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Abortion Pill Rules Relaxed.

Abortion advocates in Canada welcomed Health Canada's November 2017 relaxation of rules regarding the abortion-inducing drug Mifegymiso.

Mifegymiso (pronounced MIFY-guy-ME-so) is a combination of two medications. Mifepristone, the first pill taken, blocks the effects of progesterone, while misoprostol, taken 24 to 48 hours later, causes the uterus to expel its contents.

Approved by Health Canada in July 2015, the drug became available in January 2017 with strict regulations. Initially, Mifegymiso could only be prescribed up to the seventh week of pregnancy; that has now been extended to the ninth week. Doctors no longer have to take a six-hour online course on the drug and patients no longer have to sign a consent form.

Previously, the rules were cumbersome. A doctor would prescribe and order the medication, and then distribute it to the patient at their office. Doctors were also required to observe the patient taking the first pill.

"It really inhibited doctors from wanting to prescribe it, because of the logistics [and] the general weirdness of it. So this makes it more normal, like other drugs," said Joyce Arthur, executive director of the Abortion Rights Coalition of Canada.

Under the new regulations, women seeking an early termination obtain a prescription dispensed at a pharmacy. Patients are required to obtain an ultrasound to determine the gestational range of the pregnancy and to ensure they don't have an ectopic pregnancy. As Arthur notes, many clinics don't have an ultrasound machine, which can cause delays.

The Mifegymiso kit costs about $300. The provinces of Nova Scotia, New Brunswick, Quebec, Ontario, Alberta, and British Columbia have announced that they will cover the medication under their provincial health programs. However, the governments of Saskatchewan, Manitoba and Prince Edward Island will offer only partial coverage. Newfoundland and Labrador, the Yukon, Northwest Territories and Nunavut have not committed to pay for the drug. This means that, for many women, it may be more affordable to obtain a surgical abortion than to take Mifegymiso. The drug is also covered under the federal government's non-insured health benefits program.

In Canada, abortion services are typically available in cities and women in rural areas often have to travel several hours to obtain surgical abortions. Mifegymiso is expected to improve access for women in rural areas. Given the choice, many patients would prefer to take Mifegymiso than to have a surgical abortion.

"It's considered to be sort of a more private process," Arthur explains. "[A woman] might feel she has more control over the process if she's at home."

"Pharmacists and doctors who are signing up to prescribe and dispense it are obviously pro-choice, so there's less need to worry about running into anti-choice doctors who are going to refuse," she pointed out. Nor do women have to face protestors outside of clinics. Doctors can direct patients to a pharmacy that carries the drug so they can avoid having to search for a pharmacy on their own.

Arthur wants the medication to be universally funded across Canada. She also says there is a need to motivate physicians and pharmacists to prescribe and dispense Mifegymiso, and for it to be taught as part of medical school training. Arthur also believes that other health practitioners, such as nurses and midwives, should be allowed to prescribe Mifegymiso.

Caption: Mifegymiso can now be prescribed to terminate pregnancies up to nine weeks.
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Author:Whitten, Elizabeth
Geographic Code:1CANA
Date:Mar 22, 2018
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