Data from British Hospitals Show At-Home Chemical Abortions Considerably Less Safe, Effective than Advertised

By Randall K. O’Bannon, Ph.D. NRL Director of Education & Research

Whenever the abortion industry publishes yet another study claiming that chemical abortions or, in particular, those at-home, “self-managed,” Do-It-Yourself (DIY) “medical” abortions are absolutely safe, National Right to Life has repeatedly and insistently pointed out that these studies are incredibly flawed. They are based on only the responses of those patients that researchers were able to track, ignoring the outcomes of numerous women with problems who may have sought help elsewhere.

There have been some hints of the size of this ignored, wounded population.  A study published in the January 2015 issue Obstetrics & Gynecology found that women having first trimester chemical abortions were four times more likely to visit the emergency room with complications than those with first trimester surgical or “aspiration” abortions. Women have often found these abortions much bloodier, much more difficult than expected.

For the most part, however, recent medical journals and newspapers have been filled with claims of telemedical and “self-managed” chemical abortion safety and effectiveness (1) ignoring the fate or dismissing the relevance of hundreds, or now thousands of women lost to followup.

The implicit assumption of researchers was that these women were just fine, with completion or complication rates similar to the women the studies were able to follow. But a new report out of Britain shows failure and complication rates, particularly for at home abortions, are much higher than what has been reported. 

Numbers too good to be true

Abortion activists in Britain were able to do what activists in America have attempted, using the pandemic as an excuse to get the government to approve home delivery and use of abortion pills. 

Not surprisingly, abortion advocates have argued that the “pills-by-post” program was a resounding public health success, with minimal safety problems and high effectiveness rates.  

According the British Department of Health and Social Care (DHSC), the number of at home abortions (with both the mifepristone and prostaglandin taken at home) jumped from zero in April 2020 after the government authorized at-home use to 51% by June. 

At the same time, the British Pregnancy Advisory Service (BPAS) claimed that the risk of complication, hemorrhage, and incomplete abortion were all down in the first three months following the inception of the “pills-by-post” program (April-June 2020) than they were compared to a similar time frame (April-June 2019) the year before, before the pandemic (New Statesman, 12/15/20)

One of the more dramatic claims by the DHSC, of course picked up and broadcast by media, is that the British government agency recorded only one complication from the 23,061 abortions performed between April and June of 2020, once the new policy was put in place. This was supposed to be documented evidence of the safety of self-managed home abortions (New Statesman, 12/15/20).

An independent investigator with a background in public health says the British government only got those sanguine results by ignoring a lot of clear data to the contrary.

Former abortion industry insider skeptical of safety claims

Kevin Duffy, a data analyst and public health researcher who once worked for Marie Stopes International (MSI), Britain’s international abortion giant (think Planned Parenthood with a massive international presence), saw the reports of the success of the pills-by-post program and decided to investigate.

Duffy had spent four years as a senior level executive with MSI, responsible for 550 clinics across 37 countries. The strategies he helped develop enabled MSI to double the number of abortions it performed worldwide.  He left MSI in 2019 when his conscience and Christian faith got the better of him. 

“Life begins at conception, and none of us should ever be involved in supporting or enabling a woman to end that life,” Duffy says in an interview posted on the Percuity website (https://percuity.blog/2021/11/25/from-abortion-executive-to-pro-life-advocate-a-former-international-abortion-worker-speaks-out/). 

Since leaving MSI and the abortion industry, Duffy has been working as an independent consultant for Percuity, a public health research group he founded. Studying various aspects of “global reproductive health,” he has been particularly wary of the abortion industry’s push for “self-managed” chemical abortions  “Women are not being well served and are missing out on essential clinical assessments,” Duffy says in the Percuity blog. “They are left to manage the expulsions on their own at home—and with no follow-up care afterwards. This is a long, long way from the comprehensive, safe abortion care that MSI claims to provide.”

Casualties of the British campaign for at-home abortions

Towards that end, rather than take the government’s and abortion industry’s claims at face value, Duffy’s group Percuity investigated. They sent freedom of information requests to each of the 127 National Health Service (NHS) Trusts and Foundation Trusts which provide Britain’s acute hospital services (general and emergency care). Trusts, for the NHS, are the public sector corporations set up by the government to manage healthcare in a particular region (or to provide a particular type of service, e.g., ambulance service).

