Freedom of Information investigation into complications from abortion at home.

In this briefing we bring you three new sets of data about early medical abortion services being provided across England and Wales. Our analysis will help to inform those responding to government consultations, which ask for your views on whether or not the temporary measure introduced during the COVID-19 pandemic, allowing women and girls to take both pills for an early medical abortion at home, should be made permanent. In summary:

  1. Data from a freedom of information (FOI) request to the Care Quality Commission (CQC) show that it investigated 29 serious incidents where women who had accessed early medical abortion (EMA) had suffered complications; 17 of these women had accessed the pills-by-post process, in which the abortion treatment is posted to a woman after only a phone consultation.
  2. These CQC data reveal 19 cases in which women were being treated in hospital for complications arising from early medical abortion in which the gestational age (GA) of the pregnancy was greater than the legal limit for EMA of 9-weeks-6-days, including four cases in which the GA was beyond 24 weeks. The CQC disclosed that 11 of these 19 cases were resulting from women accessing the pills-by-post process; each of these 11 cases were in breach of the temporary approval given by the Secretary of State for the Department of Health and Social Care on 30 March 2020.
  3. Data from FOI requests to NHS Ambulance Services indicate that on average 36 women make 999 calls every month seeking medical assistance for complications arising from the taking of abortion pills; each month across England and Wales there are an average of 20 ambulance emergency responses for complications related to medical abortion at home.
  4. FOI data from NHS Hospital Trusts reveal that every month 495 women attend hospital with complications arising from retained products of conception (RPOC), which is when the abortion pills have failed to complete the abortion and parts of the embryo/fetus and/or the placenta remain in the uterus. Each month, 250 women using the abortion pills at home will require hospital treatment to surgically remove retained products of conception (ERPC). Our analysis shows a 2020 rate of 2.4 ERPC per 100 medical abortions, which is consistent with previously published rates.
  5. FOI data from NHS Hospital Trusts reporting on the numbers of women being treated for complications of haemorrhage and sepsis arising after medical abortion suggest a complications rate of 7.5 per 1,000, five times higher than the rate reported by the DHSC (1.5 complications per 1,000 medical abortions).

These data tell a different story from the one being published by the major abortion providers, often quoting a DHSC report of just one complication in 23,000 abortions using the pills-by-post process during Q2 2020.[1] [2] We show that these data are being underreported; the CQC states at least 13 complications arising from pills-by-post in the same time period and the ambulance service reports 20 emergency responses each month to women at home with complications arising from the administration of abortion pills.

It would be simple for the DHSC to gather these data from NHS Hospitals and Ambulance services and to use these alongside the data on the HSA4 forms from the abortion providers when it is considering the safety and effectiveness of medical abortion at home. Continuing to conduct a public consultation without fully considering and assessing all available data does not seem to be a prudent or proper approach.

The full report is available:


[1] Source: https://www.newstatesman.com/politics/health/2020/12/how-pandemic-revolutionised-abortion-access-uk

[2] Source: https://www.bpas.org/media/3417/england-ema-consultation-template-response-december-20.pdf

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