MPs question government on home abortion

29 May 2020

Communications Manager Paul Huxley comments on how MPs have begun questioning the government about DIY abortion.

Following on from our legal challenge to the government on DIY abortions, MPs have been questioning the government about the policy.

The High Court hearing last week uncovered how the abortion industry has been at work in the Department of Health, able to get its way without proper scrutiny. Now, thanks to media coverage and people writing letters, MPs are beginning to realise the extent of the problem.

Did the government review the safety of home abortions before introducing the law?

Sir Edward Leigh MP asked:

“To ask the Secretary of State for Health and Social Care, whether his Department undertook a risk assessment before issuing the March 2020 Approval of a Class of Places approval enabling at-home abortions.”

In response, Helen Whately, Minister of State for the Department of Health, replied:

“Powers under the Abortion Act 1967 were used to temporarily approve women’s homes as a class of place where both abortion pills can be taken for early medical abortion following careful consideration of the risks and issues. In particular account was taken of social isolation and social distancing advice, that services were closing and appointments being cancelled. The measures were put in place to ensure that the vast majority of women and girls could continue to access abortion services whilst limiting COVID-19 transmission. In addition, access to abortion is an urgent matter as the procedure’s risk increases at later gestations and there are legal gestational limits for accessing services. This change was made on a temporary basis only and is time limited for two years, or until the pandemic is over.”

This answer strongly suggests that the only evidence the department considered was an emotive email sent by BPAS to try to get what they wanted all along – DIY abortions. Pro-choice activists used to say that legal abortion was needed to stop dangerous backstreet abortions – now they seem to be encouraging very risky treatments.

The government’s original position was that DIY abortions risked women being coerced into abortions and that in-person visits were an “essential safeguard”. It appears that this, and significant other risks of home abortion simply weren’t taken into consideration.

How will the government report on complications from home abortions?

Sir Edward Leigh also asked:

“To ask the Secretary of State for Health and Social Care, how his Department plans to record any complications that result from at-home abortions; and whether the NHS will be required to report on the number of women that are admitted to hospital for complications after being prescribed (a) Mifepristone and (b) Misoprostol by telephone, video conference or other electronic means.”

Helen Whately responded:

“The Department is carefully monitoring the impact of home use of the administration of abortion medication which has been introduced as a temporary measure during the COVID-19 pandemic. Complications are recorded on the HSA4 abortion notification form sent to the Chief Medical Officer. In addition, there is a statutory requirement for providers to notify the Care Quality Commission (CQC) in cases of serious injury. Providers should be reporting and escalating issues to the CQC, who will follow up directly with the provider as required. Patients presenting in a National Health Service setting unexpectedly, due to complications, should be highlighted to the relevant independent health provider and all cases should be reported on the Strategic Executive Information System. The CQC engages regularly with the Department and NHS England and NHS Improvement on these matters.

“The Required Standard Operating Procedures set out in the Department’s Procedures for the Approval of Independent Sector Places for the Termination of Pregnancy require that all providers should have in place a formal risk management system and keep a risk register to identify and minimise any risks to patients and staff.”

This leads us to Sir Edward Leigh’s third question:

“To ask the Secretary of State for Health and Social Care, whether his Department is able to ensure that a woman prescribed both abortion pills (a) over the phone, (b) via video conference and (c) by other electronic means will consume (i) both pills and (ii) both pills in the manner required; and if he will make a statement.”

to which Helen Whately responded:

“Ministers have used powers under the Abortion Act 1967 to temporarily approve women’s homes as a class of place where both abortion pills can be taken for early medical abortion up to 10 weeks gestation.

“As part of their consultation prior to treatment commencing, women will be clearly informed that medical abortion is a two-stage process which requires the administration of Mifepristone followed by Misoprostol to successfully complete the procedure.

“In addition, the taking of Misoprostol at home, a policy which has been in place since December 2018 and has not led to any identified clinical compliance or other concerns.”

This answer simply doesn’t address the elephant in the room – that with a mere 40-minute phone consultation there is no way that gestational age can be properly identified. Many women are not aware of the exact dates of their periods and, sadly, some deliberately mislead others. This week it was revealed that the ‘Pills by Post’ scheme run by BPAS was used by one woman to procure an abortion at 28 weeks gestation.

Clinical evidence shows real dangers to mothers after the 10-week limit Helen Whately noted in her answer. This scheme is accidental misuse or deliberate abuse, risking the woman’s wellbeing.

Are phone consultations really accurate?

In the House of Lords, Baroness Stroud also raised a question:

“To ask Her Majesty’s Government what assessment they have made of the ability of a medical professional to establish the gestation period of a child accurately via a telephone consultation before prescribing the at-home administration of mifepristone and misoprostol for an abortion.”

Lord Bethell answered:

“The Royal College of Obstetricians and Gynaecologists has issued clinical guidelines for healthcare professionals on Coronavirus infection and abortion care. The guidance sets out the circumstances where women should be asked to attend a clinic for an ultra-sound scan. However, it states that “most women can determine the gestational age of their pregnancy with reasonable accuracy by last menstrual period (LMP) alone”. The National Institute for Health and Care Excellence recommends in their guidance Abortion Care that services should consider providing abortion assessments by phone or video call, as evidence shows that community services and telemedicine appointments improve access to abortion services. A copy of this guidance is attached.”

It was Lord Bethell who defended the government’s original policy not to allow home abortions due to the risk of coercion. For him to be the one now defending telephone-only consultations is a very sad state of affairs.

BPAS pressured the government to allow home abortions on the basis that the first clinical appointment was only to take a pill. Questions need to be asked about what clinical services BPAS actually provides to women on the abortion pathway beyond giving them pills and sending them home. Either they misrepresented the nature of in-person appointments or they have routinely been offering bargain basement treatments handing out pills without proper checks.

Marie Stopes, by contrast, clearly states that ultrasounds are routine at these first appointments. These revelations make BPAS appear to be the cowboy traders of the abortion industry.

Is this policy definitely temporary?

Scott Benton MP asked:

“To ask the Secretary of State for Health and Social Care, whether the March 2020 regulations permitting the use of both sets of abortion pills at home are in force temporarily.”

Helen Whately:

“The changes to abortion regulation made on 30 March 2020 is on a temporary basis only and is limited for two years, or until the COVID-19 pandemic is over. It is not permanent.”

It is good to have continued assurances that this is only a temporary policy. But just how temporary is it?

Two years is a long time. It’s not at all clear how long this pandemic will last, given medical uncertainties about how the virus will progress and mutate.

The decision to allow home abortions was utterly wrong – but was put in place on the claims of BPAS that women were struggling to access abortions due to clinic closures and the danger of catching the virus.

But these facts have moved on significantly from when the decision was made. The virus has come significantly under control. The government’s five tests for loosening the lockdown have been met, meaning restrictions (which never prevented abortion clinics from being open) are being lifted.

Reverse the policy now

Even the spurious reasons given for the policy are no longer relevant. Health Secretary Matt Hancock should immediately reverse the policy and clip the industry’s wings for misleading the government.

BPAS won’t be reminding the government that this policy is unnecessary. They wanted it anyway, sneaking it in under the guise of emergency measures.

It’s up to us to protect women and save lives.

Please write to your MP, asking him or her to call for this dangerous policy to be reversed.

Find out more about DIY abortions
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