Government fails to report 99% of early medical abortion complications

Analysis of abortion complications data published by the DHSC and by NHS England shows that the government continues to deliberately under-report, and that it has excluded more than 99% of complication treatments for early medical abortions, from its official 2023 statistics report.

On 15 January 2026, the Department of Health and Social Care (DHSC) published its “Abortion statistics commentary, England and Wales: 2023”.[i] These ‘accredited official statistics’ provide the following data and commentary about complications arising from abortions.

The DHSC starts by stating this cautionary note:

• Data on complications should be treated with caution, as it may not capture all complications. This report includes complications recorded on the HSA4 form up until the time of discharge from the abortion provider. Therefore, complications that are not recorded on the HSA4 form or that occur after discharge may not be recorded. For early medical abortions where either medication is administered at home, complications may be less likely to be recorded.

Notwithstanding its stated caution, this government department proceeds to inform us that:

• In 2023, there were 315 abortions resulting in at least one complication reported on the HSA4 form, a rate of 1.1 per 1,000 abortions. This was a decrease from 2022 (1.2 per 1,000).

I think this is misleading and perhaps even dishonest. The DHSC knows that it does not have all of the data, yet it still states an annual number of complications and, worse still, it then confidently states a rate of 1.1 per 1,000 abortions, which it has calculated by using the total number of abortions in 2023 as the denominator, rather than just the cases for which it has fully completed HSA4 forms. Then, like some ideology-driven campaigner, it leans into this and shows a perceived improvement with a year-on-year decline in the rate of complications.

This is not what we should expect, or accept, from ‘accredited official statistics’.

Let’s take a closer look at those cases which the DHSC says are less likely to be recorded — early medical abortions (EMA) managed at home by pregnant women with gestational age under 10 weeks.

The 2023 statistics show a total of 236,000 EMA.

• The DHSC reports a complication rate for all early medical abortions of 0.3 complications per 1,000 abortions.
• From this we can see that the DHSC is reporting complications in 71 EMA.

In one of the detail tabs of the DHSC published spreadsheet, we read that 228,000 EMA were self-managed by women at home — these are abortions that happened after patient discharge and after the completion and submission of the HSA4 forms to the Chief Medical Officer (CMO) at the DHSC — 96.6% of the overall total, the ones for which the DHSC says complications are less likely to have been recorded.

In an earlier post, 54,000 admissions to NHSE hospitals for abortion complications, I explained how NHS England reports cases in which women are admitted to an NHS hospital for treatment of complications arising from early medical abortion. In the twelve months up to 31 March 2023, NHSE reported 11,256 such treatments and in 2023/24 a total of 12,287. From these we can estimate that in 2023, the same period as the DHSC published statistics, 12,000 women were admitted to hospital for treatment of abortion complications.

Now for the purists, I understand that neither of these reported complications totals are complete e.g., some women who experienced complications may not have reported to the abortion provider, they might not have been admitted to an NHS hospital, and for some they may have been recorded as having complications from a miscarriage. Also the NHSE data does not include abortions in Wales, which are included by the DHSC.

However, there is a very significant difference between reporting 71 women with complications from an early medical abortion, and 12,000.

In November 2023, the Office for Health Improvement & Disparities (OHID) (a team within the DHSC) published a report about its own analysis of NHSE hospital episodes data and comparison of these data with those from the HSA4 forms.[ii] So, we know that the DHSC knows about the NHS data and its relevance to the fuller reporting of abortion complications, and yet the government has on many occasions refused to include the NHS data in these annual reports.[iii]

It is not honest for the government to be publishing an official statement that the complication rate for early medical abortion is just 0.03%, when it knows that it is not including the treatments for complications provided by its own NHS hospitals. The government is deliberately failing to report 99.4% of all known complications from early medical abortions.[iv]

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[i] Abortion statistics commentary, England and Wales: 2023. (2026, January 15). GOV.UK. https://www.gov.uk/government/statistics/abortion-statistics-for-england-and-wales-2023/abortion-statistics-commentary-england-and-wales-2023

[ii] Complications from abortions in England, 2017 to 2021. (2023, November 23). GOV.UK. https://www.gov.uk/government/statistics/complications-from-abortions-in-england-2017-to-2021

[iii] Duffy, K. (2025, October 20). 54,000 admissions to NHSE hospitals for abortion complications. Percuity. https://percuity.blog/2025/10/02/54000-admissions-to-nhse-hospitals-for-abortion-complications/

[iv] 71/12071 = 0.6%