Some general information on chemical abortions. This information does not constitute medical advice
Essentially abortions fall into one of two general types – surgical or chemical.
Both types of abortion are abhorrent to Pro-Life Christian people because they both end the life of the child in the womb.
The chemical abortion can be used early in a pregnancy and involves the mother taking two very potent drugs in tablet form. No surgery is required.
These drugs should only be used up to the 63rd day (9 weeks) of gestation.
There is only one brand available in Australia. It was approved for use by the TGA (Therapeutic Goods Administration) in 2012. It is known as MS-2 Step. It is subsidised by the PBS (Pharmaceutical Benefits Scheme) and was bought into Australia by the Marie Stopes organisation between 2013 and 2015 (depending on which state you are in).
Marie Stopes International are abortion providers. They have surgical abortion clinics in 36 countries worldwide. They have recently (2020) rebranded themselves MSI Reproductive Choices).
The MSI organisation have a monopoly on the chemical abortion pill market in Australia. There are cheaper options available but not in Australia. MSI charge the Australian government approximately $400 per dose. Under the PBS (the product has the code 10211K) the cost to the user is $31.60.
Since August 2023 doctors no longer need specific training or registration to prescribe MS-2 Step, and other health professionals such as Nurse Practitioners can also prescribe it. Whilst a prescription is still required once prescribed there is no longer a requirement for medical supervision.
Pharmacists can stock the drugs on their shelves. There is a push to allow pharmacists to supply the drug without prescription.
There are no reliable figures on how many chemical abortions occur in Australia because reporting is not required. However in the USA approximately two thirds of all abortions are chemical abortions.
Why are chemical abortions preferred over surgical abortions?
Chemical abortions are touted as ideal because they are private and non-invasive for the mother. She can have the abortion in her own home unsupervised. Whilst the drugs must be prescribed by a doctor or nurse practitioner this can be done via Telehealth without any physical examination.
The mother takes the first tablet (Mifepristone) which causes the abortion itself.
The second tablet (Misoprostol) induces labour to expel the child by breaking up the lining of the uterus.
Mifepristone acts on progesterone receptors to cause the end of the pregnancy, but it can act on all smooth muscles – not just in the uterus – which is why woman can experience upper GI problems and other problems.
These two drugs are fast acting and usually get eliminated quickly through the bowels – but they can stay in a woman’s system for up to 20 days.
Potential problems with the use of MS-2 step
The claimed advantage of the chemical abortion – its privacy and non-invasive nature – is also the reason most women have problems. In other words, the lack of medical supervision by a doctor is the concern, particularly because without an examination the prescriber cannot be sure he or she has the necessary information in order to treat appropriately.
For example, the prescriber may not know if the patient has an ectopic pregnancy, is using an IUD, has high blood pressure or if the gestation has advanced beyond the limit for a chemical abortion.
An examination is even more important when for privacy reasons a pregnant woman is not using her usual medical practitioner and may also not be open about her condition.
And because serious complications can occur in one in ten women taking the drugs medical supervision is vitally important during the procedure and after the procedure.
Interestingly, Raymond, Dumble and Klein, the staunchly pro-abortion authors of the book RU 486: Misconceptions, Myths, and Morals do not support the use of chemical abortions because of the risks to women.
Complications with the use of chemical abortion medication
A number of contraindications (reasons for not prescribing the drugs) that are not considered before they are provided because the patients are not under medical supervision include:
- Very common (1 in 10) headaches, nausea, vomiting
- Rare (1 in 1000 to 1 in 10000) : Toxic shock, Arhythmia, Myocardial Infarction, Hepatic failure, renal failure, uterine rupture
Other complications include
- only partial expulsion of the baby.
- Intense pain and heavy bleeding
- Because the drugs can cross the blood brain barrier severe headaches and depression can occur.
It cannot be predicted which woman will have which complication, or any complication
There is anecdotal evidence that potential complications are not explained, or not explained fully, to the woman prior to prescription.
● In the USA approximately one in ten women experience a serious adverse event within 45 days of using Mifepristone.
How the regulatory landscape has changed
When MS -2 Step was first brought out the recommendation was that women should be within 8kms of medical help and advice was immediately available over the phone. Now, there has been an erosion in safeguards: the recommendation now is that you only need to be two hours from medical support – which is entirely inadequate. The drugs have been available by telehealth and pharmacies since 2023, although there are divergent laws and access zones across the states. Doctors and other prescribers no longer have to undergo registration or take a four hour course in order to prescribe chemical abortion drugs.
Ethical and conscientious objections provisions to protect health care workers are also being eroded.
Can a chemical abortion be reversed?
The short answer is yes. Abortion Pill Reversal (APR) is possible but treatment needs to be given within 72 hours of the mother taking the first drug – and assuming she hasn’t taken the second drug. The success rate (a continuation of the pregnancy) is up to 70%.
APR is safe and there is no known birth defects risk.
The treatment uses high dose progesterone to counter the mifepristone. Women should be given this option and health care professionals should be aware of this option.
There is no data on how many women might want to use APR, or even if they know about it. It may be appropriate to put information about APR in the abortion pill boxes, just as health warnings are placed on cigarette packets.
In some countries Mifeprostol only is used for the chemical abortion – because it is cheaper – and in those cases the APR may cause birth defects but this is currently unknown.
● Genesis Pregnancy Support is one group in Australia providing help and advice on Abortion Pill Reversal.
Do women regret chemical abortions?
Many women experience grief and guilt about their abortion for the whole lives. There is no evidence that the type of abortion used makes any difference to this grief and guilt but women do report a fear of being alone when using a chemical abortion procedure and they also report the associated physical pain and discomfort.
There are countless social media messages from women saying they do and don’t regret their chemical abortions. One source is Reddit
Sources:
- Pro-Life Health Professionals Australia
- https://www.genesispregnancysupport.org.au/medical-abortion
- https://eppc.org/publication/insurance-data-reveals-one-in-ten-patients-experiences-a-serious-adverse-event
- https://www.pbs.gov.au/medicine/item/10211K
- https://www.msichoices.org/who-we-are/our-story/
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By Steve Klomp
President, Right to Life Association of WA
August 2025