual and Reproductive Health in Primary Care. She is also a special adviser to the Australian National Women's Health Advisory Council.

She has been following the Senate inquiry closely, and welcomes the TGA's decision. 

Speaking to Mamamia, Professor Mazza says this is a step in the right direction towards destigmatising and increasing access to abortion in Australia. 

"It's excellent news and it's a monumental step to improving access. Women are far more likely to find a local GP who can provide them with the service, and they also won't have to hunt around to find a pharmacy, because all pharmacies will be able to stock and dispense the medication," she says.

"We're finally getting to a place in Australia where abortion is seen as essential healthcare. For so long, the restrictions resulted in unnecessary suspicion and confusion, and we just don't need that."

Interestingly, we've seen how well this sort of deregulation works in other countries, like Canada.

In 2017, Canada completely deregulated (removed restrictions) on the medical abortion pill mifepristone. Professor Mazza says the flow-on effects have been extremely positive. 

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"Canada has a very similar healthcare system to us, so to look at their country's approach to reproductive healthcare is really comparable. A paper was published that evaluated the outcomes of the deregulation, and they found that abortion rates didn't increase exponentially like critics 'feared'. Instead, they remained stable, there was no compromise to safety, and the number of providers went up – therefore providing more widespread access to people across Canada."

Ultimately, the recent Senate inquiry into universal access to reproductive healthcare devised a report that made 36 recommendations to further improve access.

In an ideal world, all those recommendations would be implemented. 

But in the meantime, the recommendation Professor Mazza hopes to see enacted next is a national hotline that women can ring to get transparent information and help with navigating services. 

"I want women to know they shouldn't hesitate to reach out to their GP for assistance. There are options available to women, and we need to make sure those options are more readily known and widespread."

*Lucy's identity is known to Mamamia. Her first name has been changed for privacy reasons. 

With AAP.

Feature Image: Getty.

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