Women seeking an abortion in Canada will now be able to use the abortion pill up to nine weeks into a pregnancy.

Health Canada updated its product monograph for Mifegymiso, the two-drug combination of pills that doctors can prescribe to women who want a medical abortion. The current monograph, approved in July 2015 after years of delays, states that Mifegymiso is safe for use up to seven weeks into a pregnancy — even though most countries that have legalized the abortion pill use a 10-week limit.

The Society of Obstetricians and Gynaecologists of Canada also states that the abortion pill is safe to use up to 10 weeks into a pregnancy, and some clinics in Canada already use that guideline rather than the seven-week restriction put in place by Health Canada because provinces can also issue their own recommendations.

The abortion pill became publicly available in Canada in January 2017.

Since then, critics of the Health Canada prescribing restriction have said it prevents many women from being able to access a medical abortion because they often do not realize they are pregnant until around five weeks into a pregnancy.

After that, they face a tight timeframe to decide whether to terminate — and to find both a doctor willing to prescribe the pill and a pharmacy willing to dispense it.

Dr. Supriya Sharma, chief medical advisor at Health Canada, told iPolitics the change follows a departmental review of scientific literature along with a submission from Celopharma, the company which distributes the drug in Canada.

“A woman might not know she’s pregnant until several weeks into her pregnancy,” Dr. Sharma said. “If you were pregnant and eight weeks along, for example, you may not have that as an option. So this is giving another option to women that are between seven to nine weeks along with their pregnancy.”

She said Health Canada’s review only suggested that the product is safe and effective within the nine week time-frame, but using it further along in the pregnancy is still an option as an off-label prescription if a practitioner decides the patient’s circumstances warrant that.

The Health Canada changes announced Tuesday will also allow pharmacists to directly prescribe the pill to patients.

The Canadian Pharmacists Association said in a statement that allowing pharmacists to directly dispense the drug to patients is an “important step to address the patchwork of dispensing rules across Canada.” But the organization also called for governments to provide universal coverage of Mifegymiso across Canada.

“Universal coverage of Mifegymiso in Canada is limited and out-of-pocket costs to access the medication are overly restrictive for patients who are not covered by a drug plan,” it said.

Health Canada’s monograph changes also mean that health professionals no longer have to register with Celopharma, the company that produces Mifegymiso, in order to prescribe or dispense the drug. The government is also dropping the requirement for patients to provide written consent to use the drug.

This will be the second time Health Canada has eased restrictions on access to the abortion pill over the last year.

When it first approved Mifegymiso, Health Canada required pharmacists to complete a mandatory training course before being allowed to dispense the drug.

That requirement was axed in May 2017 and pharmacists can now dispense the drug directly to patients.

Dr. Sharma said Health Canada is not currently reviewing anything else about the drug, and said more studies are needed before any other tweaks can be considered to the prescribing timeline.