Medical abortion: the Australian experience

The provision of medical abortion has been the subject of considerable political controversy in Australia over the past two decades. Specifically, use of the drug mifepristone (RU486) was virtually prohibited in the country in the years 1996–2006. Synthetic prostaglandins (in particular gemeprost and misoprostol) have been widely available and used for late (second and third trimester) termination of pregnancy since the late 1980s, usually for indications of fetal abnormality or serious maternal medical conditions, and there are numerous reports of the Australian use of these drugs in the literature. However, first-trimester medical abortion using mifepristone with misoprostol, a procedure which gained increasing acceptance overseas in the years following 1990, was unavailable to Australian women until 2006. The political and legal aspects of medical abortion are integral to an account of the experience of medical abortion in Australia, and will therefore be discussed in this article together with all aspects of clinical medical abortion practice.