MS-2 Step Prescribing
PVOGS supports RANZCOG’s 2025-2027 Strategic Plan and Advocacy Priorities, including ensuring equitable access to sexual and reproductive health services, including access to abortion – a fundamental health right.
https://ranzcog.edu.au/wp-content/uploads/RANZCOG-Strategic-Plan-2025-2027.pdf
Termination of Pregnancy:
There are two main methods available in Australia to induce an abortion, also known as termination of pregnancy (TOP). These can be surgical (STOP) or medical (MTOP). A health provider may recommend one over the other due to various factors including, but not limited to, patient preference and gestation.
What is MTOP?
MTOP is usually performed as a two-step process, called MS-2 Step, either at home or as an inpatient in hospital.
The first step of mTOP is mifepristone, which inhibits progesterone to stop the pregnancy progressing. It also starts to soften the cervix to help allow the passage of the products of the pregnancy through at the second step. The second step, taken 36-48 hours later, is misoprostol. This further softens the cervix, as well as induces contractions of the uterus to help expel the products of the pregnancy.
Do you need MS-2 Step certification to offer MTOP?
As of 2023, the TGA has made changes to the MS-2 Step process so that MS-2 Step can now be prescribed by any healthcare practitioner with appropriate qualifications and training, including nurse practitioners and endorsed midwives, without the need for certification. Restrictions on pharmacists have also been lifted to further increase accessibility of MTOP.
Although not not compulsory, it may be helpful to complete MS-2 Step online training to upskill in providing evidence-based and safe access to MTOP services. If you are an Australian AHPRA registered healthcare professional, you can complete the MS-2 Step online training here:
Learning more about the provision of TOP services:
If you are a health practitioner that wants to learn more about providing safe and evidence-based abortion care in Australia and Aotearoa New Zealand, RANZCOG has produced a clinical guideline and decision making aid to help clinicians provide safe and accessible and MTOP and STOP services for patients:
RANZCOG Clinical Guideline for Abortion Care:
https://ranzcog.edu.au/wp-content/uploads/Clinical-Guideline-Abortion-Care.pdf
RANZCOG Abortion Decision Aid:
https://ranzcog.edu.au/wp-content/uploads/Abortion-Decision-Aid.pdf
Establishing and Managing a Medical Abortion Service:
If you are a General Practitioner, the University of Melbourne Centre for Excellence in Rural Sexual Health (CERSH) offer a great array of links, resources, and online modules to assist with establishing a medical abortion model in your clinic, as well as further information to upskill in sexual health:
https://medicine.unimelb.edu.au/cersh/resources/health-practitioner-resource-hub/establishing-and-managing-medical-abortion-services#:~:text=To%20become%20a%20certified%20prescriber%20or%20dispenser%20of%20medical%20abortion,accessed%20via%20the%20provided%20link.
Overall, being a clinician that understands MTOP can help make abortion more accessible, cheaper, and less medicalised for patients, ultimately fulfilling an important demand in Australian healthcare.
https://www.1800myoptions.org.au/blog/how-does-a-medication-abortion-work/