Extreme abortion amendment must be defeated as more abuses exposed
6 July 2020 Issued by: Christian ConcernAhead of radical amendments delivered by MPs today in parliament that could result in the UK having the most extreme abortion law in Europe, a mystery client study has proven that women can obtain and administer dangerous ‘DIY’ abortion pills in breach of healthcare regulations.
The study also reveals that abortion providers are supplying the pills beyond the gestational time limits which have been set to protect pregnant women’s health.
The research follows after the The Sun revealed on May 22 eight real life cases where women were beyond the ten-week limit.
Christian Concern commissioned a public health consultant to conduct a mystery client survey (a commonly used evaluation strategy) to explore aspects related to compliance, and patient safety and safeguarding arising from the provision of remote consultations under the abortion-at-home regulations.
The volunteers made calls to abortion provider organisations, Marie Stopes and British Pregnancy Advisory Service (BPAS) presenting as women who were pregnant and seeking a termination of pregnancy. Volunteers, themselves, were non-pregnant women of reproductive age (between 18-45 years old) and men.
A ‘mystery client’ is a persona. In this instance someone pretending to be a client or customer who presents to a business to assess how well staff are adhering to company policy and guidelines as well as the laws of the land. All calls were audio recorded and full transcripts are available upon request.
Why Assessment of Gestational Age is critical
In accessing abortion pills by post getting the correct assessment of gestational age (GA) is critical for two reasons: 1) Abortion-at-home is only legal if GA is less than 9 weeks and six days on the day on which the mifepristone is self-administered 2) The effectiveness of medical abortion decreases as GA increases, along with an associated increase in side-effects and adverse events.
This is the BPAS website showing that one week of difference from less than 9 weeks to a GA of 9-10 weeks doubles the risk of an incomplete abortion; rising from 3% to 7%.
Given the importance of an accurate assessment of GA the mystery client exercise revealed that BPAS and Marie Stopes were willing to leave this assessment to the women requesting the abortion pills.
Before lockdown, when women were visiting a clinic as part of their care pathway, a service provider would never have consented a client for EMA (early medical abortion) based solely on her recall of the first day of her last menstrual period. It was routine to use an ultrasound scan to assess gestational age.
Persona used for mystery client survey
Lisa in Berkshire, Claire in Cambridgeshire, and Laura in Essex were each already 10 weeks gestational age when they made their first calls to their selected abortion provider (Lisa and Claire with BPAS and Laura with Marie Stopes).
Each of them had read about early medical abortion online and knew that the limit for EMA at-home in GB is 9.6. Reading more widely, including Women on Web, they were aware of the higher incidence of side-effects and failure rates but still decided that this is what they wanted to do.
Each of them used an online GA calculator to find a date for their LMP which would indicate a GA at just over 7 weeks. They provided these details to their selected provider and all three successfully received the abortion treatment pack in the post a few days later.
Nikki in Kent, also 10 weeks GA, phoned both BPAS and Marie Stopes, giving the same data to both including lying about her LMP and pretending that this was just seven weeks. She received abortion treatment packs from both providers and is now wondering what she might do with the second pack.
On the Boundary
Anna in Sussex made her first call to BPAS and provided a date for her last menstrual period which on the day of that call meant that she was GA 8 weeks and 5 days.
This was taken by the service provider with no comment. After making that call, she realised that she would be close to the 9.6 limit by the time of receiving the abortion pills at home. Fearing that the service provider would spot this and insist that she came into the clinic, she decided to change the date of her last period.
On her second call with BPAS, the consultation, Anna was again asked for her LMP and this time she gave a date which was two weeks later, indicating a GA of just over seven weeks. The service provider was quick to accept this critical change of date and proceeded with the consultation. Anna received the treatment pack and was able to self-administer the mifepristone the following week.
A mother accessing the pills for her underage daughter
Hannah in Hertfordshire was facing a real dilemma, her 15-year-old daughter had just told her that she was pregnant. After a sleepless night, Hannah had decided that she just couldn’t have her daughter go through the system, there was no way that she wanted the authorities to be involved or to have this on the record.
She decided that she would phone an abortion provider pretending that she was pregnant, get the abortion pills sent to their home, and then she would administer these to her daughter and this nightmare would be over.
She wasn’t too sure how this would work out, so Hannah phoned both BPAS and Marie Stopes presenting as seven weeks pregnant and asked for a termination of pregnancy using the pills at home.
The process was much easier than she had thought it would be and after a few calls she received the abortion treatment packs from both BPAS and Marie Stopes. She used one of these for her daughter and is now wondering what she might do with the second pack, perhaps one of her Mumsnet friends might want to use it for their daughter.
It’s clear that neither BPAS nor Marie Stopes knew anything about our mystery client cases until we revealed them. There were no concerns raised by either providers’ internal systems or processes, otherwise the abortion pills would not have been posted out.
Lack of proper process revealed
Andrea Williams, chief executive of Christian Concern, said: “We’re simply asking, based on the BPAS disclosure to The Sun on May 22, that there were already eight cases where women were beyond the ten-week limit, and from our own study, how many more women have obtained and self-administered the abortion pills in breach of the regulations?
“We are for the women and we are trying to point out legitimate concerns about telemedicine services related to legal compliance, client safety, and quality of care. These women need better client-centred counselling and a face-to-face consultation in which they can be assessed by a service provider before giving their consent to this procedure. A rushed telephone call, by voice only, is not the quality of care which these women deserve.
“The system is wide open to abuse from abusers, pimps, and human traffickers.
“Lockdown is over and now that restrictions are easing, we can safely reintroduce the clinic visit and an ultrasound assessment as part of the abortion care pathway.
“The amendments presented in parliament is not harmless but harmful and it is open to huge abuse. It needs to fail today.
“Abortion pills through the post is a system that needs to be stopped immediately and a thorough investigation needs to occur around the legality and practices of the two major abortion providers in the UK.”
