Marie Stopes Australia (MSA) says that more than 5% of the medical abortions it provides, fail to complete. Meaning that 1-in-20 women will have fragments of the baby and/or placenta remaining in their womb after taking both sets of the tablets, mifepristone and misoprostol. These women will need to seek further treatment to prevent ongoing bleeding and the risk of infection. For some, this will be a surgical procedure (ERPC) to remove the retained products of conception (RPOC).
Across England and Wales every month, 10,000 women self-manage their medical abortion at home, some after first attending an abortion clinic, the majority using the telephone pills-by-post process. What we learn from Marie Stopes Australia is that of these, every month 500 women will need further treatment to complete their abortion. This is consistent with the findings from our freedom of information investigation. In this we found 495 women each month seeking hospital treatment for RPOC and 365 of these needing the surgical intervention.
When advocating for telemedicine abortion, MSI Reproductive Choices has made loud claims that medical abortion is highly effective and that complications are rare. It seems that their colleagues in Australia don’t agree. A failure rate of 5% can hardly be called ‘highly effective’; a rate of 1-in-20 is classified by The National Institute for Health and Care Excellence, NICE, as Common. (Rare is less than 1-in-1,000)
It is worth noting that the medical abortions provided by Marie Stopes Australia, for which they report a 5% failure rate, are for women whose pregnancies are at a gestational age (GA) of no more than 9 weeks (63 days) and each of these women has first had an ultrasound scan to confirm the GA. We know that the risk of incomplete abortion increases as GA increases and have raised our concerns about the lack of effective verification of GA under the GB telemedicine abortion guidelines, which permit abortion without a prior ultrasound scan.
In recent months, the Secretary of State for Health and Social Care and his team have announced that they are conducting an independent review of how data related to abortion complications are collected, analysed, and reported. Various answers given by the DHSC indicate that it will include hospital data related to RPOC and ERPC as part of this review. The following is such a response to a written question given on 13 July 2021.
Gareth Bacon Conservative, Orpington
|To ask the Secretary of State for Health and Social Care, whether his Department has plans to collect data on the number of women presenting in clinical settings as a result of complications arising from (a) incomplete procedures and (b) retained products of conception following an early medical abortion at home; and if he will make a statement.|
Minister of State, DHSC
|The Department is undertaking a project to review the system of recording abortion complications and we anticipate this work will be completed later this year. The review will cover all data on complications arising from abortion.|
Women need to be fully informed; they need to be told that there is a 1-in-20 risk that they will need to attend hospital to complete their medical abortion and that most of these women will need a surgical procedure to fully remove the retained products of conception.