Illegal abortion pills are on the rise in Britain. Is it because abortions take too long to get?

A bitter pill

Health bodies are proposing a change to make abortions easier to get. Could this stop the trade in illegal abortion pills?

6th November 2017

You need to be at home or somewhere comfortable. Know which hospital you’re going to if things go wrong, and be able to get there in less than an hour. It’s normal to carry on bleeding for days, even weeks.

That makes up some of the online advice for women who buy abortion pills online instead of having a termination on the NHS. Despite having access to free abortions, under medical supervision, many British women are paying money to buy pills online and going it alone.

In 2015 Ruby* discovered she was pregnant after a one night stand. After telling the person she had slept with, he made it clear he wanted her to seek an abortion – but “knew it was my decision and seemed supportive of whichever route I took”. Deep down, however, she was conflicted.

“My parents are separated and I don’t see my dad. This means I’m close with my mum and it’s rare that I don’t tell her things that are playing on my mind, particularly when it comes to guys and relationships”.

What made it particularly difficult for Ruby was her mother’s quiet but insistent view that abortion should be illegal. “She was always comfortable with the idea of me having sex as long as I used protection, which for the most part I did. It just happened that I was stressed with work, had forgotten to re-do my injection and in the drunken state me and him were in, forgot to use a condom. As soon as I saw the pregnancy test, I felt faint at the thought of how my mum would react.”

At best, she thought her mum could change her mind if she did decide to seek an abortion. At worst though Ruby worried her mum would disown her completely, leaving her without the contact of either parent. She was still only 18.

This meant she felt like she was backed into a corner. Having considered the impact of having a baby, Ruby decided to terminate the pregnancy after seeking advice from friends. “My two best friends knew how my mum disagreed with abortion, but they told me how many sacrifices I’d have to make if I kept the baby, especially with me wanting to go to uni at the time.” Ultimately, these were sacrifices she wasn’t ready to make.

Ruby says how living in a small town influenced her decision to go down a more unusual abortion route. Having researched the possible options, in particular where to go locally to get an abortion, she thought the risk of her being found out by either her mum or someone who would tell her was too great. “I saw that I needed the permission of two doctors but didn’t know how long it would take and I was already stressing about people finding my secret out.

“I researched online and saw a website that sold these pills. I knew what the health risks were but I felt powerless to do anything else,” Ruby says.

For the two pills, mifepristone and misoprostol, Ruby paid about £50. Three days later the pills arrived, her mum still none the wiser as to what Ruby had just picked up off the doormat.

Low risk

Despite their reputation, the risks of abortion pills, known as medical abortion, are low. The World Health Organisation recommends it as a safe abortion method and it’s statistically 13 times safer than childbirth in the UK. The risks come from complications, which might go unaddressed outside of a clinic, and the fact that the pills are bought on illegal websites, with no way of verifying their authenticity.

Nevertheless, women who buy them are breaking the law, as they’re illegal outside of a clinic and without the consent of two doctors. “While it would be better if these women were able to seek care at a local clinic, we do not believe that they should be prosecuted for purchasing abortion medication online,” the British Pregnancy Advisory Service (BPAS) tells The Overtake. In 2013, Interpol’s Operation Pangea seized just five illegal abortion pills. In 2016, this number jumped to 375. This suggests awareness and usage in Britain is on the rise, BPAS says.

A woman experiencing domestic violence and unable to make it to the clinic without her partner finding out [might resort to online abortion pills]

It adds: “We know that women in very desperate circumstances do resort to online abortion medication because of obstacles to care and because they may be very vulnerable – for example, a woman experiencing domestic violence and unable to make it to the clinic without her partner finding out.”

Ruby is dismissive of possible repercussions she could have faced. She says she was aware medical abortion was illegal, but that she didn’t realise the extent of punishment that she could have been handed. “One of the websites I looked at said that it was illegal but the chances of being caught were low. I remember reading it but just not thinking twice which I guess is pretty bad,” she says.

Asked what advice Ruby would give to any young women who felt, like she had, backed into a corner, looking at ordering abortion pills from internet sites, she is frank and honest.

“I took them and everything worked out fine. If it’s your last resort, then you might have to think ‘fuck it’ and go for it. If it is, then yeah, I’d recommend them. I genuinely think had I not taken them and kept the baby, I wouldn’t have done half the stuff I’ve been lucky enough to achieve so far.”

She says she wasn’t naive to the fact what she had done was indeed against the law and considered dangerous without medical supervision, but she recognises the desperation some women feel, particularly those who are in more vulnerable situations than she was. “It’s a cliché, but desperate times sometimes call for desperate measures. That’s the best way I can put it.”

