More than half of abortions in Scotland 'now take place at home'

During the pandemic, women were able to take both sets of pills required for a medical abortion for the first time.

More than half of medical abortions in Scotland take place at home, new Public Health Scotland figures show iStock

More than half of abortions in Scotland are now taking place at home, new figures from Public Health Scotland (PHS) have shown.

In 2021, a total of 13,758 abortions were undertaken across the country, fewer than in 2020, with 53% taking place in women’s homes.

During the coronavirus pandemic, for the first time women were able to take both sets of pills which are required for an early medical abortion at home. 

Before the pandemic, it was only possible to take the second drug at home, but in recent weeks the Scottish Government’s women’s health minister Maree Todd confirmed that where it is judged clinically appropriate, telemedical abortions can continue.

The decision followed a spate of protests outside abortion clinics across the country, namely at Glasgow’s Queen Elizabeth University Hospital and the Sandyford clinic, which pro-choice campaigners have claimed are on the rise.

The telemedical abortion method was introduced from October 2017 and its usage has increased each year since then.

In 2021, 7,310 women opted to take both drugs at home as their termination method.

The latest figures from PHS also showed that 39% of women took only the second drug at home.

Just 18% of terminations – 2,427 – were carried out in clinics or hospital settings.

In a statement earlier this month, Ms Todd said allowing terminations at home help women access abortions without delays.

A slight decline in abortions was noted in the PHS report – with 138 fewer terminations undertaken compared to 2020.

In 2020, abortion rates in Scotland were at the second-highest level since 2008.

The new figures released on May 31, showed that women from deprived areas are more likely to terminate their pregnancies than those in more affluent communities.

The rate in Scotland’s poorest communities was almost twice as high as in the least deprived areas.

NHS Tayside recorded the highest termination rates per NHS Board, with 16 per 1,000 women aged 15 to 44, while Dundee City had the highest number by council area – with 18.7 per 1,000 women.

Women in remote areas continued to have the lowest rates of early access to termination services, figures showed.

A Scottish Government spokesperson said: “Early Medical Abortions at Home were introduced at the start of the pandemic to ensure that women could continue to access abortion safely, and in a timely manner.

“The Scottish Government announced last month that early medical abortions at home would continue.

“We will continue to work closely with NHS Boards to help improve access to abortion services in line with our Women’s Health Plan that was published last year.

“The First Minister has confirmed that she will soon chair a round-table summit to look at abortion rights issues in Scotland.”

The rate of abortion per 1,000 people in Scotland in 2021 was 13.4, compared to 13.5 in 2020.

Claire Murphy, chief executive of the British Pregnancy Advisory Service (BPAS), said there were “significant disparities” with regards to access to home treatment.

Five health boards, she said, only have 5% of all abortions being taken in the privacy of women’s own homes.

She said: “That’s nearly a third of abortions in Scotland where the most preferred method of abortion is simply not offered.

“An extensive body of clinical evidence has demonstrated that at-home early medical abortion care via telemedicine is safe, effective and preferred by many women.

“The ability to access care from home without having to travel to a clinic has brought down the average gestation at which women are ending pregnancies, and while abortion is safer than continuing a pregnancy at any gestation, the risk of complications are lower the earlier in pregnancy a woman can access abortion care.”

Dr Asha Kasllwal, president of the Faculty of Sexual and Reproductive Healthcare, said: “We are incredibly pleased that girls and women in Scotland have continued access to telemedicine for early medical abortion.

“The evidence shows that the telemedicine pathway is safe, effective, timely, more accessible than the alternative and preferred by most women.”

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