Medical Abortion refers to “the use of medication to induce abortion instead of suction or curettage of the uterus.”
Although medication has been used for abortion for a long time, the development of a drug regimen for abortion in the first trimester, with research confirming the efficacy and safety of the drugs, has only emerged in recent years. The use of medication for abortion allows women to access safer services because it can be provided in facilities that do not have the equipment for uterine curettage.
5 significant events to raise awareness and recognition of the use of medication for abortion worldwide in each period are as follows:
1998 (B.E. 2541)
A meeting was held in Bellagio, Italy, among researchers on women’s health and international executives from various countries worldwide. The meeting discussed medical abortion and concluded that the regimen of Mifepristone combined with Misoprostol is a safe, effective, and acceptable regimen for women in developing countries. Misoprostol is currently the most widely used due to its safety, affordability, ease of storage, and widespread availability.
2000 (B.E. 2543)
A meeting of experts on medical abortion from countries worldwide was held to provide comprehensive recommendations for drug users and inform public health policy executives from countries worldwide.
2004 (B.E. 2547) The World Health Organization conducted research to study the efficacy, safety, and user acceptance in several countries worldwide and used this empirical data to make recommendations on the use of drugs and regimens for abortion.
2005 (B.E. 2548) The World Health Organization’s expert committee proposed including both drugs, Mifepristone and Misoprostol, in the WHO’s essential medicines list for abortion.
Additionally, the International Federation of Obstetricians and Gynecologists (FIGO) recommended the global use of these drugs due to their safety, acceptance, and high efficacy, achieving a success rate of 95-98% when used according to gestational age, dosage, and WHO guidelines.
2006 (B.E. 2549) The World Health Organization published frequently asked clinical questions about medical abortion based on empirical evidence, recommending that medical abortion for women with a gestational age of up to 9 weeks is safe and more than 96% effective when used correctly according to the guidelines, using the following two drugs:
- Mifepristone 200 mg, taken as one tablet, and
- Misoprostol 800 mcg, inserted vaginally 24-48 hours after taking the first tablet. Recent empirical evidence suggests that sublingual administration of Misoprostol is as effective and safe as vaginal insertion, but sublingual administration may cause more side effects, such as nausea and vomiting.
Currently, there is ongoing international research on the use of medical abortion for gestational ages beyond 9 weeks, as well as the management of service systems to improve access to medication, aiming to prevent and reduce unsafe abortion issues.
Reference: The use of medication for early abortion
Compiled by Dr. Wannapa Narawet, Concept Foundation, and Tasanai Khantayaporn, Path2health