Following the removal of restrictions on mifepristone—a pill to induce abortions—in Canada, abortions remained safe in the country, according to a study published in the New England Journal of Medicine. The study examined government health data on 315,000 abortions in Ontario between 2012 and 2020, finding no increase in abortion-related health complications following the removal of restrictions on mifepristone.
"Complications were already very rare, and we found that abortion continued to be safe and effective when mifepristone was prescribed without restrictions," said Laura Schummers, ScD, the study's lead author and a postdoctoral fellow in UBC's department of family practice, in a press release. “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.”
The original restrictions, first put into place when the drug was approved in 2015, required that physicians observe patients taking the medication. Further, the drug could only be dispensed by specially trained physicians who registered with the manufacturer, and not pharmacists. Many of these restrictions remain in place throughout the world, including the United States.
“Our study is a signal to other countries that restrictions are not necessary to ensure patient safety,” said Wendy Norman, MD, CCFP, FCFP, DTM&H, MHSc, professor in UBC's department of family practice, in a press release. “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.”
Following the availability of mifepristone, the percentage of abortions performed medically as opposed to surgically rose from 2.2% to 31.4% over 2 years after the drug became available as a normal prescription. During this same time period, the overall abortion rate continued to decline after restrictions were removed, decreasing from 11.9 to 11.3 abortions per 1000 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 Sheila Dunn, MD, MSC, CCFP (EM), FCFP, scientist and family physician at Women's College Hospital in Toronto, in a press release. "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."
Prescribing the abortion pill without restrictions is safe and effective, study finds [news release]. Science Daily; December 8, 2021. Accessed December 14, 2021. https://www.sciencedaily.com/releases/2021/12/211208182541.htm