Australia's surgical abortion rate is dropping by 5.1% per year as access to abortion drugs improves

The rate of surgical abortions nationally has declined by 5.1% per year since the listing of mifepristone/misoprostol (medical abortion) on the Pharmaceutical Benefits Scheme in 2013, according to research published by the Medical Journal of Australia.

"It is difficult to estimate the abortion rate in Australia, as most states do not routinely report abortion data and published national data have been incomplete," wrote the authors, led by Dr. Louise Keogh, a health sociologist at the University of Melbourne's Centre for Health Equity.

"Consequently, some clinicians and academics have been accused of inflating reported rates for political reasons."

Keogh and colleagues analyzed publicly available National Hospital Morbidity Database (NHMD) data for 2014–18. The NHMD includes data on all episodes of care in private and public Australian hospitals and day procedure clinics, which defines abortion procedures as "abortion with operating room procedures" and separates them from non-pregnancy-related dilatation and curettage procedures.

"The number of surgical abortions for all women declined from 75 514 (15.4 per 1000 women aged 15–44 years) in 2014‒15 to 67 546 (13.2 per 1000 women aged 15–44 years) in 2017‒18," Keogh and colleagues reported.

"The mean annual decline in rate was 5.1%. The number of prescriptions of combination mifepristone/misoprostol for medical abortion increased from 3220 in 2014‒15 to 20 741 in 2017‒18.

"The total number of abortions for all women during 2017–18 was therefore 88 287 (17.3 abortions per 1000 women aged 15–44 years), slightly higher than the often cited estimate of 80 000 abortions per year."

Keogh and colleagues recommended further analysis of Australian data "both to ensure that this medical procedure is provided across Australia, and to contribute to the evidence base informing interventions to improve sexual and reproductive health."