Abortion Services in New Zealand

 

Medical abortion

What is medical abortion?

Medical abortion (also known as 'medication' abortion) is a way to end pregnancy without surgery. This can be used safely at any stage of pregnancy, but in later pregnancies (after 9 weeks from the beginning of the last normal menstrual period) women will need to stay in hospital until the procedure is completed and this may take more than one day.

In New Zealand almost all hospitals/clinics which provide first trimester surgical abortion also offer medical abortion (except Northland, Hawkes Bay and Blenheim). Tauranga provides a medical abortion only service for women in Bay of Plenty.

Many other hospitals offer medical abortion for later terminations, especially terminations for fetal abnormality. Under New Zealand law all medications used have to be given in a licensed hospital/clinic and women must stay in the hospital until it is considered medically safe for them to be discharged home.

Early medical abortion

(Up to 63 days after the beginning of the last menstrual period)

The treatment

The treatment will usually consist of one Mifegyne® tablet containing 200mg of mifepristone. This acts by blocking the effects of progesterone, a hormone which is needed for pregnancy to continue. The Mifegyne® data sheet can be viewed on the MedSafe website.

This will be followed 0-48 hrs later by the insertion into the vagina, or inside the mouth (buccal), four tablets each containing 200µg of Cytotec® (misoprostol). This is a different type of hormone, a prostaglandin, that helps to expel the pregnancy. If the woman remains in hospital a second dose may be given if the woman has not passed the pregnancy sac within 4 hours.

In many countries women are given this second medicine to take home. In New Zealand and in the UK the law requires that both these medications are given "on licensed premises" i.e. in the abortion clinic.

Who can use this treatment?

Most women can have the treatment. However it is not suitable:

In some other circumstances the treatment may also be unsuitable so the doctor must be advised:

The doctor will discuss whether the treatment is suitable.

Some other precautions

Taking the treatment

What are the effects of treatment?

Follow-up

What about contraception?

If the woman is Rh negative

What may be expected after going home

Second trimester medical abortion

In the second trimester of pregnancy (after 12 weeks) a pregnancy is aborted medically by inducing labour. This process has been used for many years in NZ as an alternative to late surgical abortion.

The treatment consists of two different pills Mifegyne® (mifepristone) followed by Cytotec® (a prostaglandin). The process is similar to that with early medical abortion except that it is likely to take longer and be more painful.

The treatment

Mifegyne® (mifepristone) 200-600mg (one to three tablets) is the first medication.This acts by blocking the effects of progesterone, a hormone which is needed for pregnancy to continue.

This will be followed 24-48 hrs later by a course of prostaglandin, usually Cytotec® (misoprostol). The dose, frequency and method of delivery of the drugs varies from clinic to clinic. This prostaglandin acts on the uterus in a number of ways to induce contractions that expel the pregnancy.

Who can use this treatment?

Most women can have the treatment but it is imprtant that the doctor knows the full history of the woman.

How is the treatment taken?

What are the effects of treatment?

Follow-up

What about contraception?

If the woman is Rh negative

What may be expected after going home

Last Updated: 13 August 2014