The British Pregnancy Advisory Service (bpas) today announced that it is challenging the current interpretation of abortion law to allow women to choose where to take the second stage of Early Medical Abortion medication, to bring Britain into line with many other countries.
Early Medical Abortion (EMA), which is suitable for women in the first 9 weeks of pregnancy, involves two sets of medication taken 24 to 48 hours apart; the first blocks the pregnancy hormones so that the pregnancy ceases to be viable, the second causes the uterus to contract and to expel the pregnancy much like a miscarriage.
At present, women seeking this form of termination are required to take both sets of medication in a clinic, involving two separate journeys – often in addition to an initial consultation with a GP. Bpas is challenging this practice, to allow the second stage to be taken at home.
The Abortion Act of 1967 stipulates that “any treatment for the termination of pregnancy” must be carried out in a hospital or clinic which is interpreted to mean that both pills must be taken in a clinic. However, when the Act was put in place abortion was a surgical procedure, requiring hospital or clinic treatment. Today women are increasingly opting for medical abortion – EMAs accounted for 48% of all women seeking abortion below nine weeks in England and Wales in 2009.
The abortion law is therefore interpreted in an outdated fashion which bpas believes ‘is not in keeping with the intentions of parliament when it passed the original legislation’.
A renewed interpretation of this Act would allow for the increased comfort and choice of women having an abortion, and would improve patient safety. Multiple clinic visits can cause unnecessary stress and inconvenience for women, particularly those balancing work and family life or struggling financially.
Women also face the anxiety that symptoms of miscarriage – including bleeding, nausea and abdominal pain – may begin while they are travelling. Bpas studies show that many patients have to travel for more than an hour to access services and some for up to three hours on public transport. Figures suggest that 86% of women would prefer being able to complete EMA treatment at home, if they had the option.
The court challenge is supported by the Family Planning Association who argue that “some women, for personal and practical reasons, will be more comfortable taking the second stage of medication at home and this option should be open to them”.
Evidence from the House of Commons Select Committee on Science and Technology, which examined the issue of EMA in 2007, has demonstrated that ‘self-administration of misoprostol [the drug used in the second pill] at home is safe, effective and acceptable”. It concluded that:
“There is no evidence relating to safety, effectiveness or patient acceptability that should serve to deter Parliament passing regulations which would enable women who chose to do so taking the second stage of early medical abortion at home”.
In spite of this, the Department of Health opposes such changes on the grounds of patient safety.
At present many countries allow the second stage of medication to be taken at home including the USA, Norway, Sweden and France and evidence from these countries have shown no reason to question the safety of this method. Within the UK this drug is also administered for home use to women who have experienced a spontaneous miscarriage. If the drug is safe enough to be administered to women in the case of miscarriage there is little argument to support the idea that this drug is unsuitable for home use.
The case will be heard on January 28 2011