Asked by: Baroness Coffey (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government how many abortion pills by post have been issued; how many people those pills have been issued to; and of those how many were under 16 years old.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
From 28 December 2018, eligible women in England could take the second of the two drugs for early medical abortion (EMA), misoprostol, at home. This was changed from 30 March 2020, to allow eligible women in England to take both drugs for EMA, mifepristone and misoprostol, at home, without the need to first attend a hospital or clinic.
The Department does not hold a record of how many drugs for EMA have been issued. However, from 2019 to 2022, latest available data on home use, for one or both drugs taken at home, for residents of England, there were 481,179 abortions where either one or both of the drugs were taken at home. Of these, 2,127, or 0.4%, were for those aged under 16 years old.
From 2020 to 2022, latest available data on home use, for both drugs taken at home, for residents of England, there were 316,795 abortions where both medications were taken at home. Of these, 1,250, or 0.4%, were for those aged under 16 years old.
Please note, the second set of statistics, both pills taken at home, is included within the first, one or both pills taken at home.
Asked by: Lord Porter of Spalding (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what are the criteria for determining whether an in-person consultation is required following a request for at-home abortion tablets.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
In March 2022, Parliament voted to amend the Abortion Act to allow women in England and Wales to take one or both pills for early medical abortion at home at up to 10 weeks’ gestation. The legislation came into force on 30 August 2022.
Women should be given the choice to either have an in-person consultation with a clinician or to have a virtual consultation and, if eligible, will be able to take both pills for early medical abortion at home. If there is any uncertainty about the gestation of the pregnancy, or if the doctor has any concerns, the woman will be asked to attend a clinic. If she does not attend the clinic, the doctor would not be able to form an opinion in good faith that the pregnancy is below ten weeks, and would therefore not be able to proceed with prescribing abortion pills for home use.
Asked by: Andrew Rosindell (Conservative - Romford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to help prevent abortion drugs sent in the mail from being used to commit crimes.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Before an early medical abortion can be undertaken at home, a consultation is held with the woman requesting the termination. Women are given the choice to have either an in-person consultation or a virtual consultation. If the medical practitioner has any concerns during a virtual consultation, the woman will be asked to attend a clinic for an in-person consultation.
The prescription of mifepristone and misoprostol for abortions is controlled by the Abortion Act 1967 and the Human Medicines Regulations 2012. During the consultation, women are informed that it is illegal to give their prescribed abortion medication to anyone else.
Asked by: Andrew Rosindell (Conservative - Romford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that (a) gestational ages of pregnancies are accurately recorded in cases without ultrasound scans and (b) abortion pills are not sent in the mail to women beyond the legal limit of 10 weeks.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Pregnancy duration can be assessed from the first day of the last menstrual period (LMP). Advice from the Royal College of Obstetricians and Gynaecologists is clear, that most women can determine the duration of their pregnancy with reasonable accuracy by their LMP alone.
Before an early medical abortion can be undertaken at home, women are given the choice to have either an in-person consultation or a virtual consultation. However, if there is any uncertainty about the gestation of the pregnancy, the medical practitioner would ask the woman to attend an in-person appointment to enable them to form an opinion that the pregnancy will not have exceeded 10 weeks at the time the first abortion pill is taken.
Asked by: Lord Porter of Spalding (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to ensure that medical complications and associated risks arising from at-home tablet-induced abortions are accurately monitored, recorded, and reported.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
It is a legal requirement in England and Wales that all terminations must be notified to the Chief Medical Officer within 14 days of the procedure. The Department provides the HSA4 form for this purpose. Information is collected on the abortion and the woman that had the abortion, including the method of the abortion, whether any abortion pills were taken at home, the gestation, or number of weeks, and details of any known complications.
The Department publishes data from these notifications in annual abortion statistics reports, which include data on complications up until the time of discharge from the abortion service.
In November 2023, the Department published a one-time analysis comparing data from the Department’s Abortion Notification System and the Hospital Episode Statistics, which are produced and controlled by NHS England.
Abortion continues to be a very safe procedure for which major complications are rare at all gestations. The complication rates for the Abortion Notification System and the Hospital Episodes Statistics data remains similar to both before and after the introduction of the home use of early medical abortion pills.
Asked by: Andrew Rosindell (Conservative - Romford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will make an assessment of the potential merits of reversing whether the decision to allow women to take (a) mifepristone and (b) misoprostol at home to terminate a pregnancy.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government has no plans to assess the potential merits of reversing the decision to allow women to take mifepristone and misoprostol at home to terminate a pregnancy. Abortion in England and Wales is governed by the Abortion Act 1967, which defines the criteria under which terminations can take place. Under the act, women have access to regulated and National Health Service funded abortion services, which now includes taking both abortion pills at home, up to a 10-week gestation.
As with other matters of conscience, abortion is an issue on which the Government adopts a neutral stance. It would be for Parliament to decide whether to make any changes to the law on abortion.
Asked by: Andrew Rosindell (Conservative - Romford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will commission an inquiry into the safety of taking (a) mifepristone and (b) misoprostol at home to terminate a pregnancy.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
The Government has no plans to commission an inquiry into the safety of taking mifepristone and misoprostol at home to terminate a pregnancy. Abortion is a safe procedure for which major complications are rare, at all pregnancy gestations. Data does not show an increase in abortion complications following the introduction of home use of mifepristone and misoprostol for early medical abortion.
Asked by: Mary Glindon (Labour - Newcastle upon Tyne East and Wallsend)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that abortion providers meet their obligations to ensure that a woman’s gestational age is accurately assessed before she may be prescribed abortion pills to be taken at home.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
In accordance with the Abortion Act 1967, home use of early medical abortion pills is only permitted if the pregnancy has not exceeded 10 weeks gestation, at the time the first medicine in the course is administered. Before prescribing abortion medicine for use at home, the doctor terminating the pregnancy must be of the opinion, formed in good faith, that the pregnancy is not beyond 10 weeks. This opinion is formed following a consultation with the woman concerned.
If there is any uncertainty about the gestation of the pregnancy, the woman should attend an in-person appointment. If she does not attend in-person when there is any uncertainty about the gestation, the doctor leading the termination would not be able to form an opinion in good faith that the pregnancy is below 10 weeks gestation, and therefore would not be able to prescribe abortion pills for home use.
Asked by: Baroness Eaton (Conservative - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to ensure that any risks to a woman's health are accurately assessed before she may be sent abortion pills to be taken at home.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
The wellbeing and safety of women accessing abortion services, including early medical abortion at home, is our first and foremost priority. Before prescribing abortion medicine for use at home, either an in-person or a virtual consultation is held with the woman concerned. If any health issues are identified during a virtual consultation which could make home use of early medical abortion medicine potentially unsuitable, the woman will be asked to attend an in-person appointment for further assessment.
Asked by: Baroness O'Loan (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask His Majesty's Government what steps they are taking to ensure that abortion providers verify that a woman is not being coerced into an abortion before she is sent abortion pills to be taken at home.
Answered by Baroness Merron - Parliamentary Under-Secretary (Department of Health and Social Care)
Abortion providers are required to have effective arrangements in place to safeguard children and vulnerable adults, in compliance with the Department’s required standard operating procedures for the approval of independent sector places for termination of pregnancy in England. Providers must ensure that all staff are trained in recognising the signs of potential abuse and coercion in adult women, and how to respond.
In addition, the Royal College of Paediatrics and Child Health (RCPCH) has published national safeguarding guidance for under 18-year-olds accessing early medical abortion services, which will ensure that robust safeguarding processes are embedded across all abortion services. We expect all providers to have due regard to the RCPCH safeguarding guidance.