Background: Medical termination of pregnancy (MTOP) has been available and successfully used as an option for women internationally since 1988. The regimen for MTOP results in abortion in 99% of cases. Since Mifepristone’s recent availability in Australia, Marie Stopes International has performed more than 10,000 MTOP procedures in Australia since 2009. In Victoria, the Law Reform Commission removed pregnancy termination (“abortion”) from the criminal statutes in August 2008, which provided women and health care professionals with protection from criminal prosecution for their legal involvement in termination of pregnancy (TOP).
Approach Taken: Such favorable developments (change of legislation and the availability of Mifepristone) have prompted the Barwon Health TOP service providers to engage in discussion with the Sexual Health Clinic to review their service and in particular the feasibility of introduction of MTOP to the current TOP service. results: Such discussions have not been hindered by budget – but by staffing complications. Such complications arise from the “conscience clause”. Areas of set-back to progress this option for women have included the difficulty to enlist doctors to participate in prescribing the Mifepristone and also in gaining doctors to undertake the gestational ultrasound to confirm the ability to participate in a MTOP.
Conclusion: Although we are able to administer safely the combination of Mifepristone and Misoprostal, why are there such hurdles to provide the choice? So, where are we up to with providing options for local women to have the right to choose between MTOP or Surgical Termination of Pregnancy (STOP)? Here I would like to review perceived and real reasons other services may have encountered and reflect on such barriers to determine the practicality of what is surmountable and what is not.
