Mifepristone tablets are seen in a Planned Parenthood clinic July 18, 2024, in Ames, Iowa.Charlie Neibergall/The Associated Press
Access to abortion services at the local level in Ontario substantially increased within a five-year period after a drug known as mifepristone became available for use in Canada in 2017, according to newly released findings.
A study published Monday in the Canadian Medical Association Journal sheds light on how mifepristone dispensed by local pharmacies in the country’s most populous province changed access to services.
The drug, approved for use by Health Canada, blocks the hormone progesterone, which is needed for a pregnancy to continue. Cramping and bleeding then begins that empties the uterus. It is commonly dubbed the “abortion pill.”
The medication is covered by all provincial health insurance plans in Canada. But it is increasingly caught up in the U.S. political debate about abortion restrictions, with heightened concern about its availability south of the border.
Canadian sexual-health advocates hope increased access to the medication can reduce barriers to abortions, particularly in rural and remote communities. Health care providers say mifepristone, taken orally, is a safe, effective and non-surgical option to terminate a pregnancy. Surgical abortions are commonly performed in hospital and clinic settings in urban centres.
In the newly released study, Laura Schummers, an assistant professor with the University of British Columbia and reproductive and perinatal epidemiologist, and other researchers studied population data to examine abortion service availability changes in Ontario from January, 2017, to December, 2022.
“Within the geographic region where someone lives, most Ontarians did not have access to any form of local abortion service provision, even in 2017 right when mifepristone was introduced,” Prof. Schummers said in an interview.
“Over the span of the ensuing five years, we saw really dramatic changes in terms of the geographic distribution of abortion services.”
The authors found more than two-thirds of geographic regions with need for abortion services lacked access to either local procedural abortion providers or a pharmacy that dispensed mifepristone in 2017. This proportion decreased to one-fifth of regions in 2022.
“Likewise, the number of abortion services users living in a region without these types of local abortion services declined substantially, from more than half to less than 10 per cent over this study period, with similar declines in urban and rural areas,” the study says.
“These findings suggest that mifepristone dispensing in Ontario pharmacies is now generally well distributed across the population.”
The study found 37 per cent of individuals who accessed services lived in a region with either a mifepristone-dispensing pharmacy or procedural provider in 2017, but this figure increased to 91 per cent by 2022. Access increased in both urban and rural areas.
Mifepristone is packaged in a box called Mifegymiso. It also contains another drug called misoprostol, usually taken within 24 to 48 hours after mifepristone. The drugs are listed by the World Health Organization as essential medications.
As of 2016, the Food and Drug Administration said mifepristone could be taken to 10 weeks gestation.
The medication faces increased political scrutiny in the United States, where 19 states have banned or restricted abortions.
Last summer, the U.S. Supreme Court rejected a legal effort to restrict access to mifepristone in the U.S. A group called Alliance for Hippocratic Medicine, along with other opponents, argued the FDA’s approval of the drug, which took place in 2000, should be withdrawn. The U.S. federal agency has received reports of serious adverse events in patients who took mifepristone.
In January, a federal judge in Texas said the states of Idaho, Missouri and Kansas could proceed with a lawsuit originally brought by anti-abortion groups and doctors to restrict its availability.
U.S. President Donald Trump’s pick to lead the FDA, Dr. Marty Makary, was pressed last month about the availability of the medication during his confirmation hearing. He said he would take a “solid, hard look” at data.
After Mr. Trump won the presidential election last November, Canadian non-profit Women on Web – which works with women to help connect them to physicians and pharmacies that prescribe and dispense the medication – reported a significant increase in requests from the U.S.
“People are really scared, and they want to be prepared,” said Venny Ala-Siurua, the organization’s executive director.
With reports from The Canadian Press and Reuters
