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    A rural doctor has been found guilty of professional misconduct for giving women drugs to induce abortions. The physician, whose name has been kept secret, was suspended from practising for six months by the Health Practitioners Disciplinary Tribunal and was granted another practising certificate three days after the suspension ended. She told the tribunal that she considered it a necessary service. In one case, a patient later had to have a fallopian tube removed when an ectopic pregnancy ruptured, according to a decision from the tribunal. The GP, known as Dr N, gave four women who wanted to terminate their pregnancies misoprostol. The medication is commonly used to treat stomach ulcers, but cannot be given to pregnant women as it can cause miscarriages or damage to the fetus. Dr N, who has had more than 30 years' experience, hid her actions by not updating the patients' records. zithromax samples Mifepristone is an anti-progesterone that in pregnancy causes decidual shedding in pregnancies less than nine weeks gestation, sensitizes the myometrium to the contraction-inducing action of prostaglandin and causes cervical ripening. Misoprostol is a prostaglandin analogue that causes uterine contractions and cervical dilatation. In New Zealand early medical terminations consist of 200 mg mifepristone orally, followed 24–72 hours later by the vaginal administration of 800 mcg misoprostol (a prostaglandin analogue). This can be followed by smaller doses of oral misoprostol if required. New Zealand law states that oral mifepristone followed by misoprostol 24 to 48 hours later, depending on the clinical protocol, must be taken in a licensed institution. If a woman lives close by she may not have to stay in the clinic after taking the medication, but it is important she knows who to call should she have any bleeding. Medical termination is recommended by the UK RCOG as the method of choice for women up to nine weeks gestation.

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    Hile the spectre of the illegal abortionist in rough premises with dirty instruments is a thing of the past in New Zealand, there is mounting evidence that our cumbersome and onerous abortion legislation is pushing some women to bypass the law in an effort to obtain an abortion on their own terms. According to figures from the Ministry of Health, a steady flow of medication that can be used to induce abortions is being intercepted at New Zealand’s borders each year by Customs. Last year, the Ministry says, 32 consignments containing mifepristone or misoprostol, both of which are used in legal medical abortion services, were intercepted and referred to Medsafe, the medical safety authority, for action. What cannot be known is how much is slipping past the Customs net. At the same time, the international abortion telemedicine service Women on Web, which provides advice and in some cases abortion medication to women primarily in areas with no safe abortion access, has reported that its help desk has seen a rising number of inquiries from women in developed countries where abortion is, in theory, available, including New Zealand. Women on Web answers about 80,000 email inquiries each year from across the globe, and in about 4,000 to 5,000 of those cases, it also provides abortion medication directly to the woman, though only after an online consultation with a doctor. Rebecca Gomperts, the Dutch physician who founded Women on Web (and before it, Women on Waves, which runs ocean-going campaigns), says New Zealand is no different from other countries, like Britain and the United States, where abortion is accessible in theory but, in practice, “not for some groups of women”. One recent inquiry the organisation received from New Zealand was from a woman who because she wasn’t a resident faced out of pocket costs of around $2,000 for an abortion. “She absolutely didn’t have the money,” Gomperts said. Medical abortion (also known as 'medication' abortion) is a way to end pregnancy without surgery. This can be used safely at any stage of pregnancy, but in later pregnancies (after 9 weeks from the beginning of the last normal menstrual period) women will need to stay in hospital until the procedure is completed and this may take more than one day. In New Zealand almost all hospitals/clinics which provide first trimester surgical abortion also offer medical abortion (except Northland, Hawkes Bay and Blenheim). Tauranga provides a medical abortion only service for women in Bay of Plenty. Many other hospitals offer medical abortion for later terminations, especially terminations for fetal abnormality. Under New Zealand law all medications used have to be given in a licensed hospital/clinic and women must stay in the hospital until it is considered medically safe for them to be discharged home. (Up to 63 days after the beginning of the last menstrual period) The treatment The treatment will usually consist of one Mifegyne® tablet containing 200mg of mifepristone.

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