From 30 August 2022, at home abortions were permanently legalised for women in England and Wales. This change is a huge step forward for women’s health and improved access to medical care in these countries.

What is an At Home Abortion?

An at home abortion, teleabortion, or medical abortion is an early termination of pregnancy carried out (in Australia) before the 9th week of gestation.

The basic process is as follows:

  1. The woman is given a telephone consult with a doctor who then refers her for an ultrasound to confirm and date the pregnancy.
  2. Another phone consult follows with a doctor who is specialised in providing medical abortions.
  3. The medications are then discreetly couriered to the woman, with full instructions, and the abortion proceeds in the privacy and comfort of the woman’s home.
  4. 24/7 telephone access to medical support is also provided.

Two drugs are used, given in pill form.

  1. Mifepristone is a synthetic steroid that stops the progression of the pregnancy and causes the placenta and embryo to detach from the inner lining of the uterus, as well as softening and dilating the cervix.
  2. Misoprostol is a prostaglandin analogue, which contracts the uterus to evacuate the contents.

The second pill is usually taken 36-48 hours after the first, and cramping, bleeding, and expulsion of the products of the pregnancy occur within 6 hours of this. Bleeding may continue for 10-16 days, sometimes longer, and the effect overall is similar to having a miscarriage.

Medical abortion is effective in over 95% of cases and complications are not common.

Throughout the world, at least 95% of first-trimester abortions are medical abortions and the WHO actively promotes increased access to these services.

The Change to English & Welsh Law

The legislation recently implemented in England and Wales enables women from the age of 18 years to access pills legally and easily for medical abortions via teleconsultation. In the UK, these pills will be available to be taken at home for abortions up to 9 weeks and 6 days (69 days total) gestation.

Furthermore, all independent/private abortion clinics and hospitals in England have been reapproved to legally provide abortion services countrywide until at least 31 July 2026.

Robust data will be collected on an ongoing basis to ensure the continued safety of women. Data will also be collected to better understand the use and requirement for remote abortion services going forward.

Providing doctors will be required to, according to the Abortion (Amendment) Regulations 2022, and in all cases, collect and notify information including:

  • Location of consultation
  • Whether consultation was entirely remote
  • Location of termination and whether one or both medical abortion pills were taken at home
  • Certification in “good faith” that the gestation period is below 10 weeks

Why is this important for women?

These legislative changes open access to the medical care women in England and Wales need and deserve. It also means that early abortion access for women in rural and remote areas, or who are in complex personal situations, now have options they otherwise would not, including when they, for whatever reason:

  • Cannot visit a doctor’s clinic
  • Cannot travel to a hospital or private abortion clinic
  • Cannot afford a surgical abortion
  • Seek the most discreet route to ending an early pregnancy

UK Minister for Public Health, Maggie Throup, stated that “the wellbeing and safety of women requiring access to abortion services is paramount … women will (now) have more choice in how and where they access abortion services”.

In the case of young women under the age of 18 years requiring an early medical at home abortion, the Royal College of Paediatrics and Child Health will publish national safeguarding guidance. This will reinforce the principle that all young women should be able to access early medical abortions safely, and promptly, and that providers must address their unique holistic needs.

Medical vs Surgical Abortions & Legislation in Australia

Abortion is legal in all Australian states and territories, with each having its own conditions.

In the ACT and NSW – medical abortion is legal when provided by a medical professional up to 63 days gestation.

One-third of Australian women experience an unplanned pregnancy in their lifetime, and the rate of this is disproportionately higher for women who are socioeconomically disadvantaged and/or reside in rural or remote areas. 30.4% of these unplanned pregnancies will end in abortion.

In terms of early abortion (before 9 weeks), medical abortion has a definite role to play, however, it is not necessarily the best choice for all women.

Surgical abortion remains the standard of care for many women, even from very early in gestation.

  • The risk of an incomplete abortion occurring is lower than for medical abortion (which is up to 8%)
  • Surgical abortion may be performed at any time in the first trimester, but usually from 6 weeks onwards to confirm intrauterine pregnancy plus exclude ectopic pregnancy. Same for medical abortion.
  • The procedure takes just 5-10 minutes and the total time in the clinic is just a few hours
  • In most cases, surgical abortion leads to only light bleeding over up to two weeks and less cramping than a medical abortion which can result in heavier bleeding for three weeks or more and significant cramping
  • The woman is supported in person by medical professionals throughout the surgical abortion procedure.
  • Performed under twilight sedation, the woman is unaware of the surgical abortion as it takes place, minimising the trauma (which may be associated with the process of a medical abortion)
  • Surgical abortion has a low rate of complication and a very high success rate of 99%

While surgical abortion is preferred for most women, a medical or at home abortion, however, can be the right option for women who are eligible and for whom accessing a surgical abortion is more difficult. It may be particularly suitable for women in rural or remote areas, who experience partner violence or coercive control, or for whom the out-of-pocket costs of accessing a surgical abortion (including travel, accommodation, time away from home, etc) are prohibitive.

Medical at home abortion is a less invasive alternative to surgical abortion, however it is suitable only for women of up to 9 weeks (or 63 days) gestation and who are otherwise considered to be medically suitable candidates. Few GPs offer this service (due to concerns about its legality and personal moral, ethical, or religious beliefs), and limited access means that many, many women are unable to get the care they need when they need it. Furthermore, the costs and other practicalities make it difficult for many women to access surgical abortion services.

Since many women are unaware of the option and limitations of medical abortion, many present for consultation for this type of abortion beyond 63 days gestation, thereby making them ineligible for this medical service.

At home abortion facilitates a private, affordable, convenient, and discreet way to terminate an early pregnancy for women who are deemed medically suitable. It is an important option for women’s health. The key to improving access to at home abortion in Australia lies in better access to education regarding the procedure and its legality, as well as ensuring GPs become better informed about and supported in their role, and access and participate in the short training program to offer this care.

Safe, Legal Surgical Abortions in NSW & ACT

Gynaecology Centres Australia offers women of all ages specialised surgical abortion services.

With clinics conveniently located in Greater Sydney, Gosford, Newcastle, Wollongong, and Queanbeyan(ACT), Gynaecology Centres Australia offers high-standard modern women’s health services and uncompromised access to safe, legal first-trimester surgical abortions. Our world-class women’s health services provide the non-judgmental care women need and deserve regardless of their age or other circumstances.

Contact us now for confidential care, the most up-to-date unbiased information, and compassionate support.

You do not need a GP referral to visit our clinics.

Please call 02 9585 9599 or complete our online booking form.