Abortion pills at home: what the government isn't telling you

Last year, then Minister for Health, Simon Harris – a man with a disquieting commitment to making abortion easily available – said that the abortion pill could be prescribed remotely during the Covid crisis. 

Previously, the HSE had said that pregnant women needed to attend a pre-abortion consultation in a surgery or clinic.

When this radical change to the regime was made in March 2020, pro-life doctors and nurses warned that dropping the requirement for a physical consultation could be dangerous. They pointed out that an ultrasound may be required to determine gestation – and can be crucial to determine if the pregnancy is ectopic, since an undiagnosed ectopic pregnancy can be life-threatening.

In fact, during the referendum, voters were told that because women were putting their lives in danger by importing abortion pills and taking them without medical supervision. Then Taoiseach, Leo Varadkar, said that if people voted No it was “only a matter of time before someone haemorrhages or bleeds to death after taking one of these pills unregulated”

It seemed strange, then, that no such fears were raised about women’s safety when taking the abortion pill at home after a phone or Skype consultation. Sadly, we know that the HSE tells women to flush their baby’s body “down the toilet” after using abortion pills. Clearly, they have no respect or regard for the child whose life has been ended. But since the government – Harris in particular – spent so much time tweeting about a woman’s right to abortion, and about women’s wellbeing and safety, it was naturally expected that the use of abortion pills at home would be carefully monitored for any adverse outcomes and to ensure women were not endangering their lives.

That didn’t happen. Instead, incredibly, the HSE has now admitted it is not collecting any data on complications that arise from “at-home abortions” – even though it is considering whether to continue the remote consultations in place after the pandemic.

In response to a parliamentary question from Eamon O’Cuiv TD, the HSE confirmed  “no analysis as such on remote consultation has been conducted in Ireland”. However, it did add that “the Department has requested the HSE to revisit the Model of Care to review its operation and consider whether it should be retained going forward.”

This is astonishing. If the HSE hasn’t bothered to examine the evidence – and, in fact, as previously acknowledged to Carol Nolan TD, it has no central system of collecting adverse abortion outcomes – how can they possibly know that it is safe to continue with remote consultations?

(You might have noticed that most of the information we have about the abortion regime comes from parliamentary questions asked by Independent or Aontú TDs. The HSE doesn’t seem interested in gathering any data which might show adverse outcomes of abortion. What happened to women being fully informed?)

The HSE, through Mary-Jo Biggs, General Manager of the National Women and Infants Health Programme, says that Ireland is only using evidence from the UK. “There has been good feedback from providers and patients and there is good evidence from published literature from the UK that remote provision of abortion care is very safe,” she said.

Leaving aside the scandal that the HSE can’t be bothered to gather its own data, let’s look at some of the outcomes from the UK.

In May 2020, just two months after at-home abortions were legalised, a leaked email from a Regional Chief Midwife at NHS England and NHS Improvement revealed that there had been “two maternal deaths linked to this issue”. The email also revealed that women were presenting at hospitals after talking abortion pills for a range of incidents including ‘significant pain and bleeding related to the process through to ruptured ectopics’, ‘major resuscitation for major haemorrhage,’ and incidents involving the ‘delivery of infants who are up to 30 weeks gestation.’

An undercover investigation by Christian Concern found that abortion clinics were not carrying out basic checks before sending women abortion pills for use at home.

In fact, such is the growing concern amongst medical professionals in Britain on the issue, in May of this year more than 600 medics demanded that the controversial ‘pills in the post’ scheme be scrapped, citing fears that abortion pills mailed after phone or online consultations were being used when the baby was beyond the ten-week limit stipulated – and might even be beyond the 24-week limit for surgical abortions. They also said that taking abortion pills at home made it easier for men to coerce women into abortions against their will – and failed to protect women who were being trafficked or abused.

That call has been echoed this month by two former presidents of the Royal College of Physicians and Surgeons of Glasgow who said the Scottish government “should reinstate in-person appointments at the earliest possible opportunity.”

We also know – again thanks to a question asked by Carol Nolan TD – that here in Ireland some 94 claims have been made against the State in relation to adverse outcomes after abortion since it was legalised. Yet we are not being told whether abortion pills at home are a factor.

The government, it seems, doesn’t want women to have this information. Women need to start asking why that is.