Rule change around medical abortion

WA’s abortion reform bill was passed by State Parliament last month, and here sexual health expert Dr Alison Creagh reminds doctors of some amended rules around medical abortions.

From 1 August 2023, any doctor in Western Australia has been able to prescribe the medical abortion medications MS-2 Step (mifepristone and misoprostol), and they are no longer required to complete an online training course every three years.

Dr Alison Creagh

In addition, pharmacists no longer need to be authorised to dispense these medications.

These changes are likely to significantly improve access to medical abortion for patients. However, it is important that each practitioner new to medical abortion think about their own process to minimise the risk of complications. It is recommended to seek support from those with significant experience, and/or who have completed some training.

Online training, while no longer a requirement, is still available at no cost from the drug manufacturer. More information is available at

Factors to consider

For those hoping to offer medical abortion soon, it is important to consider:

  • Will I offer ’very early’ abortions (before the pregnancy tissue can be seen on ultrasound in the uterine cavity)? If so, how will I make sure the patient is well-informed about the risk of ectopic pregnancy?
  • How will I make sure the patient has all the information they need to make an informed choice of procedure, how to take the medications, and what to do if any difficulties occur?
  • How will I ensure that the patient understands the follow-up process, and the risk of complications?
  • How will I ensure that follow-up is completed?

There are resources about abortion for patients and for health professionals, including:

  • King Edward Memorial Hospital – WNHS pregnancy choices and abortion care service (booklets for medical practitioners and patients)
  • The SHQ patient resource – I’m Pregnant: What Are My Options?
  • And for more information about assessment, management, and referral for unintended pregnancy and abortion, the following recently reviewed pathways are available from HealthPathways WA: Unintended Pregnancy and Abortion; Medical Abortion; and Follow-up After Abortion.

Sexual Health Quarters (SHQ) also has a course on medical abortion prescribing in development.
Those interested should contact 

Dr Alison Creagh is Medical Educator at Sexual Health Quarters.

ED: The Abortion Legislation Reform Bill 2023 was passed by the WA Parliament on September 20, to streamline access to abortion and bring WA’s regulations in line with other states. 

Key changes included removing the need for women to be referred for an abortion by a doctor; no longer requiring women to undergo mandatory counselling; and moving provisions out of WA’s criminal code. Additional requirements that are imposed on late-term abortions will also be applied from 23 weeks, rather than 20 weeks currently. Doctors with a conscientious objection to abortion will need to refer women to a doctor who offers it.