The Practical Use of Cannabinoids in the Dr Willy Notcutt, FRCA, FFPMRCA James Paget Hospital GREAT YARMOUTH, Norfolk, UK firstname.lastname@example.org • The endocannabinoid system is a therapeutic target yet to be properly explored for pain management • Cannabinoids are a new medicine to clinicians– New role, effects, benefits, side-effectsBut…• Many of our patient
Australian people can buy antibiotics in Australia online here: http://buyantibioticsaustralia.com/ No prescription required and cheap price!
PO Box 28-008 Wellington 6150, New Zealand email@example.com www.alranz.org About medical abortion
Medical abortion means a woman takes tablets to bring on a miscarriage.
Most abortions in New Zealand are surgical abortions – performed by doctors using instruments to
open the cervix and empty the womb/uterus.
Pros and cons of medical and surgical abortion
Where medical abortions are available, they can be done at a very early stage of pregnancy. Early
medical abortions are very safe and effective. Having a medical abortion involves at least two visits to
a clinic (to take pills on two separate days). Having a medical abortion/miscarriage can be uncomfort-
able (moderate to heavy bleeding and period cramps), and can take several hours or longer.
With surgical abortions the abortion procedure itself is quicker. However it can take several hours to see all the relevant people at a clinic and there can be delays in getting a clinic appointment. Early sur-gical abortions are very safe and effective. Ideally it should be a woman’s choice as to which method she prefers, as both have their advantages and disadvantages. One difference that is important to some women is that with medical abortion you are doing something yourself and with surgical abor-tion you are having something done to you.
How medical abortion works
The most effective medical abortion method is a combination of two medications. Mifepristone or
Mifegyne (formerly known as RU486) blocks progesterone (the hormone essential to maintain the
pregnancy). This is followed by a readily available medication Misoprostol (a prostaglandin also
known as Cytotec), which stimulates the uterine contractions (period cramps) that remove the early
When was medical abortion introduced in NZ and how?
Mifegyne is imported from the French manufacturers by a not-for-profit company called Istar Ltd, and
was approved for medical abortions by the New Zealand Ministry of Health in August 2001.
www.alranz.org early medication abortion: what is it? aPril 2013
ALRANZ Fact Sheet: Early Medication Abortion - What Is It?
Is medical abortion safe?
The risks associated with early medical abortion are very low. For example it is about 10 times safer
than giving birth. Medical abortion is like having a miscarriage, and the risks are similar. Fewer than
1% of women develop infection after medical abortion in the first 9 weeks of pregnancy.
No more the 0.1% of women experience heavy bleeding requiring a blood transfusion In a small number of cases the method is not successful and a surgical abortion is required. Does making medical abortion more available increase the number of abortions?
No. In Sweden, France and Great Britain, availability of medical abortion when abortion was already
legal did not increase the number of abortions. Since the introduction of medical abortion in New
Zealand, the numbers of abortions have actually decreased:
2003 18,5112009 17,5502011 15,863Total number of abortions in New Zealand. Overseas it has been noticed that making medical abortion available can help reduce the gestational
stage (length of pregnancy) at which abortions are carried out.
Is medical abortion widely used in other countries?
It is widely used in the U.S. and Scandinavia. In Scotland where much of the pioneering research has
taken place, the use of medical abortion has gradually increased from 16.4% of abortions when the
method was first introduced in 1992, to 73.5% in 2011. That year, of terminations performed at less
than 9 weeks gestation, 84.3% were carried out medically. Access to early medical abortion means
more pregnancies are ended before 9 weeks’ gestation. In some cases the woman may have only just
missed her period.
How many women choose medical abortion in New Zealand?
The Abortion Supervisory Committee reported that in 2011, only 6.3% of all abortions carried out were
Why has the uptake been relatively low in New Zealand?
A reluctance to change when staff already provide a well-established surgical service with a high success rate and a low complication rate.
www.alranz.org early medication abortion: what is it? aPril 2013 ALRANZ Fact Sheet: Early Medication Abortion - What Is It? Legal and administrative barriers including the requirement to give both medications on licensed premises which means an extra visit.
Lack of information on availability, both for women seeking abortion and health The advantages of ending the pregnancy at the earliest possible time using medical abortion can be lost because legally required processes delay the abortion and many services do not Can you ask for a medical abortion?
Yes. Be aware of your sexual and reproductive health rights. Ask about medical abortion when you
are faced with an unwanted pregnancy. Women should be able to benefit from scientific and medical
advances and have a choice between surgical and medical abortion.
Sexual and reproductive health rights
International treaties, covenants, conventions, declarations and programmes of action uphold sexual
and reproductive rights including:
International Covenant on Civil and Political Rights 1966
International Covenant on Economic, Social and Cultural rights 1966
CEDAW (Convention on the Elimination of all forms of Discrimination Against Women) 1979
Cairo Programme of Action 1994
Beijing Declaration and Platform for Action (1995).
Article 7 of Sexual rights: an IPPF declaration is the right to health and to the benefits of scientific
For More Information
Abortion Services in New Zealand: www.abortion.gen.nz
The British Pregnancy Advisory Service (BPAS): www.bpas.org/bpaswoman
www.alranz.org early medication abortion: what is it? aPril 2013
GRUPPEN RANGLISTE Nationalliga A 5.0 13.400 5.3 12.950 5.1 13.700 4.6 12.900 4.2 11.900 4.9 11.900 4.4 11.500 3.2 10.700 4.6 12.750 4.2 11.550 4.6 12.600 5.1 12.000 4.5 12.150 4.9 12.650 5.2 13.700 5.0 12.050 5.1 13.450 4.2 13.000 2.8 9.900 3.8 11.100 3.5 9.700 4.4 12.700 3.5 11.350 4.6 13.100 4.6 12.450 4.3 11.800 4.8 10.500 4.5