In response to the coronavirus (Covid-19) pandemic, the Government has temporarily allowed drugs for early medical abortions to be taken at home, rather than by visiting a hospital or clinic. The decision, published on 30 March 2020, will apply for up to two years (it expires when the provisions of the Coronavirus Act 2020 expire, or two years after the decision was made, whichever is sooner). The Government originally published the decision a week earlier, but then retracted it. During the passage of the Coronavirus Act through Parliament, Members of the House of Lords tried to amend the bill to allow early medical abortion at home, but at that time the Government opposed the amendment.
What is early medical abortion?
Early medical abortion involves the termination of an unwanted pregnancy within the first ten weeks by taking two drugs: mifepristone and misoprostol. Before the Government’s change to the law, the first pill could only be taken at a hospital or registered clinic, following a medical consultation. The second pill is taken within 24 to 48 hours, often at home or during a second visit to a clinic.
What are the new legal changes?
The Government’s decision, which applies to England only, uses powers provided by the Abortion Act 1967 to amend the definition of what is an ‘approved place’ to receive treatment for ending a pregnancy. It makes the home of a pregnant woman an approved place for taking the two drugs, provided they have been prescribed following an online or telephone consultation with a medical professional. The decision also defines a registered medical professional’s home as a suitable place to have the consultation and to prescribe the drugs.
Health is a devolved matter. Since the decision in England, similar reforms have been implemented in Wales and in Scotland. In Northern Ireland, the decriminalisation of abortion came into force on 31 March 2020. However, the BBC has reported that home medical abortions are not included in the new legislation and it is “not clear if that will be allowed to happen, as the Covid-19 crisis grows”.
House of Lords proposal to allow home medical abortion
The issue of early medical abortion was debated during the passage of the Coronavirus Act 2020 through the House of Lords. At the bill’s committee stage on 25 March 2020, Baroness Bennett of Manor Castle (Green Party) moved an amendment that would have made similar changes to the Abortion Act 1967 to allow medical abortions at home. At the time, the Government did not support the amendment.
Moving the amendment, Baroness Bennett, said:
In the next 13 weeks, based on the average figures, 44,000 women will have to travel to a clinic […] to take [the medical abortion] pill, which is utterly medically unnecessary […] This amendment provides for […] temporary modifications to the Abortion Act 1967. It provides for a woman to take both those pills at home.
Other opposition parties supported the amendment.
In response to the amendment, the Government minister, Lord Bethell, stated:
It is the Government’s priority […] that abortions should be performed under the legal framework already set out by the Abortion Act […] The safety of women remains our priority, but it is vital that appropriate checks and balances remain in place regarding abortion services, even while we are managing a very difficult situation such as Covid-19 […] We do not agree that women should be able to take both treatments for medical abortion at home. We believe that it is an essential safeguard that a woman attends a clinic, to ensure that she has an opportunity to be seen alone and to ensure that there are no issues.
Baroness Bennett later withdrew the amendment. (For more information on what happened during the Lords stages of the bill, see the House of Lords Library blog, ‘Coronavirus Bill: what happened in the House of Lords?’, 27 March 2020.)
Reversal of the Government’s decision
On 23 March 2020, prior to committee stage of the bill in the House of Lords, the Government issued guidance allowing early medical abortion at home. However, it retracted the decision several hours later, stating that it had been “published in error”. Asked about that reversal in the House of Commons the next day, Matt Hancock, Secretary of State for Health and Social Care, said that there were “no proposals to change the abortion rules due to Covid-19”.
It is unclear what prompted the Government to change its policy and re-issue the guidance. On 1 April 2020, Paul Goodman, editor of the Conservative Home website, claimed that the decision was “apparently taken by Boris Johnson and a group of advisers”. Mr Goodman criticised the decision, saying that MPs should make changes to abortion procedures “via a free vote”. He added that “big changes to controversial social and political issues are ill suited to decisions made by ministers and advisers behind closed doors”.
However, allowing early medical abortion at home during the coronavirus outbreak has been supported by organisations such as the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, and the reproductive health charity Marie Stopes.
Read the House of Lords Library’s latest articles on the coronavirus (COVID-19).
Image by Women on Waves