Women in England will be able to take abortion pills at home from the end of the year, the government has announced.
“Abortion can be a difficult experience so it is important that women feel safe and as comfortable as possible,” England’s chief medical officer, Dame Sally Davies, said. “This decision will increase choice for women and help ensure they receive safe and dignified care.”
The move brings England in line with Scotland and Wales, which announced the plans in October 2017 and June 2018, respectively.
Professor Lesley Regan, chair of the Royal College of Obstetricians and Gynaecologists, said: “This simple and practical measure will provide women with significantly more choice and is the most compassionate care we can give them.”
The decision to allow home use of the abortion pill is one of the first significant policy announcements by newly appointed health secretary Matt Hancock, who replaced Jeremy Hunt when Hunt became foreign secretary in July.
“I very much hope that it bodes well for the future,” Regan told BuzzFeed News.
“He’s only been in post for a few weeks. He’s got an awful lot of problems to get his head around, and I’m just thrilled that he has agreed that the evidence shows this is the right thing to do for women.”
Currently, women seeking early medical abortion in the first 10 weeks of pregnancy are required to take two drugs — mifepristone and misoprostol — in a licensed medical setting such as an abortion clinic.
The drugs must be taken 24–48 hours apart, meaning it is necessary to attend two appointments, and women begin to pass the pregnancy shortly after taking the second drug. This has led many women to experience heavy bleeding and cramping before they arrive home.
But soon those seeking early medical abortion will be able to take the second drug, misoprostol, in their own homes.
Last year the Scottish government became the first in the UK to allow for home use of the abortion pill, followed by Wales in June this year. Earlier this month a legal challenge to home use of misoprostol in Scotland by anti-abortion group the Society for the Protection of Unborn Children (SPUC) was rejected by Scotland's Court of Session.
The Department of Health said that clinical and legal advice made it clear that home use of the abortion pill was both safe and legal. Misoprostol has also been recognised as being safe for home use by the World Health Organisation.
The decision follows continued pressure from MPs to allow for home use of the abortion pill, including Labour MP for Hull North Diana Johnson, who last month wrote to Hancock to urge him to act on the matter where his predecessor Hunt had not.
Very good news & hope @MattHancock Secretary of State for Health in England will now give English women the same right to be treated in a dignified & humane way at home. @bpas #Trustwomen Judge throws out challenge to Scots abortion pill move - BBC News https://t.co/iYhRIg2XxC
Johnson welcomed the government’s decision to act on this issue.
“This announcement is great news for women in England, who will now have access to safe, effective and compassionate abortion services, just as women in Scotland and Wales already do,” she told BuzzFeed News.
“I think the arguments based on sound clinical advice, including the backing of the World Health Organisation, was overwhelming.
“I am pleased that Government ministers have listened to clinicians, MPs, and women themselves and made the right decision.”
Research published last year in the journal Contraception showed a dramatic increase in the number of women in the UK who had bought abortion pills online and taken them at home illegally. Many of those women, particularly those living in rural areas or with other children, said that they had bought pills online because they struggled to attend two appointments. It is hoped that by allowing the second pill to be taken at home, legal access to medical abortion will be improved.
Ann Furedi, chief executive of the British Pregnancy Advisory Service (BPAS), which provides abortion services for the NHS in England and Wales, said that the decision “represents an outbreak of common sense”.
“It will dramatically improve the experience of the more than 100,000 women in England who undergo Early Medical Abortion every year,” Furedi said.
“Our only disappointment is that it has taken so long for a Health Secretary for England to authorise this, and that so many women have suffered needlessly in the interim.
“We applaud Matt Hancock for finally taking this important step, and look forward to offering this service to the women who need it as soon as possible.”
The Department of Health will now work with clinical partners, including the RCOG, to implement the changes by the end of this year, ensuring that safeguards are introduced to protect women undergoing this treatment at home.
“Nothing is being broken in terms of medical oversight,” Professor Regan told BuzzFeed News. “It doesn’t change the regulation of abortion and I wouldn’t want it to. It’s a win-win for everyone.”
While allowing home use for the abortion pill in England is a victory for abortion rights campaigners, who have long lobbied for change on this issue, it throws a renewed spotlight on Northern Ireland, where abortion is still illegal in almost all circumstances. Its closest neighbour, Ireland, has also relaxed tough laws around abortion following a referendum in May.
While women in Northern Ireland can access NHS abortion services in England, there has been a significant increase in the number of women who are unable to travel buying abortion pills illegally online.
“I very much hope that in time we’ll be able to persuade the politicians and the people of Northern Ireland that [allowing access to abortion] is the right thing to do for their girls and women,” Regan said.
“As a clinician, I know what happens in societies where women can’t access early abortion. At the end of the day, the problem doesn’t go away — it just goes underground.”