Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Sexual Health Sexual Health Society
Publishing on sexual health from the widest perspective
RESEARCH ARTICLE

Ten years on: a review of medical terminations of pregnancy performed in a sexual health clinic

Sandra G. Downing A C , Colette Cashman B and Darren B. Russell B
+ Author Affiliations
- Author Affiliations

A College of Public Health, Medical & Veterinary Sciences, James Cook University, McGregor Road, Smithfield, Qld 4870, Australia.

B Cairns Sexual Health Service, Cairns and Hinterland Hospital and Health Service, PO Box 902, Cairns, Qld 4870, Australia.

C Corresponding author. Email: sandra.downing@jcu.edu.au

Sexual Health 14(3) 208-212 https://doi.org/10.1071/SH16177
Submitted: 23 September 2016  Accepted: 18 January 2017   Published: 30 March 2017

Abstract

Background: Access to medical termination of pregnancy (MToP) services in regional Queensland remains inadequate and it is still possible for women and providers to be criminally prosecuted for accessing or providing abortion. Cairns Sexual Health Service (CSHS) has been providing medical terminations of pregnancy for 10 years, demonstrating that this service can be safely and successfully integrated into a primary healthcare setting. Methods: A retrospective audit of MToPs performed between 2011 and 2015 was conducted to follow on from our previously reported audit covering 2006–09. Results: In total, 1859 MToPs have been performed by CHSH since 2006, with 1712 within the 5-year period of 2011–15. Changes in clinical practice over this time have streamlined the service and reduced unsuccessful outcomes from 12.2% between 2006 and 2009 to 0.9% between 2011 and 2015. Conclusion: The initial provision of MToP through CSHS was anticipated to be a short-term arrangement; however, 10 years on, this service continues with strong community demand. Provision of MToP services through primary healthcare settings can help improve access for women living outside of major metropolitan areas. If moves to decriminalise abortion in Queensland are successful, there is potential for even greater access.


References

[1]  Chan A, Sage LC. Estimating Australia’s abortion rates 1985–2003. Med J Aust 2005; 182 447–52.

[2]  Grayson N, Hargreaves J, Sullivan E. Use of routinely collected national data sets for reporting on induced abortion in Australia. Sydney: AIHW National Perinatal Statistics Unit; 2005.

[3]  Hutchinson M, Joyce A, Cheong M. Induced abortions in Western Australia 2010–2012. 4th Report of the Western Australian abortion notification system. Perth: Department of Health, Western Australia; 2013.

[4]  Scheil W, Jolly K, Scott J, Catcheside B, Sage L, Kennare R. Pregnancy outcome in South Australia 2014. Adelaide: Pregnancy Outcome Unit, SA Health, Government of South Australia; 2016.

[5]  de Costa C, Douglas H, Hamblin J, Ramsay P, Shircore M. Abortion law across Australia – a review of nine jurisdictions. Aust N Z J Obstet Gynaecol 2015; 55 105–11.
Abortion law across Australia – a review of nine jurisdictions.Crossref | GoogleScholarGoogle Scholar |

[6]  News ABC. Qld women forced interstate for abortions. Updated 8 September 2009. Available online at: http://www.abc.net.au/news/2009-08-31/qld-women-forced-interstate-for-abortions/1412338 [verified 21 September 2016].

[7]  Queensland Government. Queensland maternity and neonatal clinical guideline: therapeutic termination of pregnancy. April 2013. Available online at: https://www.health.qld.gov.au/qcg/documents/g-ttop.pdf [verified 21 September 2016].

[8]  Downing S, McNamee H, Penney D, Leamy J, de Costa C, Russell DB. Three years on: a review of medical terminations of pregnancy performed in a sexual health service. Sex Health 2010; 7 212–5.
Three years on: a review of medical terminations of pregnancy performed in a sexual health service.Crossref | GoogleScholarGoogle Scholar |

[9]  U.S Food and Drug Administration. Postmarket drug safety information for patients and providers. Mifeprex (mifepristone) information. Updated 30 March 2016. Available online at: http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm111323.htm [verified 21 September 2016].

[10]  World Health Organization. Clinical practice handbook for safe abortion. Geneva: WHO Press; 2014.

[11]  Doran F, Nancarrow S. Barriers and facilitators of access to first-trimester abortion services for women in the developed world: a systematic review. J Fam Plann Reprod Health Care 2015; 41 170–80.
Barriers and facilitators of access to first-trimester abortion services for women in the developed world: a systematic review.Crossref | GoogleScholarGoogle Scholar |

[12]  Cameron ST, Glasier A, Johnstone A. Shifting abortion care from a hospital to a community sexual and reproductive health care setting. J Fam Plann Reprod Health Care 2016; 42 127–32.
Shifting abortion care from a hospital to a community sexual and reproductive health care setting.Crossref | GoogleScholarGoogle Scholar |

[13]  Snook S, Silva M. Abortion services in a high-needs district: a community-based model of care. J Prim Health Care 2013; 5 151–3.

[14]  Goldstone P, Michelson J, Williamson E. Early medical abortion using low-dose mifepristone followed by buccal misoprostol: a large Australian observational study. Med J Aust 2012; 197 282–6.
Early medical abortion using low-dose mifepristone followed by buccal misoprostol: a large Australian observational study.Crossref | GoogleScholarGoogle Scholar |

[15]  The State of Queensland. Cairns and Hinterland Hospital and Health Service annual report 2015–16. Cairns: Cairns and Hinterland Hospital and Health Service; 2016.

[16]  Australian Bureau of Statistics. Census of population and housing: 2006 Census Basic Community profile. Canberra: Australian Bureau of Statistics; 2007.

[17]  Cameron ST, Glasier A, Dewart H, Johnstone A, Burnside A. Telephone follow-up and self-performed urine pregnancy testing after early medical abortion: a service evaluation. Contraception 2012; 86 67–73.
Telephone follow-up and self-performed urine pregnancy testing after early medical abortion: a service evaluation.Crossref | GoogleScholarGoogle Scholar |

[18]  Australian Government Department of Health, Therapeutic Goods Administration. Registration of medicines for the medical termination of early pregnancy. Available online at: https://www.tga.gov.au/registration-medicines-medical-termination-early-pregnancy [verified 21 September 2016].

[19]  Australian Government Department of Health, Therapeutic Goods Administration. Australian public assessment report for mifepristone/misoprostol. October 2014. Available online at: https://www.tga.gov.au/sites/default/files/auspar-mifepristone-misoprostol-141013.pdf [verified 21 September 2016].

[20]  Queensland Parliament. Abortion Law Reform (Woman’s Right to Choose) Amendment Bill 2016 and inquiry into laws governing termination of pregnancy in Queensland. Available online at: http://www.parliament.qld.gov.au/Documents/TableOffice/TabledPapers/2016/5516T645.pdf [verified 21 September 2016].

[21]  Queensland Parliament. Health (Abortion Law Reform) Amendment Bill 2016. Available online at: http://www.parliament.qld.gov.au/Documents/TableOffice/TabledPapers/2016/5516T1292.pdf [verified 21 September 2016].