Medication abortion access still limited by location, study finds

A study led by Flinders University and published in the journal BMJ Sexual & Reproductive Health, shows inequities in access to medication abortion in Australia compared to similar procedures overseas.

Medication abortion, otherwise known as medical abortion, is a non-surgical and less invasive option for ending pregnancy in its early stages, within the first nine weeks.

While this study shows a steady increase in the uptake of medical abortion since it was subsidised through the Pharmaceutical Benefits Scheme in 2013, accessing the medication through general practice was inconsistent.

Access dictated by location

Lead author Associate Professor Luke Grzeskowiak is a practising clinical pharmacist and practitioner Fellow in the College of Medicine and Public Health at Flinders University. He told InSight+ it’s clear that women’s access to medical abortion largely depends on their location.

“Where you live continues to play a major role in whether you can access care through a local GP and for some people, that can mean travelling long distances or navigating unfamiliar services,” he said.

“More than half of patients were new to the practice where they received care, suggesting many had to seek out a new provider.

“That tells us people are often having to go to considerable effort to find a GP who offers this service.

“We are seeing higher use in areas where there may be fewer alternatives, such as limited access to surgical services, or where barriers like cost and distance are more pronounced.”

While early medication abortion accounts for up to 90% of procedures in many high-income countries around the world, only around half of early abortions in Australia receive medication care.

“Medical abortion is widely used internationally and offers a safe, effective option for early pregnancy care, but in Australia we are not yet seeing the same level of access,” he said. 

Access is improving, but more needs to be done

Experts from study partners Monash University, La Trobe University, and Canada’s University of British Columbia tracked the data from more than one million women who visited around 400 Australian general practices from 2014 to 2021.

Over that time, the number of women receiving medication abortion through GPs rose from about 1 in 10,000 to just over 2 in 1000, while the share of practices offering the service increased from around 1 in 25 to about 1 in 5.

Only about one-third of those practices provided early medication abortion during the study period.

Associate Professor Grzeskowiak said this gap needs targeted action to change, such as expanding telehealth, supporting GPs, and exploring new models of care.

“Thankfully since this study was conducted, efforts have since been made to remove prescribing restrictions and improve education and training for GPs. These moves take time to implement,” he said.

“There is still more work to do to make care consistent and accessible across Australia.”