A woman has been sentenced to 28 months in prison, after it was found that she misused the 'pills by post' at-home abortions service, which the UK introduced during the height of the Coronavirus pandemic.
In a first-of-its-kind court proceeding, a judge has handed out a jail sentence of over two years, to a woman who took medication sent to her home to end a pregnancy that was beyond the 10 week cut-off point.
The 44-year-old mother of three, whose identity has been protected, will be required to serve a large part of her sentence behind bars, separated from her existing children, one of whom has additional needs.
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In court, the woman expressed that she did not know how far along she was in her pregnancy, though it has been claimed that she thought she was about 28 weeks pregnant. Doctors have concluded that the foetus was more like 32-34 weeks.
She was found to have been guilty of misleading the British Pregnancy Advisory Service (BPAS) in order to be sent the abortion medication and she has been prosecuted under the Offences against the Person Act, which was first introduced in 1861.
In court, the woman expressed that she was in a state of 'emotional turmoil' and that she 'cannot forgive herself and that it will haunt her forever.'
With this news, it becomes increasingly important to familiarise yourself with the rules and processes around the at-home medical abortion service, which was only made a permanent option last year.
Here is everything you need to know about new medical abortion legislation in the UK:
How did 'pills at home' come into existence?
Back in March 2020, during the peak of the coronavirus pandemic, the government announced that women would be able to have an at-home abortion at up to ten weeks of gestation.
While the decision marked a landmark move from the government, the change had been carried out on a temporary basis, initially limited to two years.
‘Public safety and continued access to key services is our priority during this difficult period,’ a spokesperson from the Department of Health and Social Care (DHSC) said at the time.
However, it was announced last year that women in England and Wales will be able to have early at-home abortions on a permanent basis.
What is a medical abortion?
Women who request an early medical abortion during the first trimester of pregnancy will take two types of tablet to do so, the NHS explains.
Mifepristone is the first tablet which stops the hormone that allows the pregnancy to continue. The second is known as misoprostol, which is normally taken 24-48 hours after a patient takes the first tablet and makes the womb contract to terminate the pregnancy.
After four to six hours the lining of the womb breaks down, which results in bleeding and the loss of the pregnancy.
If a medical abortion is carried out after nine weeks, a patient may need more doses of misoprostol and might need to stay in the clinic or hospital.
In 2018, there were 200,608 abortions for women resident in England and Wales and 205,295 abortions including non-residents, according to the DHSC. The abortion rate increased from 16.7 per 1,000 women in 2017.
In November 2019, a report titled ‘Better for Women’, published by the Royal College of Obstetricians and Gynaecologists (RCOG), called on the DHSC to reconsider its guidelines regarding medical abortions.
Professor Lesley Regan, president of the RCOG, said the DHSC greatly improved women’s experience of abortion care when it allowed women to take misoprostol (the second tablet) from home.
As a result of the decision, she said it has allowed women to avoid the ‘distress or embarrassment of bleeding and cramping pain’ during their journey home from the clinic.
Urging for the DHSC to consider allowing women to take mifepristone (the first tablet) at home, too, Regan said at the time: ‘This would improve the accessibility of early medical abortion care for women, particularly for those who live in rural areas or those with child caring commitments.’
In the report, a RCOG survey of more than 3,000 women found that many were struggling to access basic services around contraception, abortion care and the menopause.
What is the change in policy to home abortions?
The government reached a turning point when confirming on Tuesday, August 23 its new decision to allow women in England and Wales access to early medical abortions on a permanent basis.
It previously introduced at-home abortions during Covid-19, despite decision facing numerous upheavals in the weeks leading up to the change pushing for the opposite.
This revolutionary move means those under 10 weeks will be granted access to both pills needed for termination, provided they've had a consultation beforehand.
The measure has already been allowed to permanently continue in Scotland, and while Wales announced earlier this year that it would be adhering to this too, the decision has only now been legalised.
Conditions in the law require doctors to record where the abortion is taking place and where and how the woman was consulted.
Minister for Public Health Maggie Throup has said: 'The wellbeing and safety of women requiring access to abortion services is paramount. With these measures women will have more choice in how and where they access abortion services, while ensuring robust data is collected to ensure their continued safety.'
