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June 29, 2020 Women in Tuscany will soon be able to voluntarily terminate their pharmacological pregnancy even in adequately equipped and functionally connected public health clinics. This was determined by the resolution approved by the regional council in today's session. The "Operative protocol for voluntary pregnancy termination (IVG) pharmacological", drawn up on the basis of the opinion of the Regional Health Council of 2014, is attached to the resolution, in order to guarantee the offer of pharmacological IVG as an outpatient service. Tuscany was the first region to adopt drug abortion, with Ru486. Now it is the first to foresee its implementation also in clinics, provided they are connected with hospitals.

Rossi: "Important step"
"Tuscany will be the first Region to provide for the administration of Ru486 outside the hospital, but always in connection with the hospital, in specialized clinics authorized to do so - underlines the President of the Region, Enrico Rossi -. It is a important step forward to further extend an appropriate health service, in line with our historical approach. We were the first to start by purchasing Ru486 abroad, considering it safer than surgical abortion. Then in 2014 the Regional Health Council adopted an opinion , declaring hospitalization unnecessary, and here is the evolution that was long awaited ".

Respect for women's rights
The Protocol specifies that the aim is to ensure a uniform, high-quality, respectful of women's rights for all women who require IVG. The pharmacological method for IVG involves the use of a dose of mifepristone, followed by one or more doses of prostaglandins. The reference treatment scheme is the one approved by the FDA (Food and Drug Administration) and Aifa (Italian Medicines Agency). Medical abortion is considered by the WHO, the World Health Organization, to be a safe and effective method.

What does the protocol provide?
To the woman who decides to terminate the pregnancy and comes to one of the offices authorized to practice IVG, with an Ivg request document / certificate issued by the doctor of the counseling center, by the family doctor or by another doctor of trust, all necessary information on pharmacological IVG must be provided and informed consent must be acquired.

How it works
The health facilities where acceptance can be carried out are all structures authorized by law 194, including adequately equipped public outpatient clinics, functionally connected to hospitals and authorized by the Region, in possession of the specific requirements provided for by the legislation, as well as defined consultants "main", in functional connection with the reference hospital. The first intervention is taking mifepristone. After the administration of the drug, the woman will have to stay inside the garrison; after the medical re-evaluation he will be able to go home. You will be provided with the telephone number of the advisory center and that of the doctor on call of the hospital unit. And the next visit will be scheduled.

The second surgery takes place on the third day, after about 48 hours from the first, in the same structure as the first surgery. The woman is given misopristol. After a period of observation, the third access is scheduled (after about 10-15 days). The check takes place about 14 days after the second surgery. If a check has taken place, a subsequent check is booked after about a month. In case of missed abortion or incomplete abortion, the surgical procedure is activated in the reference hospital.

Prevention
After closing the folder, the woman is exposed with particular care to the methods of contraception, to prevent further IVG. All possible methods must be clearly illustrated, highlighting indications and contraindications, differences, advantages, possible side effects of each method; highlighting the physical and psychological risks of having repeated IVG.

Costs
The rate of this service (completely paid by the Public Health Service, because the woman is paid under the exemption from participation in the cost) was set at 500 euros: a figure that includes the cost of the drug and refers to the entire care path.