Instead of being admitted to a clinic for a surgical abortion, women may soon have the option of a ”take-home” pill to end a pregnancy.
The stigma facing women presenting themselves at public clinics and hospitals for abortions, and the health-care workers who perform them, could soon be eased with the introduction of the RU486, or ”abortion pill” in South Africa.
The Johannesburg-based Women’s Health Project, an NGO that advises the Department of Health on women’s health issues, has secured funding to start piloting the drug at five designated sites countrywide from the end of September.
The organisation is lobbying the government to become involved in both publicising the drug and providing the infrastructure in public health facilities for it to be administered.
The RU486 could mean that instead of being admitted to a clinic or hospital for a surgical abortion, women will have the option of a ”take-home” pill to end a pregnancy. The drug must, however, be prescribed by a physician or qualified and trained health-care worker such as a midwife.
The Choice on Termination of Pregnancy Act, promulgated in 1996, entitles women in South Africa to abortion on request for up to 12 weeks.
The drug, registered under the name Mifepristone, was originally engineered in France in 1980, and has already been used in nearly 20 countries, including Sweden, the United Kingdom and China, since the early 1980s. It was approved by the South African Medicines Control Council last year and is used by some local private practices in medical abortions.
The funding for the piloting of the drug will come from the Medi-Team Trust, a consortium of South African NGOs working in the reproductive health sector.
In March this year five local doctors and nurses were trained in Paris on the pharmacology, usage and administration of the drug. This is in addition to the normal training for performing pregnancy terminations, in pre-and post abortion-counselling.
The treatment with the RU486 involves orally consumed pills, which firstly weaken the attachment of the foetus to the womb, then cause contractions and bleeding of the womb, expelling the tissue. Eligibility is determined by length of pregnancy, which must be confirmed by ultrasound.
Dr Kin San Tint, who heads the RU486 research project for the Women?s Health Project, says the drug will empower women by expanding their reproductive health choices.
Tint says a medical abortion using the RU486 is far cheaper than a surgical abortion, saving the public health sector money by reducing hospital bed occupancy, in-hospital stay costs and the costs of training staff in surgical abortions.
But one of the most important considerations, says Tint, is that using the drug will create a ”distance” between a health-care worker and a patient, thereby removing the stigma faced by many reproductive health workers as a result of their work.
Beyond counselling Tint says, involvement of medical personnel in the use of the RU486 is minimal, except if complications arise and referral to a hospital is necessary.
The Department of Health says it is in discussion with the Women’s Health Project on the proposed piloting of the drug.
Citing concerns over infrastructure, the office of maternal, child and women?s health and nutrition in the Department of Health says investigations are under way ”to assess the sustainability of such an intervention within public health facilities, as well as the size of the population that would benefit from this drug”.