After a two-and-a-half-year wait, the Canadian health authority has approved an abortion pill that's used in nearly 60 countries worldwide.
Following a series of delays, Health Canada announced this week the drug mifepristone will be available in January 2016 through a doctor's prescription — prompting cheers from abortion advocates and warnings from pro-lifers.
Experts tell VICE News the newly approved drug will be safer and more effective than the current cocktail of harsh pills prescribed for medical abortions, but it won't necessarily mean an end to issues of access to abortion in Canada.
Abortion is legal in Canada, but access is patchy. One province, Prince Edward Island, has no abortion clinics, so women and trans people aiming to terminate their pregnancies must leave the island for surgery. For patients seeking non-surgical abortions, it can be tough to find physicians who will prescribe abortion pills, meaning patients rely on word of mouth to access medical abortions in PEI.
If a patient finds a willing doctor, the physician can prescribe a cocktail of misoprostol, an abortion pill with spotty results when used alone, and a harsh drug called methotrexate that is also used to treat cancer.
Mifepristone, on the other hand, is recognized as the "gold standard" for medical abortions, according to its manufacturer Linepharma International Limited. Also known as RU-486, the drug works by suppressing progesterone, and is safe to use up to nine weeks of pregnancy.
It was first approved in France in 1988, in Britain in 1991, and in the United States in 2000. Despite its ubiquity around the world, in Canada its approval has been somewhat controversial. The pill was denounced by Jim Hughes, the national president of Campaign Life Coalition, as a "human pesticide which kills the pre-born child and harms women."
But as one OBGYN told VICE News over the phone Thursday, it's shocking mifepristone wasn't approved earlier in Canada.
"It's not a revolutionary new drug," said Dr. Robyn MacQuarrie, who practices in Nova Scotia. "It's been well accepted that Canadian women have the right to control their reproduction, and medication like this has been sitting there for three years during the approval process when it's not a revolutionary therapy."
Health Canada's delayed approval of mifepristone had to do with politics, she believes, not the safety of the drug.
"It's something that clearly falls in the realm of politicking. And I continue to be outraged that women's reproductive health, particularly in the Maritime provinces, are held hostage by politicians, very few of whom have a uterus," she said.
But a spokesperson for Federal Health Minister Rona Ambrose told VICE News in an email Thursday that "drug approval decisions are arms-length decisions made by Health Canada officials based on analysis by Health Canada scientists."
And in a statement to VICE News, Health Canada said the "rigorous" review of the drug followed standard regulatory processes and timelines. "Health and safety is Health Canada's primary concern," a spokesperson said. "The time period for the review is what would be expected given the complexity of the submission."
Mifepristone has been studied specifically as an abortion pill and has been found to be safe for that purpose, MacQuarrie explained, while drugs doctors previously prescribed, like misoprostol, cause bleeding but may not actually end the pregnancy.
Another pregnancy-terminating drug doctors lean on, methotrexate, is used for chemotherapy and certain types of arthritis. It's also not guaranteed to cause a completed abortion.
"It's a harmful drug," MacQuarrie said of methotrexate. Doctors prescribe it "because we have no alternative."
If the drugs don't work, a surgical abortion is usually necessary. In a recent case that made international headlines, PEI woman Courtney Cudmore was prescribed abortion pills, but was then denied emergency room care when the drugs didn't work properly.
"It's just not ideal," MacQuarrie continued about the drugs doctors currently prescribe. "We wouldn't allow a lung infection to be treated with an antibiotic that's not appropriate for treating that lung infection, right? We wouldn't do that because that's not the right drug for that cause. So I don't know why we would have a different standard of care for women who need abortions."
She is hopeful that mifepristone's approval will help eliminate some barriers that exist in Canada regarding abortions.
Abortion Rights Network spokesperson and psychologist Colleen MacQuarrie echoed that sentiment, but said there's still a long way to go.
"There's still some serious issues that need to be solved on the ground here," she told VICE News. "Mifepristone is not a panacea at all. I think the cost of it will be potentially prohibitive and we'll still be looking at local access issues."
She said the ARN put in a request to Health Canada to find out why the approval was taking so long and the health authority told them it was an administrative issue, not a political issue. "There wasn't any sort of malfeasance happening around that — it was just a matter of making sure all the i's were dotted and t's were crossed," she said.
Follow Hilary Beaumont on Twitter: @hilarybeaumont
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