Contraception, abortion and fertility
Choosing contraception, emergency contraception, medical abortion and initial infertility work-up. Consent and confidentiality for young people are often tested.
High-yield points
LARCs (implant, hormonal IUD, copper IUD) are the most effective reversible methods and are recommended first line.
The etonogestrel implant lasts 3 years; the copper IUD is also the most effective emergency contraceptive if inserted within 5 days.
Oral emergency contraception: levonorgestrel 1.5 mg (best within 72 hours) or ulipristal 30 mg (up to 120 hours), both available from pharmacies without a prescription.
Australia uses the UK Medical Eligibility Criteria (UKMEC) for contraceptive safety; e.g. migraine with aura is an absolute contraindication to combined hormonal contraception.
Enzyme-inducing drugs (e.g. carbamazepine, rifampicin) reduce the effectiveness of the pill and implant.
Medical abortion (mifepristone then misoprostol) is available up to 63 days gestation through trained prescribers and pharmacists.
Infertility: investigate after 12 months of trying (6 months if the woman is 35 or older); assess both partners, including semen analysis.
India vs Australia
Where the answer the AMC marks correct differs from what’s usually taught in Indian MBBS.
| Aspect | India (MBBS)What you learn in MBBS | Australia (AMC)What the exam marks as correct |
|---|---|---|
| Abortion law | Medical Termination of Pregnancy Act (national), with gestation limits and doctor opinions. | State and territory law. Medical abortion (MS-2 Step) to 9 weeks can be prescribed in general practice. Objecting doctors must usually refer on. |
| Contraceptive mix | Female sterilisation dominates; also condoms, copper IUD, DMPA and centchroman. | LARCs (implant, hormonal IUD) are promoted as most effective. Centchroman is not available. |
| Young people's consent | Parental involvement is usually expected. | A Gillick-competent young person can consent to contraception confidentially. |
| Surrogacy | Commercial surrogacy banned; altruistic only. | Largely the same: only altruistic surrogacy is legal. Donor-conceived people can usually learn donor identity; rules vary by state. |
Abortion law
India (MBBS)
Medical Termination of Pregnancy Act (national), with gestation limits and doctor opinions.
Australia (AMC): what the exam expects
State and territory law. Medical abortion (MS-2 Step) to 9 weeks can be prescribed in general practice. Objecting doctors must usually refer on.
Contraceptive mix
India (MBBS)
Female sterilisation dominates; also condoms, copper IUD, DMPA and centchroman.
Australia (AMC): what the exam expects
LARCs (implant, hormonal IUD) are promoted as most effective. Centchroman is not available.
Young people's consent
India (MBBS)
Parental involvement is usually expected.
Australia (AMC): what the exam expects
A Gillick-competent young person can consent to contraception confidentially.
Surrogacy
India (MBBS)
Commercial surrogacy banned; altruistic only.
Australia (AMC): what the exam expects
Largely the same: only altruistic surrogacy is legal. Donor-conceived people can usually learn donor identity; rules vary by state.
The Australian context
Abortion is legal and regulated by state or territory law throughout Australia, not by the Medical Termination of Pregnancy Act as in India. Doctors may conscientiously object but in most jurisdictions must refer the patient on. Young people can consent to contraception if they are Gillick competent.