Progress in Medical Abortion
On December 30, 2014, the Ministry of Public Health recognized the importance of medical abortion technology and requested the registration of Mifepristone (RU486) and Misoprostol (Cytotec) packaged together with the Food and Drug Administration (FDA) for use in terminating pregnancies. Later, on June 13, 2016, the Subcommittee on the National List of Essential Medicines considered selecting both drugs to be included in the National List of Essential Medicines under sub-list J(1). Under this sub-list, a special project must be implemented under government agencies, with the Bureau of Reproductive Health, Department of Health, Ministry of Public Health playing a role in organizing the special project, supported by the National Health Security Office (NHSO) for the expenses of Mifepristone (RU486) and Misoprostol (Cytotec) packaged together.
Under this special project, healthcare facilities wishing to use medical abortion drugs must be part of the NHSO network or be a service unit providing medical services of the NHSO, or register the drugs with the Department of Health. Forms for drug registration and related reports can be found on the Bureau of Reproductive Health’s website http://rh.anamai.moph.go.th/main.php?filename=safe_abortion
Although both types of medical abortion drugs are registered as part of the National List of Essential Medicines, they still need to be distributed under a special project, making it quite difficult for women facing unplanned pregnancies who choose to terminate their pregnancies to access these drugs. This is due to the limitations of the existing healthcare service system, and the number of hospitals registered to receive drugs under the special project is not many. Additionally, hospitals providing services set criteria for pregnancy termination that do not cover all guidelines, especially mental health indications. As a result, both types of abortion drugs are still widely sold on the internet without any pregnancy history being taken, leading women seeking to terminate pregnancies to face the risk of whether the drugs ordered are genuine or counterfeit, and the dosage does not correspond to the gestational age, often claiming to be usable at any gestational age.
Furthermore, after purchasing abortion drugs online, there is no consultation service for drug use and side effect management, causing many women to experience incomplete abortions, hemorrhaging, and subsequent bloodstream infections, with many losing their lives.