RU486: Women, not politicians, should choose

November 17, 1993
Issue 

Natalie Zirngast

When the Australian Democrats initiated a private member's bill in October 2005 to remove responsibility for the abortion drug RU486 from the federal health minister and return it to the Therapeutic Goods Administration (TGA), an opportunity was created to remove a moralistic and senseless ban on an effective medical alternative to surgical abortion.

However, anti-choice campaigners and conservative politicians have hijacked the debate in an attempt to erode majority public support for abortion access and maintain restrictions on women's right to choose.

Currently, RU486 is classed under "restricted goods", a category that only includes drugs that induce abortion. The health minister must provide written permission before these drugs can be evaluated, licensed or registered by the TGA.

The TGA was set up in 1989 to allow people in Australia timely access to safe new medicines. The "restricted goods" category resulted from a 1996 amendment to the act governing the TGA's jurisdiction.

The amendment, proposed by anti-abortion campaigner and former independent Senator Brian Harradine, was specifically designed to prevent women in Australia from accessing RU486 by giving the health minister veto powers. Federal Coalition support for the amendment was traded for Harradine's support for the partial sale of Telstra. The ALP and one Greens senator also supported Harradine's amendment, but the Democrats voted against.

While RU486 was not banned by the amendment, potential sponsors were put off by the extra approval required and did not apply to market the drug in Australia. An additional disincentive was the drug's prohibited status for customs purposes.

Four women senators are now sponsoring the bill to overturn Harradine's amendment — Lyn Allison (Democrats), Fiona Nash (National Party), Claire Moore (Labor) and Judith Troeth (Liberals). It has the Democrats' and Greens' support, but Labor and Coalition MPs will be able to exercise a conscience vote on the bill.

Last December, the Senate referred the bill to a committee of inquiry and more than 4000 submissions were received. Most vehemently opposed the change. Only half specifically addressed the inquiry's terms of reference, with many attempting to use the opportunity to open a debate on the availability of abortion, rather than the method used. A flood of pro-forma letters and the use of emotive terms, such as "a drug to kill babies", in many submissions, indicate that anti-choice forces have spurred their supporters into action to stop the bill from being passed.

Half the senators on the committee, including the Nationals' Barnaby Joyce and Ron Boswell, and Family First's Steve Fielding, are vehemently anti-choice. From both sides of the debate, the committee was continually pushed towards discussing the merits of abortion in general, rather than the veto powers. The committee is expected to report its findings to the Senate on February 8, with a parliamentary vote soon afterwards.

Anti-choice mobilisation

A group called Australians Against RU486 has been formed specifically to mobilise churches, anti-abortion groups and others to put pressure on the Senate. Simone Holzapfel, former media adviser to federal health minister Tony Abbott, is the group's executive director.

The group's official launch on January 24 was attended by conservative NSW MP Reverend Fred Nile and Liberal NSW MP David Clarke. The anti-abortion organisation Right to Life and the Australian Christian Lobby are giving strong support to its campaign.

Australians Against RU486 claims to involve a number of doctors and "pro-choice" individuals who are concerned about the safety of the drug. Holzapfel claims that Australians Against RU486 does not aim to widen the debate to the general availability of abortion, but argues that the TGA cannot adequately assess the ethics of a drug "in a league of its own". The group is planning a national day of action on January 29 in support of the health minister's veto powers.

One tactic of Australians Against RU486 has been to conduct a dishonest opinion poll using Quantum Market Research. Fabricated statistics asserting that RU486 was responsible for 100 deaths per 100,000 users were provided to women before they were asked if it should be available in Australia. The 500 women surveyed were not informed that the survey was backed by Australians Against RU486. From this poll, the group claims that two-thirds of women oppose RU486's introduction.

A Newspoll survey conducted on January 13-15 and commissioned by the Australian Reproductive Health Alliance, a women's rights focused non-government organisation, found exactly the opposite. Specifically, in the context of abortion, respondents were asked if they would "personally be in favour of or against RU486 being made available in Australia for use by qualified medical practitioners". One thousand two hundred people were surveyed and 70% of women and 66% of men indicated their support.

Is RU486 safe?

Much of the case against RU486 focuses on the risks. However the evidence clearly indicates that RU486 is safe and effective. While no medications or medical procedures are risk free, the risks associated with RU486 fall well within accepted limits.

Medical abortions using RU486 have an equivalent safety record to surgical abortions; less than one in every 100,000 women dies as a result of the procedure. Medical and surgical abortions are 10 times safer than carrying a pregnancy to term. RU486 has been used by more than 21 million women in more than 30 countries. Numerous Australian and international medical organisations support the availability of RU486.

Vice-president of the Royal Australian-New Zealand College of Obstetrics and Gynaecologists Dr Christine Tippett commented on December 15 to the Senate inquiry, "In some ways Viagra is a much more dangerous drug and there has never been a consideration that it be put into a restricted category". She commented that doctors would prescribe RU486 as part of "an episode of care" including regular monitoring, not for self-administration as the anti-choice lobby claims.

A woman undergoing a medical abortion is given a specified dose of the drug by a medical practitioner at an appropriate medical facility. RU486 operates by blocking the effects of the hormone progesterone. Without progesterone, the lining of the uterus breaks down and the pregnancy cannot continue.

Two days later an additional drug is given under supervision to make the uterus contract and expel its contents. The experience is more like a miscarriage than an operation and is similar to a heavier than normal menstrual period. It is successful in 92-98% of cases and is considered the most effective method of abortion for pregnancies of less than seven weeks.

Prolonged bleeding is the most common side effect; a risk also associated with surgical abortion and miscarriage. Complications can occur with ectopic pregnancies, where the foetus is outside the womb, so an ultrasound or other checking procedure is recommended beforehand.

Anti-choice campaigners have pointed to the cases of four US women who died of a bacterial infection. However, these women were given the drug in higher doses and using a method not recommended by the US Food and Drug Administration.

RU486 could be cheaper than a surgical abortion and fulfil women's needs for privacy and a less invasive abortion method. Access to abortion could also be improved for rural and remote women, who usually have access to medical services but not to a surgical abortion clinic. With appropriate medical advice and support, women should have the right to choose the method they prefer.

Campaigning for choice

There is still a good chance that the bill will be passed, although it is likely that the vote will be close. If it doesn't pass and RU486 remains subject to ministerial bias and veto, Australian women will have suffered another blow against their right to choose.

That both major parties are allowing their MPs a conscience vote on this bill indicates that the anti-choice lobby has already succeeded in shifting the debate away from methods of abortion to the merits of abortion per se. By allowing a conscience vote and not voting along party lines, politicians demonstrate that again they are well out of step with the views of most Australians, who support women's right to choose abortion.

This time, the anti-choice lobby has been organised and mobilised in a way that pro-choice forces were not. Even if the bill passes, anti-choice forces will be ready to push

on other fronts.

We can't rely on politicians' "consciences". Supporters of choice must be prepared to also mobilise, to defend and extend access to abortion.

From Green Left Weekly, February 1, 2006.
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