Picture the scene: you’re at a hospital because you have an unwanted pregnancy and are seeking out a termination. You have seen all the appropriate professionals and had all the relevant tests. You have the required approval from two different doctors. You’ve made this tough decision and now you just want it to be over and done with.
You have opted for a medical abortion, rather than a surgical one, and you have to come along twice to be given medication that you take there and then, in front of the NHS or private health clinic professionals. You breathe a sigh of relief and go to the bus stop to get home.
On the bus, you double over in pain and you know you have started to bleed. Heavily. You were warned about this but were hoping that you would get home before the pill kicked in. The misoprostol (the second medication taken, following the mifepristone you took in a previous appointment) is working, you are miscarrying, and you are on public transport with no other option than to sit it out and hope you get home quickly.
This is the law
You might well wonder why somebody in this situation did not take the tablet home with them and take it when they knew they had a toilet, sanitary towels and a hot bath within reach but, as the law currently stands in the UK, this is illegal. Anybody using misoprostol, also known as the “abortion pill”, to terminate a pregnancy must take it in a medical setting. This is due to the 1967 Abortion Act, which was based on the idea of an abortion being a surgical procedure where nurses or doctors should be in attendance.
While it makes sense to legislate that surgical abortions should take place in hospitals and clinics, with the mifepristone / misoprostol combination, it does not stand up to reason. The British Pregnancy Advisory Service (BPAS) produced a factsheet about the home use of misoprostol, campaigning for this to be available to anybody who needs a termination up to 10 weeks into their pregnancy. These procedures are known as Early Medical Abortions (EMAs), and “Of the 198,422 abortions performed in England, Scotland, and Wales in 2016, 58% of them (115,450) were Early Medical Abortions”.
They are a less traumatic option than surgical abortions for many, and Early Medical Abortions are relatively safe procedures. BPAS says:
EMA is very safe. No medical procedure is risk free, but the risks of early medical abortion are extremely small and considerably less than the risks of continuing a pregnancy to term. EMA can often be carried out as soon as a pregnancy is confirmed, and the earlier an abortion can be performed the lower the chance of any complications.
EMA also avoids any anaesthetic risk that surgical procedures may pose, and any risk of infection is minimised by providing all women with prophylactic antibiotics. Rare complications that can occur include continuing pregnancy and incomplete abortion, which can be managed with either a further dose of misoprostol or a surgical evacuation.
All women leave the clinic with an appropriate supply of pain relief, antibiotics, and detailed advice as to what to expect, and what might indicate a problem. They have access to a specialist 24 hour, seven days a week helpline and we ensure that there is the facility to attend for urgent medical treatment, if needed.
Joining in from a political point of view, the Women’s Equality Party has been collecting signatures on an open letter asking politicians to reconsider this law, given its outdated content and the need for a modern take on a modern medical procedure. Women’s Equality Party leader Sophie Walker said that a 1960s law did not have a place today, in this matter, and that it was putting women through “unnecessary distress”.
Walker told iNews, “Our Government still doesn’t trust women to manage their own reproductive health. Women who are prescribed misoprostol after miscarrying are allowed to take it in the comfort of their own home, while those who take it for early-term abortions are forced to travel back from the clinic when the pill can be taking effect.”
A double standard
Misoprostol is the drug that causes the uterus to expel the foetus and, as such, it is sometimes prescribed to people who are miscarrying. They can pick it up from a pharmacy and take it home, having been seen by a doctor and had the treatment approved. Then they can take the tablet when they are ready. For people having a termination, this is obviously not how it plays out.
The law, as it stands, is cruel. Nobody is arguing that these pills should be given out without medical oversight but, once decisions have been made and a treatment plan has been drawn up, there is no reason that a nurse should have to oversee somebody swallowing a pill when they could take it two hours later in the comfort of their own home. There is no need for anybody to haemorrhage on a bus or be in agony on a train; there is no need for anybody to fear that their taxi ride or drive home will involve a miscarriage.
A simple law change will not make abortion any more or less available, and it will not make it any less safe. It will simply make it more of a bearable experience when the very real alternative is punitive and dehumanising.
Photo: William Murphy/Creative Commons
I essentially agree with you but am just wondering… Is it not this rule so they can be sure it is THIS particular woman taking that pill? And she isn’t passing it on to somebody else, who might suffer serious side-effects and be unwilling then to get medical help?
I’m just hazarding a guess that it’s more complex than just the rule about abortions being surgical procedures. If I’m right, there could at least be some system in place whereby the specific pill is brought to the woman at her home by, for example, a trained nurse who could oversee her taking it. It would cost the NHS more, but it would spare the woman her dignity.