'Pills by post' to terminate early pregnancies to be made permanent in England and Wales

From next week, women in England and Wales will be able to permanently access early medical abortions at home after ministers were forced to abandon plans to scrap the “pills by post” service which was trialled during the Covid pandemic, the Guardian reports.

The decision reportedly follows a record number of terminations being carried out last year in England and Wales.

'Pills by post' abortions which can be used to terminate a pregnancy in the first 10 weeks were brought in early 2020 when regular abortion services closed during the lockdown.

According to Government data, nearly 215,000 abortions were carried out in the two nations in 2021 - up 2 per cent on the year before.

Additionally, more than half the abortions were carried out at home via the ‘pills by post’ service, the report from the Office for Health Improvement and Disparities said.

The Daily Mail informs that though ministers originally wanted to scrap the scheme this summer, they were defeated by a vote by MPs in March. Following an emotional debate, 215 MPs reportedly voted to amend the Health and Care Bill to keep the service in place.

This new move will allow thousands of women to terminate their pregnancy from the privacy of their home, rather than go to a clinic or hospital.

Additionally, women will be able to secure early medical abortion pills via a phone call or via online consultation with a doctor without leaving their home.

Announcing the move today, Minister for Public Health Maggie Throup reportedly said, “The wellbeing and safety of women requiring access to abortion services is paramount.

“With these measures women will have more choice in how and where they access abortion services, while ensuring robust data is collected to ensure their continued safety.”

Medical abortion involves taking two different medicines to end a pregnancy. It involves two sets of pills – with the new scheme women will be able to take the first pill in the comfort and privacy of their home, rather than having to take it at a medical facility.

The two medications are mifepristone and misoprostol, taken at least 24 hours apart.

These pills have to be taken within the first 10 weeks of pregnancy. However, before the pandemic struck, only the second set of pills could be taken at home, informs the Guardian.

Under pre-pandemic rules, women took the first pill at a medical facility under the supervision of a clinician – the second pill was then taken at home up to 48 hours later.

The temporary measure (pills by post service) was initially introduced during the early stages of the Covid pandemic in 2020 so that women could access treatment after a phone or online consultation instead of visiting a clinic.

According to the Daily Mail, women are required to take mifepristone first (as the pill blocks progesterone) a hormone needed to maintain the pregnancy, from working.

The second pill, misoprostol, contains a hormone called prostaglandin which reportedly causes the uterus to contract, triggering the abortion.

Media reports state that the Department of Health and Social Care said doctors will be required to certify in 'good faith' that the pills are only being used to terminate early pregnancies.

Doctors will also be required to record information on abortion notification forms about the place of consultation and the place of termination of the pregnancy and whether the consultation was fully remote.

This data is meant to assist the Government in analysing the trends in at-home abortions so as to better understand the use of remote services.

The Daily Mail also informs that British women who are beyond nine weeks (and six days) pregnant can opt for a surgical abortion on the NHS. However, surgical abortions are a fraction of total abortions carried out in the UK, only accounting for 13 per cent of abortions last year.

24 weeks of pregnancy is the general limit for surgical abortions in the UK but they can be carried out after that, only under very limited circumstances – these include if the mother's life is in danger by the pregnancy continuing or if a test reveals that the child has a severe disability.

Abortions carried out in women over 35 has been on the rise over the past decade, states the Daily Mail. In 2011, 27,199 women reportedly had an abortion compared to 40,789 abortions recorded in 2021.

At the end of March 2020, the then Health Secretary Matt Hancock approved home abortions. According to the new rules, women were allowed (within the first ten weeks of pregnancy) to take the first termination pill at home following a teleconsultation with a clinician.

The Government has stated that guidance for providing the abortion pills to under-18s will soon be published by the Royal College of Paediatrics and Child Health to ensure that in case of suspected abuse, children who do need to access abortions services and the safeguarding measures, will be able to do so.

The Abortion Act will be amended from 30 August to allow eligible women in the first 10 weeks of pregnancy - up to nine weeks and six days - to continue to access the ‘pills by post’ service, said the Guardian.