(Percuti) At least 39,000 women in England and Wales have been treated in NHS hospitals over the past five years for complications arising from failed or incomplete medical abortions at home. In the past, these complications would have been treated at the abortion provider's facility.
Five years ago, abortions were only provided at licensed abortion facilities. On December 27, 2018, the Minister of Health and Human Services allowed women to self-administer misoprostol, the second form of medical abortion, at home. At the end of March 2020, as an emergency response to the coronavirus lockdown, the Secretary of State extended this authorization, allowing women to self-administer mifepristone and misoprostol, both parts of a medical abortion, at home. Made it manageable.
The Royal College of Obstetricians and Gynecologists (RCOG) says that up to 1% of medical abortion cases end in failure, meaning that women can still become pregnant after taking both mifepristone and misoprostol. I'm warning you what it means. The RCOG also notes that medical abortions can be incomplete in up to 6% of cases, leaving part of the placenta or embryo in the uterus, a complication called retained product of conceptus (RPOC), which can affect women. also stated that further efforts are needed. Medical considerations. The stated complication rate of 6% (1 in 17 women who utilize medical abortion) is consistent with the complication rate published by the manufacturer of mifepristone detailed here .
Abortion providers and the DHSC have been under-reporting these complications. Earlier this year, Lord Jackson submitted a number of written questions to the Department on this matter. In response, Lord Markham, Parliamentary Under-Secretary of the Department of Health and Social Care, acknowledged that there were gaps in reporting by health care providers under the abortion notification system, stating that complications when a woman presents for treatment are covered by a separate system. He pointed out that these events are recorded in hospital episode statistics. Her RPOC study in an NHS hospital. Lord Markham continued: “To improve the quality of data available on complications of abortion, the Department is undertaking a project to improve understanding of the data.”
The project culminated in a report published by OHID on November 23, 2023. The report provided statistics on the number of women hospitalized for inpatient treatment of abortion complications. If a woman presents to her A&E with products of conception from an incomplete abortion, she will be offered one of three different treatments. Her first two of these are outpatient treatments, one with more misoprostol, and the other with a wait-and-see approach called expectant management. Inpatient treatment is surgical removal of retained products of conception (ERPC) and is reported by OHID. Analysis of this report and its data shows that 2.8% of women who self-administered medical abortions at home were subsequently admitted as inpatients with ERPC, meaning that 3.2% of women (6% total) It turns out that I was treated as an outpatient. These treatment rates are consistent with the results of our FOI study.
OHID statistics for the first half of 2022 show a 17% increase compared to the same period in 2021. Both BPAS and MSI Reproduction Choices show this sharp increase continued through the second half of 2022 and into 2023. MSI-RC recently submitted written evidence to Parliament in which it reported that the first period in 2023 had increased by 32% compared to the same period in 2022. This is an unprecedented increase, but it is not yet reported in official data.