In Australia, the relatively recent phenomenon of ‘tele-abortions’ is being promoted to women as a safe and affordable alternative to surgical abortion, especially for women who live in regional or remote parts of the country. Women are able to access online telehealth consultations with physicians, obtain referrals for ultrasounds and blood tests if required, and then receive the required medications by way of courier to their home or pharmacies in close proximity to where they live.
Following an online consultation, the medication can be delivered directly to a woman’s home by way of courier within 1-3 days of the request.
One of the conditions of eligibility for a medical abortion at home is that the person lives within 2 hours of a hospital, in case of complications. However, the websites promoting these practices reassure women that such side effects are ‘rare’.
A new study undertaken in the United Kingdom has examined the rate at which women who undertook ‘DIY’ abortions at home in the period between June 2019 and May 2020 required hospitalisation as a result of complications.
The study found that more than 10,000 women who took abortion pills at home as part of the service ‘ended up needing hospital treatment to deal with the side effects’. This equates to 1 in 17 women or approximately 20 a day. The independent consultant who led 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’.
‘This is the disturbing truth of abortion care during the pandemic that has not been reported to the government by providers.’
‘This investigation exposes the reality of what thousands of women experiencing crisis pregnancies have been through during the pandemic. It demonstrates clearly what needs to change and why the government must not make DIY home abortion telemedicine permanent. The time to end it is now well overdue.”
The program was introduced in the United Kingdom in response to the Covid-19 restrictions imposed on residents in 2020. The abortion pills-by-post service was promoted as an alternative to attendance at a clinic or hospital for an abortion in an effort to keep people at home but still make abortion available.
The report was compiled following responses to freedom of information requests sent to the 127 NHS trusts which provide acute hospital services in England. There are a total of 226 NHS Trusts and Foundation Trusts listed for England.
The following questions were asked:
“a) How many women presented to hospitals within your Trust with Retained Products of Conception (RPOC) after medically induced abortion [also known as induced miscarriage or termination of pregnancy] for the 24 months starting 01 June 2019 to 31 May 2021, and how many of them required evacuation of retained products (ERPC), [sometimes referred to as surgical management of miscarriage, SMM]. If possible, please can this information be broken down per month?
“b) Please tell us the threshold volume of bleeding required for coding and reporting of haemorrhage at your hospitals and how many women have been treated within your hospitals with haemorrhage after starting a medically induced abortion (also known as induced miscarriage or termination of pregnancy) for each month over a 24 month period starting 01 June 2019 to 31 May 2021.”
In Australia, Marie Stopes Australia and Clinic 66 are two abortion providers that offer tele-abortions (also referred to as abortion online). However, despite this most recent study from the UK, and publicly available data from the Therapeutic Goods Administration (TGA), the practice continues to be promoted by abortion providers as safe and effective, downplaying the potential for side effects and complications.
For example, the Marie Stopes Australia website understates the rate of incomplete abortion, stating that this occurs in 1-4% of cases. Similarly, the Abortion Online website (which is closely aligned with the Clinic 66 sexual health clinic) states (in a somewhat confusing way) that in “5% of cases, medical abortion is not straightforward, though has a 98% success rate”. It further states that in “1-2% of cases of medical abortion, a surgical procedure is required to complete the process”.
This is in contrast with the TGA’s website, which cites 2-7% chance of incomplete abortion, necessitating a surgical abortion.
This latest study from the United Kingdom provides valuable information about the reality of the abortion pill and its risks for women. Informed consent cannot be said to have been provided unless women are given accurate information, and downplaying the potential risks of medical abortion will only serve to ultimately harm women. The medical profession and abortion providers are putting women at risk by promoting this practice and not providing accurate information about its harmful side effects and complications.