Friday, 31 July 2015

RU486: Game. Set. Match.

Further to the long overdue approval by Health Canada of RU486 or mifepristone, the 'gold standard' of medical abortion: an explanation and a clarification. (And some gloating.)

Medical -- non-surgical -- abortion is not new to Canada. But the protocol doctors have been forced to follow up to now is outmoded, unreliable, and subject to screw-ups.

Here, an expert explains:
"We're absolutely thrilled," Jill Arkles, from the Sexual Health Centre in Saskatoon, told CBC News Thursday.

According to Arkles, some doctors in the province were already providing an alternative to surgical abortion, using a combination of an injection and medication to induce a miscarriage.

She called RU-486 a welcome advancement. The injection-and-tablet method can take up to five weeks to complete, and involve up to five medical appointments, while RU-486 is two pills taken a day or two apart.

"It's more cost-effective than other current medications that we're using, as well it requires less time overall," she said.
So, quicker, easier, more cost-effective. Not to mention less time and stress for patients.

Thus: gold standard.

The news story I based my blogpost yesterday was less than clear on how widely available the new protocol will be.
[Vicki] Saporta [president and CEO of National Abortion Federation] said initially the drug will probably only be available through health-care professionals who already provide abortion services.
It seems that Saporta's judgement was not based on any Health Canada requirement, but on training issues and individual doctors' inclinations.

Here's part of the Society of Obstetricians and Gynecologists of Canada's statement.
The SOGC is working with the College of Family Physicians of Canada (CFPC), using the expertise of our members to develop clinical practice guidelines on the use of mifegymiso [Canadian brand name] and to provide educational opportunities to physicians to ensure that they are well-prepared to counsel and care for women requesting medical abortion.

More on the inclinations of doctors:

Canadian doctors who were wary of the makeshift cocktail [injection and tablets] will likely be more willing to prescribe an abortion drug that’s approved by Health Canada for that purpose, said Jennifer Blake, the CEO of the Society of Obstetricians and Gynaecologists of Canada. She expects the society to provide formal training around the drug and its side effects to doctors who want to offer it, and said family doctors and obstetricians will both be able to qualify. Doctors’ approaches to abortion “depends on the community,” Dr. Blake said.

“I think if you look at physicians in general as coming from the fabric of Canadians society, Canadian society on the whole feels this is a decision that is best made by a woman herself, and I would expect that to be the same among health-care providers.”
We'll have to wait and see how many doctors -- and as critically, where they are located -- will decide to offer this solution.

Now for the gloating. CBC notes that as we head into a protracted election campaign, this might not be the best timing for CONservatives wanting to placate the fetus freaks among their base.

Indeed, the initial reaction among cabinet ministers was to run like hell.
[Health Minister Rona] Ambrose told reporters in St. Albert, Alta., that the decision did not rest with her.

“It’s out of my hands and the decision is final,” she said.

“Any of those details you would have to speak to the officials at Health Canada and the scientists that actually manage the regulatory approval process. I’m not involved in it.”

Ambrose cancelled two events scheduled for Thursday afternoon and Friday in Edmonton and area. No reason was given.
Except for one CON MP (so far), David Anderson, who issued a foot-stomper of a press release demanding Ambrose roll back the clock to the 1950s.

To sum up, yes, medical abortion has been available in Canada but not very widely offered or actually undertaken, precisely because it was arduous for all involved.

The fetus freaks are particularly pissed over RU486, precisely because it is easier and more effective.

And they have good reason to be pissed. As SUZY ALLCAPS herself admits.

The problem with this [medical abortion] model, from the pro-life perspective, is that it's a little harder to protest the GP who does abortions, when he treats the community's ear infections, sore throats, STD's and so on.

If you make life hard on this person, it won't just be abortion clients who'll be unhappy. It will be all the patients this doctor sees.
When GPs, nurse practitioners, midwives, and hopefully, eventually pharmacists are able and willing to help end an early pregnancy, it's not just a game-changer. It's a game-ender.

Game. Set. And soon, the whole fucking shooting match.

ADDED: Health Canada Regulatory Decision Summary.

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