Respond to the Government’s consultation on home use of both pills for early medical abortion up to 10 weeks gestation

Last March, at the beginning of the COVID-19 pandemic, temporary legislation was introduced to allow abortions to take place at home. Early medical abortion (EMA) consists of the administration of two sets of pills within the first 10 weeks of gestation. The first medication (Mifepristone) prevents continued development of the embryo and the second (Misoprostol) forces the expulsion of the embryo from the uterus. EMA accounts for the vast majority of abortions that occur in England and Wales, and accounted for 73 per cent of abortions in 2019 (DHCS 2020). The Government has recently published a consultation in England about making this legislation permanent. 

Prior to March 2020, women and girls were legally able to take the second set of pills at home but the first set had to be administered by a doctor. This was following an in-person consultation with a doctor to assess the woman or girl’s mental and physical health prior to the abortion. Under the temporary legislation, both sets are allowed to be taken at home following an online or telephone consultation with a doctor. This legislation has been put in place for two years or until the pandemic is over, whichever is sooner.

The consultation engages with a range of topics and debates around EMA, with a focus on:

  • Impact on safety
  • Impact on the accessibility of abortion services
  • Impact on privacy and confidentiality of access
  • Impact on healthcare providers
  • Impact on protected characteristics

As the Evangelical Alliance, we believe in the value of both the woman and unborn child’s life as image bearers of God, so protecting them is of the utmost importance. Every abortion ends a human life and women are harmed by abortion. The very nature of this consultation means the lives of unborn children have been devalued, but we still want to engage in a way that emphasises the wellbeing of women and children as far as possible. The topics that are being discussed in the consultation give Christians an opportunity to highlight why the temporary legislation should not be made permanent.

Impact on safety

The impact on safety of taking both sets of pills at home is one of the greatest areas of concern with this consultation. While EMA has been deemed a relatively risk-free procedure, there are concerns arising from the probable lack of accurate data resulting from the changed procedures. There are various benefits to having meetings with medical professionals in person; their expertise means they can accurately determine the stage of fetal development, measure the gestation period as well as be aware of any potential issues, for example an ectopic pregnancy. Doctors are able to outline the risks, ensuring informed consent. They are able to offer time and space to explore alternatives to abortion. Having a medical professional on hand means that a woman has immediate access to the treatment required if anything goes wrong while administering the pills. 

There are much greater protections for women and their unborn children with in-person appointments. Doctors are trained to provide support to women who are likely to be in heightened emotional states. This cannot be as effective online or over the phone. In-person consultations also means there are more safeguarding provisions to prevent coerced abortions, incorrect use, impersonation or further abuse of a patient. 

Impact on protected characteristics

The Government has a range of protected characteristics that EMA could impact; for example, the lack of in-person appointments means abortions based on sex selection or disability could greatly increase as these cases would go unnoticed. There are also implications for wider society, as this could further the stigma that is already felt by people living with disabilities. 

There would also be a differential impact on religion or belief, as doctors with religious beliefs are disproportionately affected by this legislation. Doctors are allowed to opt out of participating in an abortion under the law; however, this new legislation would make it more difficult to define. For instance, would a doctor be allowed to opt out of posting abortion pills to a woman’s home because this might not be considered active engagement?

Other concerns

  • The accessibility and privacy of abortion services should never come before the safety of the woman and her child. If these aspects are equated or prioritised before safety, it contributes to an atmosphere that devalues human life. 
  • The abortion rate in deprived communities is already significantly higher than in wealthier areas, so questions of access do not address the socioeconomic factors that lead women to have an abortion. 
  • The priority of healthcare workers is to ensure the highest possible levels of care, which is not possible over the phone or online. 

You can get more information and respond to the consultation through the Government’s consultation page, which closes 26 February. We believe that this temporary measure should be ended immediately for the sake of women and unborn children in England for the reasons outlined in this article.