RCOG and FSRH statement on taking misoprostol at home in Wales

In October 2017, the Chief Medical Officer and Health Secretary in Scotland recognised a woman’s home as a safe and acceptable place to take misoprostol, the second drug used to effect an early medical abortion. In early 2018, the Welsh Government announced that it would be following Scotland’s lead. Today, the Cabinet Secretary for Health and Social Services in Wales has announced an agreement to allow misoprostol at home for medical abortion treatment.

In April 2018, the RCOG and FSRH signed a letter along with over twenty medical and women’s groups calling on the Secretary of State for Health and Social Care to allow women in England to take misoprostol in a setting of their own choice. This letter, published in The Times, stated that this ‘simple measure [..] would significantly improve the wellbeing of women’.

The use of misoprostol at home is safe and is endorsed by the World Health Organization (WHO).

Professor Lesley Regan, President of the Royal College of Obstetricians and Gynaecologists, said:

“In England, women who have an early medical abortion are forced to return to the clinic to take misoprostol. The need for this second visit to the clinic frequently acts as a barrier to women accessing safe, regulated abortion care, and is medically unnecessary and incurs significant NHS costs.

“Many women also experience the distress and embarrassment of bleeding and cramping pain during their journey home.

“The Royal College of Obstetricians and Gynaecologists and Faculty of Sexual and Reproductive Healthcare urge Jeremy Hunt to extend the same dignity that the Scottish and Welsh Governments have offered to women.”

Dr Asha Kasliwal, President of the Faculty of Sexual and Reproductive Healthcare (FSRH), said:

“The Faculty of Sexual and Reproductive Healthcare believes women should be able to access safe and legal abortion wherever they live in the UK. Last November, following an extensive consultation with our membership, FSRH’s Council voted unanimously on a new position supporting abortion law reform in the UK. This includes support for use of abortion medication at home or a place of the woman’s choice.

"Evidence suggests that misoprostol is safe, and allowing women to take it at home is a question of patient safety, as it would prevent women from having to deal with the effects of the medication on their way from a clinic. Women are already routinely prescribed this same medication to be taken at home when they suffer a miscarriage. Patient safety should always be at the heart of healthcare delivery.”

Dr Amanda Davies, Chair of the FSRH Wales Committee, said:

“I am delighted to hear that the Welsh Government has followed in the footsteps of Scotland and announced a change in the rules to allow women to take misoprostol at home.

In Wales, accessibility to, and availability of, abortion services is inequitable, potentially and unnecessarily leading to late-term abortions. There is variation between health boards in the provision of abortion services and some populations are disadvantaged through lack of provision. This move will help to improve access to abortion care for the most vulnerable and women who live in isolated areas.

This is undoubtedly a humane decision that will improve early medical abortion care for many women who need it. With this decision, women will be spared unnecessary visits to clinics and will be able to experience the effects of the medication in the comfort and privacy of their homes.”

ENDS

Notes

For media enquiries, please contact the RCOG press office on 020 7045 6773 or email pressoffice@rcog.org.uk

A recently published study found that over 500 women in Great Britain in a four month period in 2016/17 attempted to obtain medical abortion pills online due to inability to access services. Many of the women surveyed said they would like the option of self-administering abortion pills in the privacy and comfort of their own homes. Barriers to accessing abortion services and perspectives on using mifepristone and misoprostol at home in Great Britain. Contraception. 2017: https://www.ncbi.nlm.nih.gov/pubmed/28941978

About the RCOG
The Royal College of Obstetricians and Gynaecologists is a medical charity that champions the provision of high quality women’s healthcare in the UK and beyond. It is dedicated to encouraging the study and advancing the science and practice of obstetrics and gynaecology. It does this through postgraduate medical education and training and the publication of clinical guidelines and reports on aspects of the specialty and service provision. For more information, visit: www.rcog.org.uk

About the RCOG taskforce
The RCOG has identified the urgent need to ensure abortion services are safe, readily available and sustainable. Changes to the way abortion care is commissioned and delivered is having an impact on doctors’ access to training and women’s access to services. In order to address these issues, the RCOG has established an Abortion Task Force, led by President Professor Lesley Regan. The College has agreed to work collaboratively with the main independent-sector providers to seek system-wide solutions to ensure that women have access to safe, sustainable, high-quality care. The RCOG supports decriminalisation of abortion in the UK: https://www.rcog.org.uk/en/news/rcog-backs-decriminalisation-of-abortion/

About the FSRH
The Faculty of Sexual and Reproductive Healthcare (FSRH) is the largest UK professional membership organisation working at the heart of sexual and reproductive health (SRH), supporting healthcare professionals to deliver high quality care. It works with its 15,000 members, to shape sexual reproductive health for all. It produces evidence-based clinical guidance, standards, training, qualifications and research into SRH. It also delivers conferences and publishes the journal BMJ Sexual & Reproductive Health in partnership with the BMJ.