In line with the new change, the Royal College of Paediatrics and Child Health will create guidance for under-18s regarding early medical abortions to ensure sufficient safeguarding is established.
The government has said this reiterates the importance of young people being able to access early early medical abortions in 'a timely manner' and that 'their holistic and safeguarding needs must be addressed by providers'.
As for the Abortion Act, it will be amended on from August 30 to allow those eligible in their first 10 weeks of pregnancy (up to nine weeks and six days) to continue to use this service.
It's a relief, as back in February ministers said the new measures would be abolished in England at the end of August 2022.
Between November 2020 and February 2021 the public was initially consulted on whether the early-abortion procedure should be made permanent.
Domestic abuse was posed as a potential issue, but the government shared its commitment to giving women expert care and recertified private-sector abortion clinics in England to allow for this service too.
On March 23 2020, women and girls wanting to terminate an early pregnancy were initially told that the service would be available.
In the guidance, the Department of Health and Social Care (DHSC) said: ‘The secretary of state for health and social care has approved two temporary measures in England to limit the transmission of coronavirus (Covid-19) and ensure continued access to early medical abortion services.’
However, the decision was retracted hours later, according to what the government described as an announcement that had been ‘published in error’.
In response, numerous family planning and health organisations including the Royal Colleege of Midwives, the British Pregnancy Advisory Service and the Roycal College of Obstetricians wrote to Health Secretary Matt Hancock asking for an amendment to the law.
On Monday March 30 of the same year, the DHSC took another U-turn and announced that pills to terminate a pregnancy could then be taken at home after a phone or online consultation with a doctor.
‘This measure will be on a temporary basis,’ according to a spokesperson.‘We are updating our guidance so women who need an abortion up to 10 weeks and can’t access a clinic can use abortion pills at home.
‘We will set out the next steps, including updated guidance, shortly.’
It was announced that patients would be able to take two pills at home instead of visiting a clinic twice, to avoid the risk of contracting coronavirus.
Previously in England, women were required to take the first of the two tablets at a registered clinic. And relatively recently, women had been required to take both tablets at a clinic, requiring two separate visits. However, they are now able to take both pills in the safety and privacy of their own homes
BPAS reacted to the initial 2020 news on Twitter, posting:
Meanwhile, the Royal College of Obstetricians and Gynaecologists stated it welcomes the decision.
‘Giving women the option of taking both abortion pills at home following a video consultation is safe and effective and has rightly been judged as a vital and necessary step if we are to limit the spread of COVID-19,’ Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists said.
‘Many women will no longer be forced to make the difficult decision between leaving their home and continuing with an unwanted pregnancy.’
Dr Asha Kasliwal, President of the Faculty of Sexual and Reproductive Healthcare, added: ‘Telemedicine for abortion care assessments is already recommended in NICE guidelines. Home use of the first course of abortion pills for early medical abortion will avoid unnecessary and risky visits to healthcare facilities, ensuring women have access to safe and timely healthcare.
‘This change could not have happened soon enough.’
What about home abortions in Wales, Scotland and Northern Ireland?
The new legislation only applies to women in England and Wales.
In May 2022, the Scottish government said it wouldn't commit to a final decision on making the at-home abortion scheme permanent until autumn.
In Northern Ireland, abortions were decriminalised in October last year, with new regulations taking effect on March 31.
The new legislation means that terminations can be carried out in all circumstances in the first 12 weeks of a pregnancy. Terminations are also able to go ahead up to 24 weeks if there is a risk to the physical or mental health of the patient.
After the first trimester, abortions remain legal in limited circumstances situations such as fatal foetal abnormalities.
As a result, Grainne Teggart, Amnesty International’s Northern Ireland campaigns manager, previously urged for the same guidelines in England to be applicable in Northern Ireland.
‘It’s a huge relief that the Government has finally confirmed that women and girls in England will be given the option to self-manage abortions at home, particularly during the current global health pandemic,’ she explained on the Amnesty website.
‘Travelling for this healthcare during the Covid-19 crisis is no longer a safe or viable option, meaning Northern Ireland is effectively being left without services,’ she added.
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