The full report can be found here: https://percuity.blog/foi-investigation-into-medical-abortion-treatment-failure/

In its requests, Percuity asked for the numbers of women showing up to Trust hospitals with “retained products of conception” after chemical abortions and wanted to know how many of those required “surgical management” to complete the abortions between June 1, 2019 and May 31, 2021. They also sought data on the number of women who were treated for hemorrhage after abortion for that same period.

Eighty-five of the Trusts responded, together representing about 80% of the population of England. What Percuity found from those reports was not one complication for every 23,000 patients, a few hundred thousandths of a percent, but closer to 6%, more like one in 17.

More specifically, the data reported back to Percuity showed that 5.9% of women having a chemical abortion during the two years of the study were treated at an NHS hospital for complications connected to an incomplete abortion with “retained products of conception.” Three percent of women required surgery to deal with these incomplete abortions.  About one in 44, or 2.3% of women were treated at these government hospitals for hemorrhage.

All these are significant numbers for a population of millions of women where hundreds of thousands are having abortions a year. (2)

There’s more to it than that. This being the analysis of two years of data almost perfectly straddling the COVID outbreak, Percuity was able to examine the complication rate both before and after the British government authorized the home use of both abortion drugs in April 2020.  Results clearly showed an increase in complications, in incomplete abortions, in surgery to address these, and in cases of hemorrhage when more of these abortions were done at home.

If 10,000 women a month “self-manage” their chemical abortions at home, as Percuity estimates from government figures, the higher complication rates meant about 640 women each month dealing with incomplete abortions, with more than half of those requiring surgery, and another 230 facing hemorrhage.

This is not the profile of a “safe” or “effective” abortion method.

Reason to believe these complications are undercounted 

Percuity points out something we have noted before, that these numbers reflect only those who showed up at the hospitals and acknowledged they were taking abortion pills. Women who showed up at the Trust hospitals and claimed that they were having miscarriages (as some promoters and suppliers of chemical abortions have suggested women do), would not automatically be counted as having an abortion pill related complication.

The same would be the case for women who sought treatment for their complications or incomplete abortions at other non-Trust entities like MSI (Marie Stopes International) abortion clinics or those run by the BPAS (British Pregnancy Advisory Service). Those would not be counted in data reported by the NHS Trust hospitals. 

Data paints much different picture than government, abortion industry reports

Given this data clearly showing significant problems, particularly with at home use of the abortion drugs, how and why do the British government and medical “experts” publishing studies on the topic continue to assert that home use is “safe” and “effective?”

They do so by relying on reports from the abortionists who are prescribing the pills. Asked to explain limitations on abortion complication data, Britain’s Health Minister, Helen Whately said in June of this year that, “Abortion complications data is collected via the HSA4 abortion notification form. However, it is recognised that the data is limited as not all complications will be known to the practitioner at the time the form is submitted.”

In other words, the only official data the government receives is what comes from abortionist, who (if he or she so chooses) relays only the complications which he or she has observed or of which he or she has been informed. If a patient goes elsewhere, or has problems after the abortionist has closed the case, those will not show up in the official government record.

These others were only uncovered in the sort of inquiry made by Percuity.

As has been the case from the beginning, the reality of chemical abortion is considerably more difficult, more dangerous than the abortion pill’s promoters let on. And self-managed, telemedicine, at-home “pills-by-post” DIY abortions only increase the risk. 

Percuity’s data makes this plain in a way the abortion industry’s slanted “studies” and spin do not. 

  1. WHO Bulletin, May 2011, British Medical Journal, 5/16/17, Reproductive Health, 10/27/20, Contraception, September 2019 and July 2021, Lancet, 11/18/21 and just a few of many articles in the media, “ Telemedicine Makes It Safe to Get Abortion Drugs in the Mail” Wired, June 5, 2019, and “Abortion by Telemedicine: A Growing Option as Access to Clinics Wanes,” New York Times, April 28, 2020.
  2. Percuity cites government data showing that more than 180,000 women took at least one of their abortion pills at home between April 2020 and September 2021.