Abortion Safety and Use with Normally Prescribed Mifepristone in Canada

The rate of with expected values for September 2019, a time second-trimester abortions declined from 5.5% point selected a priori to balance model stability of all abortions to 5.1% after the availability of (greatest in the middle of the study period) and mifepristone with a normal prescription. [...] Introduction of mifepristone Removal of mifepristone with restrictions restrictions Shown are the results of interrupted time-series analy- 100 ses of the level and trend of abortion outcomes in Ontario, Canada, among all surgical and medical abortions that were provided before the introduction 75 of mifepristone in the province (2012 through 2016), after the introduction but with Risk Evaluation. [...] The modestly slower decline in the abortion rate, relative to the expected decline based on the trend before mifepristone had become avail- tion rate by enabling termination of pregnancy able, may be due in part to the provision of abor- before the occurrence of miscarriage, even in the tion earlier in pregnancy. [...] Percent of Abortions Percent of Abortions Percent of Abortions Abortion Use with Mifepristone in Canada of recent studies examining patient-reported out- become available, the expected incidence trend comes during the coronavirus disease 2019 pan- after the availability of mifepristone leveled off demic, when REMS-like restrictions were tempo- because of the more rapid increase in the num- rarily. [...] cated.33 The fundamental assumption underlying the The small increase in the incidence of ectopic validity of interrupted time-series analysis is that pregnancy that was detected after unrestricted outcome trends before the exposure of interest access to mifepristone was consistent with the would have continued if the exposure had not increasing trend before the availability of mife- occurred.