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J Fam Plann Reprod Health Care 38:117-122 doi:10.1136/jfprhc-2011-100232
  • Legal opinion

Abortion pills: under whose control?

  1. Sam Rowlands
  1. Honorary Associate Professor, Institute of Clinical Education, Warwick Medical School, University of Warwick, Coventry, UK
  1. Correspondence to Dr Sam Rowlands, Institute of Clinical Education, Warwick Medical School, Gibbet Hill Campus, University of Warwick, Coventry CV4 7AL, UK; sam.rowlands{at}warwick.ac.uk
  • Received 30 September 2011
  • Accepted 22 December 2011

Introduction

We owe a lot to scientists such as Baulieu1 in Paris who developed the progesterone receptor modulator mifepristone and Bygdeman2 in Stockholm who conducted early trials of its use in combination with a prostaglandin. Many others have contributed to the development of this drug and to finessing optimal combinations, visit intervals, dosages and routes of administration.3 This has given women an entirely new and safe option when requesting an abortion. Novel ways of providing early medical abortion have been developed, especially using non-medical personnel such as nurses or midwives,4 5 or doctors who are not on the premises.6

Early medical abortion has a key role to play in reducing unsafe abortion around the world, particularly in resource-poor settings where inadequate surgical services for abortion entail a high risk of infection and reproductive tract injury.7 An important signal went out in July 2005, when the regimen of mifepristone and misoprostol was included on the World Health Organization's WHO Model List of Essential Medicines.7 The Concept Foundation (http://www.conceptfoundation.org/medical-abortion.php) has registered Medabon® in Cambodia, India and Nepal; this is the first product to package mifepristone and misoprostol together. The Medabon introduction programme aims to launch this dedicated combination pack in 26 low- and middle-income countries.

The Economic Covenant,8 Article 15(1)(b), recognises the right of everyone to enjoy the benefits of scientific progress and its applications. With regard to early medical abortion, this must include access to mifepristone and misoprostol.

Who should be involved in controlling these drugs? Health professionals, drug regulators, customs officials, the courts or women themselves?

Criminal law

In the UK, inducing an abortion surgically or medically comes under the criminal law. This is the same as in most other countries in the world apart from Canada and two Australian states (Australian Capital …