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BPAS conference 'UK’s laws keep early medical abortion services behind international practice'

Published 25 June 2008

Please see below comment from speakers at today’s conference of the sexual and reproductive healthcare charity BPAS (the British Pregnancy Advisory Service), ‘The Future of Abortion: Controversies & Care', in Westminster, London. This was opened by the Rt. Honourable Dawn Primarolo MP, Minister of State for Public Health. Experts presented on potential changes to the UK law in response to questions about use of early medical abortion medication at home. (for use under 9 weeks of pregnancy).

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Ann Furedi, Chief Executive of the abortion and contraception provider charity BPAS (the British Pregnancy Advisory Service) said that the law hindered women from accessing abortion at the earliest possible stages, because it was framed in the 1960s when modern treatments, such as abortion drugs for home use, were not available. She said

‘The organisation of early medical abortion services should be shaped by good clinical practice and not by political caution. The current abortion law, which requires the necessary medication to be prescribed and administered in specially licensed premises, is unjustifiable and senseless. In many cases it causes women additional unnecessary expense and inconvenience and can delay some women at what is already an emotional time.

‘Women are quite capable of taking medication according to directions. Service providers are quite capable of giving appropriate out-of-hours support. International experience shows that these barriers can be safely removed to make earlier abortions as accessible as possible to women.’

Early medical abortion specialist Mitchell Creinin, Professor of Obstetrics, Gynecology and Reproductive Sciences at the University of Pittsburgh said

‘Misoprostol self-administration at home, regardless of route or gestational age (up to 63 days) has been the clinical standard of care throughout the United States for many years. The need for 24 hour availability of clinical consultation for the patient is no different whether she is administered the misoprostol under observation in a clinic, or does it herself at home. Phone calls are rare on our experience however, because pre-treatment counselling is appropriately provided. 

‘Care in the U.S. has advanced to the point that we are now completing studies that involve following women entirely by phone, without even a need for a routine follow-up visit should everything progress as expected.  Because of the high safety and efficacy of the provided medication, women are able to safely and effectively participate in their own care and undergo the abortion at home, in familiar surroundings, supported by those that love them.’

Mary Fjerstad, Director of Quality and Learning at the American reproductive healthcare provider Planned Parenthood said

‘Since mifepristone, the first part of this two-stage treatment, was approved in 2000 in the U.S., it has always been provided with the home use of misoprostol. Planned Parenthood has provided 364,000 early medical abortions, all with home use of misoprostol. For most women, the experience of medical abortion is like a heavy period. Bleeding and cramping are normal life experiences for women. As long as women are given clear information about what to expect, and which symptoms should prompt a phone call to the health care provider, whether at day or night- home use of misoprostol is safe and highly acceptable to women.’

ENDS


NOTES for EDITORS

For more information, or to arrange an interview with these speakers, or BPAS’ Chief Executive Ann Furedi, please contact the BPAS press office on 07788 725 185.

The registered charity BPAS, (the British Pregnancy Advisory Service) has been providing health services since 1968. BPAS was founded to train doctors and provide premises and healthcare because at that time the whole of the NHS was not able, or in some areas, willing to provide full family planning and abortion care. BPAS’ conference ‘The Future of Abortion: Controversies & Care' is on Wednesday 25 June - Thursday 26 June. Please see the conference website (www.futureofabortion.org) for more details and a full conference programme.

Early medical abortion is only available for use in a pregnancy of under 63 days (9 weeks) in the UK. In the USA and other European countries, this method is delivered in a different way than is legally possible in the UK, whereby women attend a clinic to receive the first dose of medication involved in the treatment, which renders the fetus non-viable. During the same visit, they are given the second part of the medication to self-administer at home, according to careful and detailed instructions, causing the uterus to contract and expel the pregnancy, as in an early natural miscarriage. They then complete their abortion in the comfort and privacy of their own home.

By contrast in Britain, the official interpretation of the abortion law means that women must return again to their clinic, making a separate visit to receive the second part of the medication that will complete their treatment. BPAS has adopted a protocol that allows women, after receiving the second part of the medication at the clinic, to return home to complete their abortion, thus mirroring as closely as possible the international experience. Around 55,000 women, following this BPAS protocol have had this treatment in the last eight years.  

For more information on a Department of Health report form May 2008 into some non-traditional locations in which early medical abortion can be provided, please see their statement: http://nds.coi.gov.uk/environment/fullDetail.asp?ReleaseID=366752&NewsAreaID=2&NavigatedFromDepartment=False

Download the report in full here: http://nds.coi.gov.uk/environment/mediaDetail.asp?MediaDetailsID=240526&NewsAreaID=2&ClientID=46&LocaleID=2

Please note: Even for doctors to clinically trial the home use of misoprostol would not be possible under the current UK abortion law. The Commons Science and Technology Committee criticised this in a 2007 report recommendation.

The Royal College of Obstetricians and Gynaecologists, (RCOG) states that ‘At least one-third of British women will have had an abortion by the time they reach the age of 45’ (see p1, ‘Care of women requesting induced abortion’, Evidence-based Guideline Number 7, Sept 2004).

 

For most women, having an abortion poses fewer medical risks than going through pregnancy and birth. See the Royal College of Obstetricians and Gynaecologists’ (RCOG) information on this -

http://www.rcog.org.uk/index.asp?PageID=649#safe

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