Judge rejects home abortions law change

A bid to relax the law on home abortions was rejected by the High Court today.

The British Pregnancy Advisory Service (BPAS) argued that advances in medical science meant the law should now allow the second dose of tablets for an early medical abortion (EMA) to be self-administered at home.

Health Secretary Andrew Lansley opposed the move.

His lawyers argued that the 1967 Abortion Act still required women to take both first and second doses under supervision in a hospital or other medical premises.

Today Mr Justice Supperstone, sitting at the High Court in London, ruled in favour of the Health Secretary and dismissed the BPAS's case.

BPAS lawyers said women suffered unnecessary anxiety about miscarrying on the way home from the clinic after the second round of tablets, especially if they had to travel long distances and/or use public transport.

Today the judge had to decide on the meaning of the words "any treatment for the termination of pregnancy" under Section 1(3) of the Abortion Act, and whether they covered both the prescription and the administration of the drugs used in abortion.

The judge upheld the Government's interpretation that the administration of both sets of abortion tablets amounted to "treatment" which must be carried out by a "registered medical practitioner" on premises approved under the Abortion Act.

He said the section was "consistent" with the Health Secretary's submissions as to the meaning of the concept of "treatment".

"Further, the section does make clear Parliament's decision that it is the Secretary of State, not the medical profession, who has the responsibility for approval of the place where the treatment may take place."

He said that the effect, "and indeed the very purpose", of what was being sought by the BPAS would be that the Secretary of State's approval would no longer be needed to designate approved places.

"In my view this would be directly contrary to Parliament's clear intention."

But the judge made it clear that it was within the Health Secretary's powers to approve a wider range of place where an abortion could take place - "including potentially the home".

Later the BPAS said it was "disappointed" that its interpretation of the Abortion Act was "not deemed viable".

But the charity said it was at the same time "very pleased" that the judge had ruled that Section 1(3A) of the Abortion Act, as amended in 1990, enabled the Secretary of State to react to "changes in medical science", and approve "a wider range of place" for abortions.

The charity said the ruling showed that Mr Lansley now had power "to ensure women receive best possible care".

The charity called for "a legal re-definition of 'treatment"' to enable women undergoing medical abortion in early pregnancy to take some of the medication at home rather than in a clinic.

BPAS stated: "This would put an end to women making multiple, medically unnecessary visits to clinics and eliminated the risk of abortion symptoms beginning - and in some cases the miscarriage itself occurring - as they travelled home after taking the tablets.

"It would also have brought UK medical abortion practice, governed by laws dating back to a time when termination of pregnancy was entirely surgical, into line with international standards of care."

The charity said the increasing number of women using tablets for abortion every year "means resolving this issue is now a matter of great urgency".

Pro-life campaigners say BPAS's intention is to make abortion "little more than a pill-popping exercise".

But BPAS chief executive Ann Furedi said: "BPAS will pursue its case to provide an early medical abortion service that is based on evidence and best international practice.

"Women deserve this, and we would be failing as a charity if we failed to advocate for the services women need.

"It cannot be morally right to compel a woman to physically take tablets in a clinic and to subject her to the anxiety that symptoms will start on the journey back when her doctor knows it is safe and indeed preferable for her to take these at home.

"If the law as it stands cannot allow what is safe, right and proper, then it is not fit for purpose and must be changed to reflect modern medical practice.

"But if the law as it stands allows the Secretary of State to approve a woman's home as a 'class of place' for abortion then this is what he must do.

"We look forward to discussing with ministers and officials how quickly this can happen."

In 2009, around 70,000 early medical abortions were carried out below nine weeks in England and Wales, accounting for about half of all early abortions.

An EMA can be used up to nine weeks' gestation and involves receiving pills in two stages.

On the first visit, women swallow one mifepristone tablet and are told to return to the clinic 24 to 48 hours later.

Women then receive a dose of four tablets (misoprostol), which are usually inserted vaginally, can be swallowed or are dissolved under the tongue or between the cheek and the gum.

Cramping and bleeding to bring about a miscarriage usually begins one to two hours after this dose but can start sooner in some cases. The abortion is usually completed within four to six hours.

The legal challenge by BPAS comes after decade-long talks broke down between ministers and experts at the charity.