Abstract
Mifepristone medication abortion was first approved in China and France more than
30 years ago and is now used in more than 60 countries worldwide. It is a highly safe
and effective method that has the potential to increase population access to abortion
in early pregnancy, closer to home. In both Canada and the United States, the initial
regulations for distribution, prescribing, and dispensing of mifepristone were highly
restricted. However, in Canada, where mifepristone was made available in 2017, most
restrictions on the medication were removed in the first year of its availability.
The Canadian regulation of mifepristone as a normal prescription makes access possible
in community primary care through a physician or nurse practitioner prescription,
which any pharmacist can dispense. In this approach, people decide when and where
to take their medication. We explore how policy-maker-engaged research advanced reproductive
health policy and facilitated this rapid change in Canada. We discuss the implications
of these policy advances for self-management of abortion and demonstrate how in Canada
patients “self-manage” components of the abortion process within a supportive health
care system.
Keywords
abortion - Canada - health policy - implementation science - mifepristone
