untitledAustralia: Tabbot Foundation, telephone abortion service

The Tabbot Foundation’s telephone abortion service, launched nearly a year ago, has so far provided more than 850 medical terminations, with many of its referrals coming from GPs.

The procedure they follow starts with a referral for an ultrasound and pregnancy (blood) test. When results are confirmed, a phone consultation is organised with a gynaecologist or GP with family planning experience and, if required by state law, a clinical psychologist. Women eligible for a termination are mailed mifepristone and misoprostol pills as well as antibiotics, analgesics and anti-emetic drugs. A registered nurse and on-call doctor are available to guide them through the process by phone and for any follow-up. Another blood test is ordered 10 days later to confirm the termination was successful. The cost to patients is AU$250 after a Medicare rebate. More information here.

untitled4France: Strengthening of the role of midwives reawakens a conflict with gynaecologists

Following a government decree of 5 June 2016, midwives will soon be able to provide medical abortion pills up to seven weeks of amenorrhoea (nine weeks LMP) without the supervision of a gynaecologist. To promote knowledge of this new policy, the Department of Health launched a communications campaign on 22 June to raise public awareness of this expansion of midwives’ roles.

On 28 June, six professional bodies for gynaecologists and obstetricians published a communiqué addressed to the government, objecting to the new policy. The communique states that they “have had to react in the face of this attempt to pit two professions against each other that have always worked in complementarity and in good agreement“. What concerns them, they say, are a series of measures that the government has justified as needed in order to facilitate greater access to care for women, especially in rural areas.

The crux of the problem, says the Le Monde article, is competition. Since 2009, midwives have been permitted to provide a growing list of sexual and reproductive health services, including contraception, Pap smears and more. More and more, midwives’ training, though lasting fewer years than that of obstetrician-gynaecologists, allows them to acquire skills which overlap with those of the doctors. This is because the procedures involved have been simplified so much. More information here.