Abortion provider MSI enabled dangerous late abortion

One of the UK’s largest abortion providers, MSI Reproductive Choices, has been named in court after supplying drugs used for a dangerous late-term abortion.

Nicola Packer is currently on trial in London after using the drugs to procure an abortion in 2020. She had a phone consultation with MSI on 4 November, was sent the pills by post and three days later attended Chelsea and Westminster Hospital. An obstetrician there estimated the child she had been carrying to be at 22 weeks’ gestation.

The then-Conservative government had rushed a DIY abortion policy through during the Covid lockdown in March. The authorisation for at-home medical abortions  only allowed until ten weeks’ gestation, with later medical abortions presenting even greater risk to the mother. The prosecution’s case against Packer is that she intentionally procured an unlawful abortion because she was in excess of 24 weeks pregnant and she knew that she was over 10 weeks pregnant at the time of taking the medication.

Predictably dangerous

At the time, Christian Concern warned and campaigned against the introduction of pills by post abortions.

We challenged the legality of the government’s authorisation through a judicial review, pointing out that it was against the purpose of the Abortion Act. We demonstrated the extra risks and trauma that these abortions brought to women and through our mystery client report demonstrated that the abortion providers were leaving their systems wide open to abuse.

Evidence presented in court this week showed that Nicola Packer, had searched on her phone about later stage abortions.

Had Nicola Packer been clinically assessed by an in-person appointment – as would have happened historically – MSI would have determined the gestation and she would not have been able to obtain the pills.

Former director of Marie Stopes International, Kevin Duffy, said in his expert witness statement to the High Court that:

“These ultrasound scans are part of the routine processes primarily to ensure accurate assessment of the gestational age (GA). This is an essential step for providers, especially when the woman might be in some doubt about the timing of her last menstrual period (LMP). . . .

“Certainty of GA is important because the new regulations limit EMA at-home to a maximum GA of 9.6 by the day on which the misoprostol is self-administered. Also, it is accepted that the efficacy of the medical abortion treatment reduces as GA increases, with an increase in potential side-effects experienced. BPAS notes this on its website.

“These new regulations mean that the assessment of GA [gestational age] is solely dependent upon the woman’s accurate and honest recall of the first day of her LMP. The prior use of ultrasound scan was to overcome any lack of provider’s confidence in the woman’s recall.”

Care for women

Christian Concern also collaborated with other pro-life groups in the Care for Women initiative demonstrating the extra risks and trauma caused to women by at-home abortions.

‘Sophie’ needed emergency surgery after taking pills, also supplied by MSI Reproductive Choices. She was seen in person, but took the pills at home.

“When I took the second pill at home … I began to experience the most excruciating pain. It continued to escalate that evening to the extent I thought I was going to die.

“I was desperate for more pain relief. Fortunately, my friend prevented me from taking too much.”

One of several cases

Nicola Packer’s case is not the first case of illegal use of abortion pills. There have been several other cases of women being convicted for committing an illegal abortion.

In one particularly egregious case last year, a man was convicted of sexually assaulting a pregnant woman and giving her abortion pills to induce a miscarriage. The pills had been obtained by deception through telemedicine, and were also given to the pregnant woman by deception.

This kind of abuse of abortion pills is only possible because of pills by post abortion with telemedicine appointments which cannot properly assess the gestation of the person or the accuracy of any other statements she makes.

Before the introduction of pills by post abortion, women were required to have an in-person consultation with an ultrasound or physical examination by a clinician. The removal of this requirement leaves the system wide open to abuse.

‘Not healthcare’

Andrea Williams, Chief Executive of Christian Concern said:

“This case shows that we were right to warn about the dangers of pills-by-post abortion.

“We warned that exactly this kind of thing would happen, and it has happened.

“We demonstrated through a mystery client survey that BPAS and Marie Stopes UK would send out pills to women in spite of fake details being provided.

“We call on the government to urgently investigate how it is that providers are sending out pills to women who are well beyond the legal gestation limit for their use.

“Pills by post abortion is not safe and it is not healthcare. The government should act to ensure that women are required to have a proper health assessment before any abortion is carried out.”