News Item

Qld: Tele-health abortion is dangerous for women

The Palaszczuk government is attempting to quietly rush through a tele-health abortion service which would result in the widespread distribution of MS-2 Step (mifepristone / misoprostol) in Queensland.

Tele-health abortion would place women and girls at serious risk, especially in remote areas, for the following reasons…

  1. Women cannot be adequately assessed over the phone.

    Having no in-person evaluation by a doctor increases the risk of undetected ectopic pregnancies, rH factor incompatibility, and misdiagnosis of gestational age – all of which can lead to severe or even fatal consequences.

    It also reduces the chances of identifying a victim of abuse or human trafficking who is being coerced into having a chemical abortion.

    Furthermore, women in remote areas may not have access to an ultrasound – yet abortifacients could still be issued. The Therapeutic Goods Administration (TGA) guidelines warn, “In the event that an ultrasound is not possible, extra caution should be exercised.”

    Essentially, there is no requirement that any procedure is done to rule out an ectopic pregnancy – which is a serious and life-threatening situation. 

  2. Many women cannot access 24-hour emergency medical care quickly – yet this is an essential requirement for anyone taking MS-2 Step.

    • The RANZCOG guidelines in relation to MS-2 Step state,

      “The prescribing practitioner must supervise and take responsibility for arrangements for the entire process of abortion from administration of mifepristone through to confirmation of abortion and completion of follow-up including implementation of a contraceptive plan. These arrangements must include 24 hour access to specific telephone advice and support and to provision of surgical uterine evacuation or other interventions required for the management of complications, for example through on call arrangements or in an emergency department resourced to respond to women’s health needs (such as required for miscarriage care).”

    • Directions from MSI Australia for patients undergoing a tele-abortion state,

      “You must stay within 2 hours’ drive to 24-hour emergency medical care for the first 3 or 4 days of the process. You need to be able to access a doctor, hospital or one of our clinics until the process is complete.”

    • Over half of Queensland’s 5 million residents live outside the Greater Brisbane area, where there are fewer 24-hour medical facilities.
    • Ambulance ramping in Queensland is at an all-time high. Even those who live within 2 hours’ drive from a hospital are not guaranteed to make it within that timeframe.
  3. There is significant potential for women to experience adverse effects or death.

    • The Therapeutic Goods Administration (TGA) guidelines for MS-2 Step state,

      • 3-6% will need a surgical abortion.
      • Other significant adverse effects include uterine rupture, missed ectopic pregnancy and death.
      • Importance of seeing a doctor after.
      • Risk for women with renal failure (an issue for indigenous women).
    • The Medical Journal of Australia confirms, “about 5% of medical abortions are incomplete or complicated; in these cases, women may be admitted to hospital for surgical abortions.” 20,741 women had a medical abortion in 2017‒18. If 5% of those had complications, up to 1,037 women needed emergency treatment that year.
    • Thousands of adverse events from chemical abortions have been reported in the U.S. with one study recording 20 deaths, 529 life-threatening events, and 1,957 severe adverse events. The actual number is likely far higher because non-fatal adverse events are no longer required to be reported, and because more than 60 percent of women and girls’ emergency room visits after chemical abortions are miscoded as miscarriages.
    • One study revealed the overall incidence of adverse events is “fourfold higher” in chemical abortions when compared to surgical abortions. Women who underwent chemical abortions also experienced far higher rates of haemorrhaging, incomplete abortion, and unplanned surgical evacuation.
  4. There are damaging psychological impacts for women.

    Studies show 83% of women report that chemical abortion “changed” them, and 77% of those reported a negative change. 38% of women reported issues with anxiety, depression, drug abuse, and suicidal thoughts because of the chemical abortion.

    The mother seeing the aborted human appears to be a difficult aspect of the medical termination process. For example, one woman was surprised and saddened to see that her aborted baby “had a head, hands and legs, with defined fingers and toes.”

  5. There is an unacceptable risk of harm for girls and adolescents.

    • There have been no clinical trials for under-18 girls undergoing reproductive development.
    • The MS-2 Step product states it is for “Females of childbearing age” (age unspecified). In Australia, this could include girls who are 12 years or younger.
    • Providing “mail-order” abortion medication will inevitably allow girls and teens to access it – potentially without the knowledge of their parents or doctor – which would be especially dangerous.
  6. Access to mifepristone has been reduced in the U.S. and cannot be dispensed by mail. It could be banned, since a Texas district Judge declared, “the US Food and Drug Administration acquiesced on its legitimate safety concerns.” Litigation is now playing out.
  7. MSI Australia has a vested interest in promoting tele-abortion in Queensland as it has licensed both mifepristone and misoprostol.

Tele-health abortion is not safe for women. The strictness of the TGA, RANZCOG and MS-2 Step product guidelines – and the current legal debate in the U.S. – reflects the seriousness of the abortifacients and the potentially lethal risks to women. And, too many women in Queensland cannot access 24-hour emergency medical care fast enough.

The only responsible course for the Government is to abandon tele-health abortion. To proceed will inevitably lead to injuries or death of women – and Queensland Health will be liable if these risks eventuate.

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