Department of Health reveals 52 illegal abortions at home

Kevin Duffy, an independent public health consultant and a former Marie Stopes director, reveals that abortion providers are already breaking home abortion rules.

On 1 October, the Department of Health and Social Care (DHSC) revealed that it had been notified by abortion provider organisations that in the first six months of 2020, across England and Wales, 52 women had been prescribed the medications for abortion-at-home even though the gestational age was beyond the 10 week legal limit.[1]

The 10 week limit was chosen by the regulator because the risk of an incomplete abortion and the incidence of harmful side-effects increases with each week of gestation. BPAS, the largest abortion provider in the UK, notes how these risks increase in the ninth week of pregnancy on its website.

These are not cases in which the woman presented to the abortion service provider with an incorrect gestational age, but rather these are cases in which the registered medical practitioner, having first checked that the completed details are correct, has authorised submission of the notification of a legally certified termination of pregnancy to the Chief Medical Officer at the DHSC.

But these 52 cases were not legal.

When the Secretary of State approved a woman’s home as a place in which the abortion medication could be taken, it was clearly stated that this applied only if the gestation of the pregnancy had not exceeded nine weeks and six days at the time the Mifepristone is taken.[2]

In its answer to a freedom of information request, the DHSC revealed that in H1 2020, 40 abortions took place at 10 weeks gestation and above where the misoprostol was taken at home (out of a total number of 30,977 abortions). 12 abortions took place at 10 weeks gestation and above where both pills were taken at home (out of a total number of 23,061 abortions).

Yes, the number of abortions-at-home which were beyond the legal limit is small, but we should still be asking the following questions:

• Who were the registered medical practitioners (RMP) who certified and prescribed these 52 illegal medical abortion treatments?
• Which abortion provider organisations do they work for?
• Have these RMPs been asked to explain why they certified and prescribed these termination of pregnancy procedures in breach of the legal gestational age limit?
• What remedial actions have been taken by the provider organisations to ensure that these RMPs do not make the same mistake again, e.g. additional training or increased supervision?
• Have the relevant Clinical Commissioning Groups been notified of these breaches of contract by the provider organisations, and what actions have been taken to ensure future compliance by the provider with the contractual terms?
• Have fee-for-service payments for each of these 52 cases either been withheld or if already paid to the provider, reimbursed?

Across England and Wales, abortion is a contested matter; one for which many people have strong views. We should expect each of the approved abortion provider organisations to provide services in full compliance with the law and hold them to account when they breach these regulations.

[1] https://www.gov.uk/government/statistics/abortion-statistics-during-the-coronavirus-pandemic-january-to-june-2020

[2] https://www.gov.uk/government/publications/approval-of-home-use-for-the-second-stage-of-early-medical-abortion