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Government publishes guidance for early at-home medical abortions

Government publishes guidance for early at-home medical abortions

Doctors will be expected to certify in ‘good faith’ that the gestation period was below 10 weeks once at-home early abortions become permanently legal in England and Wales next week.

They can do this via the EMA1 (Certificate C) form, or using alternative documentation, which must be kept with the patient’s records for a duration of three years from the date of prescribing.

GPs and other prescribing doctors who do not follow the guidance risk breaching the 1967 Abortion Act, the Department of Health and Social Care warned.

Doctors will also be required to monitor the impact of early home abortion by providing information on the place of termination, place of consultation and whether the consultation was fully remote.

Guidance published today said: ‘Certifying doctors are expected to have enough evidence to justify that they were able to form a good faith opinion that, if the medicine prescribed for the termination of the pregnancy is administered in accordance with their instructions, the pregnancy will not exceed 10 weeks at the time when the first early medical abortion pill is taken.

‘If there is evidence that a certifying doctor has not formed an opinion in good faith, then those performing the termination are not protected by the act and may have potentially committed a criminal offence by terminating the pregnancy. Failure to meet the certification requirements may be a breach of the abortion regulations.’

Under new legislation coming into effect next week (30 August), women are able to take both pills needed for early medical abortion at home for pregnancies of up to nine weeks and six days, after a remote consultation.

Before the pandemic, only the second pill could be taken at home, and GPs could not prescribe the pills remotely.

The Government had previously announced that the temporary measure – brought in to reduce Covid transmission – would end at the end of this month. But the decision was overturned in March following campaigning and free vote by MPs in the House of Commons.

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Public health minister Maggie Throup 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.’

Organisations including the BMA and Academy of Royal Medical Colleges had issued strong objections to plans to withdraw the scheme pointing to research that had shown the telemedicine service had provided safe and effective care and had been recommended by NICE.

British Pregnancy Advisory Service (BPAS) chief of staff Rachael Clarke said: ‘Having been in place since March 2020, we know that early abortion at home is safe, effective and an important option for women. BPAS has provided our Pills by Post service to more than 125,000 women so far, and we look forward to continuing this service into September and beyond.’

The extension to the at-home abortion service comes as all 133 independent sector abortion clinics in England have been reapproved until 31 July 2026.

The majority of the clinics are run by the BPAS, MSI Reproductive Choices and the National Unplanned Pregnancy Advisory Service.

The Royal College of Paediatrics and Child Health will shortly publish safeguarding guidance for under-18s accessing early medical abortion services.

The guidance will reinforce the principles that every young person should have access to early medical abortions in a timely manner and that their holistic and safeguarding needs must be addressed by providers.

Government data published in June showed that 214,256 abortions for women resident in England and Wales were carried out in 2021, the highest number since the Abortion Act was introduced in 1967.

A version of this article was first published by Pulse’s sister title The Pharmacist.


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