U.K. decides fate of “pills by post” abortions

The U.K. government announced Thursday that, after a six-month extension, it will end England’s “pills by post” program, which was set to expire in March. The program allowed women to get abortion pills through the mail after a phone or video consultation. The Welsh government announced hours later it would keep the program permanently. While praising the decision to eventually end the program in England, pro-lifers bemoaned its permanent implementation in Wales. And some fear England will reverse course.

In March 2020, then–Health Secretary Matt Hancock introduced the at-home abortion program in England. Before the pandemic, a woman had to visit an abortion facility in person to take mifepristone, the first drug in the abortion pill regimen. After that visit, the woman could take misoprostol, the second drug, at home. The pills-by-post program was supposed to last until the end of the pandemic or March 2022, whichever came first. Wales and Scotland made similar arrangements. 

Groups like the Royal College of Obstetricians and Gynecologists pushed the government to make the system permanent. But newly released data from a government-run public survey in England from November 2020 to February 2021 showed 70 percent of respondents thought the pills-by-post scheme should “end immediately.” Wales conducted a similar survey but has not yet released detailed results. In its summary, the Welsh government discounted pro-life groups’ concerns about the dangers of unsupervised abortions. The survey in Scotland, released last year, showed 61 percent of respondents thought that the government should return to pre-pandemic requirements. Pills by post is not available in Northern Ireland.

Leaked emails ultimately confirmed the legitimacy of pro-lifers’ safety concerns. The emails from the National Health Service revealed two women died and others experienced severe bleeding from undetected ectopic pregnancies after taking the abortion pill unsupervised at home. An investigation in summer 2020, sponsored by the pro-life group Christian Concern, found that women who were not pregnant could easily obtain the drugs by lying. Data from the first half of 2020 showed multiple women obtained the drugs after the 10-week gestational limit. According to freedom of information requests to the National Health Service by a pro-life activist, in 2.4 percent of all pill-based abortions in England and Wales in 2020, baby body parts remained in the woman and required surgical removal.

In England, the program was set to expire next month when it hits its two-year anniversary. But in a statement on Thursday, Maggie Throup, a member of Parliament, said that the government would extend the program into August 2022. After that, England will return to pre-pandemic requirements for distribution of the abortion pill unless government officials change their minds under pressure from pro-abortion groups.

“Pro-life people are … pleased with the news but also skeptical that the government will keep its word on this occasion,” pro-life U.K. doctor Dermot Kearney said in an email. “We know from past experience that political U-turns and giving in to pressure is all too common, especially on the issue of abortion.” The pro-life group Christian Concern said it expects the government to stick to its decision to end the program in August, although it agreed abortion providers would apply significant pressure to get another extension.

Meanwhile in Wales, Health Minister Eluned Morgan announced plans to make the pandemic measure permanent, saying, “The arrangements are safe and bring significant benefits to women and girls who wish to access abortion services.” Right to Life UK in an email said it was “unclear what is going to happen in Scotland,” but Kearney said he expects the region will also make the program permanent despite the public opposition expressed in last year’s survey.