Prescribing abortion pill without restrictions is safe, new UBC-led study finds

A woman holds a pill and a glass of water in her hands in this undated stock image. (Shutterstock)

A new study is shedding light on the impacts of Canada's decision to make one medical abortion pill more easily accessible.

The UBC-led study was published Wednesday in the New England Journal of Medicine and looked into the trends that followed Canada’s removal of restrictions on prescriptions for the medical abortion pill mifepristone in November 2017.

Previously, rules that went into place when the drug was first approved in July 2015 included a requirement that physicians observe patients taking the medication. Additionally, the pill could only be dispensed to patients by specially-trained physicians who were registered with the manufacturer, not by pharmacists themselves.

According to a news release, the researchers used government data to examine 315,000 abortions in Ontario between 2012 and 2020 to compare abortion use, safety and effectiveness before and after the removal of restrictions on the pill.

One of the key findings was that there was no increase in abortion-related health complications following the removal of restrictions on the mifepristone pill, which researchers said is considered the “gold standard” drug for medical abortions globally.

“Complications were already very rare, and we found that abortion continued to be safe and effective when mifepristone was prescribed without restrictions,” said Dr. Laura Schummers, the study’s lead author, in the news 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 research also found that before mifepristone became available, only 2.2 per cent of abortions were provided using medication, whereas two years after the drug became available as a normal prescription, that percentage rose to 31.4 per cent.

At the same time, researchers said the overall abortion rate continued to decline after restrictions were removed, decreasing from 11.9 to 11.3 abortions per 1,000 female residents aged 15 to 29 years-old.

“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 study co-author Dr. Sheila Dunn in the news release.

According to researchers, many of the restrictions removed here in Canada are still mandated by many countries around the world, including the United States.

“Our study is a signal to other countries that restrictions are not necessary to ensure patient safety,” said professor Wendy Norman, the study’s senior author in a news 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.”