New study finds widening EMA provision is safe and effective

A consultation is to be launched over whether to relax rules on the settings where Early Medical Abortion can be carried out, ministers say.

The Department of Health on 7 May published the results of a pilot study into early medical abortions carried out in non-hospital settings, looking at how to improve access.

The study shows that large community contraceptive centres, cottage hospitals or polyclinic type settings could offer a safe, high quality service for women.

It shows that some women welcomed the informality and increased availability of staff support. This confirms the experience from other countries which already offer EMA in non-hospital settings.

Medical professionals will now be consulted on whether early medical abortions (EMAs) should be made available in non-hospital settings and patients will be asked if this would be a preferable option for them.

Public Health Minister Dawn Primarolo said:

‘Our priority is to reduce the time women have to wait for an abortion at what is already a very difficult time for them. We have made considerable progress in this, with 65 per cent of women having their abortion at under ten weeks in 2006, up from 51 per cent in 2002.

‘We want to investigate whether patients can be more comfortable and feel as supported in a less clinical setting such as in a large community contraceptive centre. However, the safety of patients must remain paramount and we will now consult with the local NHS and patients to find out whether there is a demand for such a service and how it could best be delivered.’

Ann Furedi, Chief Executive of BPAS, which provides almost 13,000 early medical abortions each year and which provided a comparator site for the research, welcomed the report.

‘This report tells us what we have known for many years - early medical abortion is safe, effective and acceptable when it is provided in a whole number of settings,’ she said.

‘It’s high time that the Department considered new and more accessible options for providing women with earlier abortion care. Abortion is an intensely personal experience to each woman and they repeatedly tell us that it’s very important to them to have as much treatment choice as possible. Under present regulations, this is not always permitted. The existing rules can actually create barriers to some women accessing treatment as early as possible. 

‘Early medical abortion is increasingly favoured by women as a non-invasive, non-surgical option, and there is no clinical reason why the number of visits a woman makes to access the medication cannot be reduced, or this method provided in local or community settings suited to this specialist care. 

‘Abortion legislation will be reviewed during Parliamentary debate on the Human Fertilisation and Embryology Bill. We hope that Parliamentarians will take the opportunity to permit early abortion provision to be shaped by best practice, not bad politics.’

The study is published following media rumours last year about plans to allow abortions to be provided in GPs’ surgeries. A Department of Health spokeswoman said it was unlikely most GP surgeries would meet the standards necessary to provide early medical abortion.

In a Parliamentary debate later this month, MPs are expected to propose both the relaxing and tightening of abortion rules in what will be a free vote on the issue.

Evaluation of Early Medical Abortion (EMA) Pilot Sites: Final Report. By Roger Ingham and Ellie Lee. Department of Health, 7 May 2008

Results of pilot study on early medical abortions in community medical settings published. Department of Health, 7 May 2008

BPAS welcomes Department of Health report on Early Medical Abortion. BPAS press release, 7 May 2008

Plan to increase abortion sites. BBC News, 7 May 2008