A sixteen-year-old girl in the UK has described the horror of at-home abortion after a telehealth consultation miscalculated her gestation by 12 weeks.
Savannah (not her real name) had a phone consultation with a British Pregnancy Advisory Service (BPAS) abortion clinic, who determined that she was less than 8 weeks pregnant. When she collected the abortion pills from the clinic, they did not scan or examine her, and after taking them at home, she felt “really bad” pain.
"My relative called another ambulance because when I was pushing, my boyfriend could see feet," Savannah said.
The baby had been born with a heartbeat and they had both been taken to hospital. It was concluded she had been between 20 and 21 weeks pregnant.
Savannah said she had been left traumatised.
"If they scanned me and I knew that I was that far gone, then I would have had him," she said.
Savannah’s story is not an anomaly. According to UK politician Carla Lockhart:
“Similar reports have been made by the body that comprises all senior NHS doctors and nurses who fulfil statutory child safeguarding functions in the NHS, the National Network of Designated Health Care Professionals for Children. Specifically, it has recorded 47 cases of early medical abortions that resulted in mid-to-late pregnancy terminations, across all ages, since the start of the pandemic in March 2020. Six involved girls and in half of those cases and 12 instances in total, there had been signs of life.”
Early medical abortions lead Dr Helen Daley, a consultant paediatrician, said: "We've had young people say they are depressed, anxious, afraid to go out, months after the event.
We've also had staff being hugely traumatised."
Savannah’s story was published on the same day that the House of Commons in the UK voted to make its controversial ‘medical abortion at home’ scheme in England permanent, after originally having decided to extend the scheme only until the end of August 2022. MPs voted 215 to 188 in favour of extending the scheme indefinitely.
The measure was originally introduced as a temporary Covid-19 measure in 2020, in an effort to keep people at home during the pandemic.
Approximately 150,000 women have made use of the service since its introduction in 2020.
The decision to make the scheme permanent has been praised as a victory for women by supporters of the measure. Baroness Liz Sugg, who tabled the amendment to the Health and Care Bill, tweeted after the vote:
“Delighted is an understatement. Thank you to all the MPs who voted in favour of supporting women to access their choice of healthcare in a safe and effective way.”
The government’s decision however is in contrast with the results of an online government consultation in late 2020, which found that 70% of respondents thought the temporary measure should end immediately. Only 22% of respondents stated that they thought it should become a permanent measure. 69% of respondents thought that the temporary measures had a negative impact on the provision of abortion services for women accessing these services:
“There were a number of concerns raised about safety, the most common of which was the risk of women being coerced into an abortion when they are not physically being seen in a service. Concern was also expressed that gestation may be inaccurately assessed and about the absence of support particularly in relation to management of emotional distress.”
Despite claims that the scheme allows women to access healthcare “in a safe and effective way”, it would seem that none of the serious concerns about risks to women’s health and safety raised at the time the temporary measures were introduced have been addressed.
Critics of the scheme point to the inherent risks for women, especially those vulnerable to coercion or medical complications:
“This scheme, introduced out of desperation during COVID, allowed abortion vendors to place women’s safety at risk by sending abortion pills out in the mail to them (or potentially to their abusers). This required no face to face consulation, a critical safeguard against coerced abortion, life-threatening ruptured ectopic pregnancies and a litany of other possible risks. It was a devastating decision for the safety of the most vulnerable women.
“Abortion providers used to reassure women at risk of coerced abortion – often domestic abuse or sex trafficking victims – that they would be seen in person to ensure they were not being forced into it. Some of them still do. But telemedicine cannot possibly provide the privacy necessary to ensure this, since someone else could easily be in the room dictating the woman’s answers. Since a quarter of abortions are coerced by men, the removal of this safeguard was brilliant news for abusers, traffickers and abortion providers. It was not so good news for vulnerable women.”
Concerns about women’s physical safety have also been raised by women who have taken the pills:
“A nurse who experienced extreme complications from an ‘at-home’ abortion that required follow-up surgery expressed her shock that “the UK, with all of our research and expertise, would approve this… it just feels like we are going backwards and that… covid is an excuse to not treat women with respect”.”
Data collected about the reporting of complications following at home abortions during the temporary operation of the scheme found it was considerably underreported, and revealed that more than 10,000 women participating in the scheme “ended up needing hospital treatment to deal with the side-effects”. The author of the study, Kevin Duffy, stated that the results reveal “serious flaws in how complications are reported and how taking abortion care out of clinics and allowing women to take both abortion pills at home significantly increases safety risks”.
It was only through leaked emails and freedom of information requests that the true extent of the risks to women became known:
“Other alarming cases are well known from a leaked NHS email last year. This included more ruptured ectopic pregnancies and resuscitation for major haemorrhage. The lack of examination and ultrasound prior to abortion meant that babies could be aborted at any gestation at home, putting the mother at risk of dangerous late-term abortions with no medical supervision, and allowing the possibility of fully developed babies being born alive after attempted abortion. The e-mail noted cases of infants being born at up to 30 weeks’ gestation, and a murder investigation for a baby who was born alive and subsequently died. All of these were in one region alone.”
None of these concerns have been addressed by the government as it pushes ahead with this service on a permanent basis. It is shameful that women’s health and wellbeing regarding this extremely fraught issue have not been the top priority.