Ruby’s story is like so many others. There are hundreds of women in Britain every year who take risks buying abortion pills online for many reasons; fear of parents and partners, lack of access to clinics locally and the time-consuming process of finding two doctors to give the green light.

Life in prison

Last month marked the 50th anniversary of legislation being passed that allowed women to legally seek an abortion. A woman is now permitted to terminate her pregnancy up to 24 weeks and thanks to the historic 1967 Abortion Act, Britain has some of the most liberal abortion laws in Europe.

According to official statistics released by the Department of Health in 2016, 92% of abortions were performed within 13 weeks, and those performed at 24 weeks or after (permitted in cases where the mother or foetus is at risk of serious harm) amounted to just 226 or 0.1% of all abortions.

Currently, any woman who wants an abortion must obtain the consent and signature of two doctors. If they don’t, they can be handed down a sentence of life imprisonment under an unremoved clause included in an Act of Parliament passed in 1861, a law introduced under the reign of Queen Victoria. Indeed, last year in Northern Ireland, where abortion laws are some of the most restrictive worldwide, a woman was sentenced to three months in prison, suspended for two years having been reported to the police after performing a DIY abortion at home.  

In order to mitigate the many risks an abortion still poses for some, leading medical bodies including the British Medical Association (BMA) and the Royal College of Obstetricians and Gynaecologists (RCOG) have recently demanded these laws be relaxed further.

Under these new proposals, a woman would need the permission of only one doctor for the procedure to go ahead, with nurses and midwives also being permitted to administer abortion pills to women. Pro-choice campaigners have welcomed these proposals whilst pro-life organisations have condemned the move, denouncing them as part of an extremist agenda that trivialises the issue of abortion. Indeed, there are many women who have had abortions and feel as though they’re already too easy to get.

She is adamant that had abortions not been so accessible she wouldn’t have had one. She regrets her choice every day

Her mother’s experience of getting an abortion many years ago has had an impact on 22-year old Elana from Manchester. She says she felt overwhelmed researching the two sides to this argument.

“I can imagine it is agonising waiting for GP referrals and appointments for not one but two doctors before being granted the go-ahead. However, there is also a valid argument for maintaining the approach that two doctors should approve.” She goes on: “The time taken to do so may give the woman an opportunity to consider all of her options.”

There can be a lack of personal support in a time of such emotional anxiety, Elana thinks. “When my mum had an abortion in her late teens, she was not offered any advice from her doctors and simply gained two ticks in their boxes.

“She is adamant that had abortions not been so accessible she wouldn’t have had one. She regrets her choice every day.”

Delays

In 2006 legislation was tabled, but not passed, in Parliament that sought to reduce the limit from 24 to 21 weeks and provide a “cooling off period” for a woman after she had had her first contact with a medical professional whilst seeking an abortion. This was dubbed a “counselling period” that Nadine Dorries MP (yes, her out of I’m A Celeb) who tabled the legislation, later came out against, believing this only succeeded in making the process longer.

The breaking down of barriers surrounding mental health that has been evident recently has also informed opinion on the issue of abortion. Long delays in the NHS abortion service are causing trauma to some women who end up having the procedure much later than they had wanted to, with many reporting that waiting for the treatment was “the worst bit”. Elana sees this, saying: “For any woman suffering mental health issues, this wait could be detrimental. It is impossible to group all women into the same category and say what works for one will work for another.”

Teenage pregnancy rates are at their lowest for 40 years, and according to RCOG, at least a third of women will have had an abortion by the time they are 45. This is in line with Department of Health statistics illustrating that despite a falling trend in the number of abortions for women under 25, it is still this group that disproportionately seek an abortion the most.

Many see the education surrounding abortion as inadequately meeting the needs of young people. Indeed, because of poor sex education, young women may not realise they are pregnant, increasing the need for some to access an urgent late abortion. In these situations, time-consuming barriers like requiring the consent of two doctors could succeed in pushing young women into using unsafe abortion practices.

There may still be a silent yet sinister stigma attached to abortion, but the winds of public opinion are blowing in a brighter direction. A recent YouGov poll showed that 69% of all MP’s backed the introduction of more liberal abortion laws. It’s clear then the support is building for these laws to be relaxed and for abortion to be taken out of the criminal code.

For women like Ruby and Elana’s mum, the decision to go through with an abortion may be one of the toughest they ever have to make. For some, it’s a decision they are comfortable at having made. For others, it’s a wound that may never heal.

*Name changed.

6th November 2017