The Department cannot separate out which of mifepristone or misoprostol were administered at home, only whether one or both abortion medications were administered at home.

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for ensuring medicines, medical devices, and blood components for transfusion meet applicable standards of safety, quality, and efficacy. The MHRA rigorously assesses available data, including from the Yellow Card scheme, and seeks advice from their independent advisory committee, the Commission on Human Medicines, where appropriate, to inform regulatory decisions.

It is important to note that a reaction reported to the Yellow Card scheme does not necessarily mean it has been caused by the medicine, only that the reporter had a suspicion it may have. Underlying or concurrent illnesses may be responsible, or the events could be coincidental.

The following table shows the number of Yellow Card reports classified as serious, excluding fatal outcomes, and those with a fatal outcome, received for mifepristone from the initial licensing of the medicine, up to 13 May 2025:

Reports received via the Yellow Card scheme can contain more than one suspect medicine. It should be noted that mifepristone is used in combination with misoprostol, and as such 60 of the serious reports and five reports with a fatal outcome include both products as the suspect drug.

Misoprostol is licenced for a variety of indications, including gastroprotection in duodenal and gastric ulcers, termination of pregnancy, and induction of labour. Mifepristone is licenced for termination of pregnancy and induction of labour.

A list of the possible side effects of mifepristone and misoprostol are provided in the product information document for healthcare professionals, the Summary of Product Characteristics, and in the UK Patient Information Leaflet.

A Yellow Card report is considered serious according to two criteria. Firstly, a reported reaction can be considered serious according to our medical dictionary. Secondly, if the original reporter considers the report to be serious, they can select from the six serious criteria available, which are: patient died due to reaction; life threatening; resulted in hospitalisation or prolonged inpatient hospitalisation; congenital abnormality; involved persistent or significant disability or incapacity; or if the reaction was deemed medically significant.

The Government has no plans to assess the potential merits of reversing the decision to allow women to take mifepristone and misoprostol at home to terminate a pregnancy. Abortion in England and Wales is governed by the Abortion Act 1967, which defines the criteria under which terminations can take place. Under the act, women have access to regulated and National Health Service funded abortion services, which now includes taking both abortion pills at home, up to a 10-week gestation.

As with other matters of conscience, abortion is an issue on which the Government adopts a neutral stance. It would be for Parliament to decide whether to make any changes to the law on abortion.

The Government has no plans to commission an inquiry into the safety of taking mifepristone and misoprostol at home to terminate a pregnancy. Abortion is a safe procedure for which major complications are rare, at all pregnancy gestations. Data does not show an increase in abortion complications following the introduction of home use of mifepristone and misoprostol for early medical abortion.

Given current pressures on the sector, the Government has provided an extended period for services to plan for the return of face-to-face treatments. We will continue to work with NHS England and NHS Improvement, the Care Quality Commission and abortion providers to ensure a safe and reliable return to face-to-face services.

We are developing a new Sexual and Reproductive Health Strategy which will set out plans to improve reproductive health outcomes and wellbeing. Whilst issues relating to abortion legislation will not be in scope of the Strategy, ensuring the sustainability of accessible and high quality abortion services for women will be a priority.

No specific assessment has been made. Buying pills online outside of the provisions of the Abortion Act 1967 is unlawful and remains subject to criminal sanctions. Under the Abortion Act, women have access to safe, legal and regulated abortion services.

This information is not held centrally.

This information is not collected centrally.

The Royal College of Obstetricians and Gynaecologists (RCOG) has issued clinical guidelines for healthcare professionals on Coronavirus infection and abortion care. The guidance sets out the circumstances where women should be asked to attend a clinic for an ultra-sound scan, however it states that “most women can determine the gestational age of their pregnancy with reasonable accuracy by last menstrual period (LMP) alone”. The RCOG guidance has recently been updated and now includes a decision aid for clinicians to use to help determine if an ultra-sound scan is required.

The National Institute for Health and Care Excellence recommends in their guidance Abortion Care that services should consider providing abortion assessments by phone or video call, as evidence shows that community services and telemedicine appointments improve access to abortion services. Abortion providers will discuss possible complications with the woman in the consultation, and women will be provided with information about possible symptoms, including those which would necessitate urgent review. Copies of these guidance are attached.

It is a legal requirement for two doctors to certify that there are grounds for an abortion before treatment can proceed unless an emergency situation has arisen.

The approval to allow women to take both sets of pills for early medical abortion at home is on a temporary basis only and is limited for two years, or until the COVID-19 pandemic is over. It is not permanent.

The Royal College of Obstetricians and Gynaecologists (RCOG) has issued clinical guidelines for healthcare professionals on Coronavirus infection and abortion care. The guidance sets out the circumstances where women should be asked to attend a clinic for an ultra-sound scan, however it states that “most women can determine the gestational age of their pregnancy with reasonable accuracy by last menstrual period (LMP) alone”. The RCOG guidance has recently been updated and now includes a decision aid for clinicians to use to help determine if an ultra-sound scan is required.

The National Institute for Health and Care Excellence recommends in their guidance Abortion Care that services should consider providing abortion assessments by phone or video call, as evidence shows that community services and telemedicine appointments improve access to abortion services. Abortion providers will discuss possible complications with the woman in the consultation, and women will be provided with information about possible symptoms, including those which would necessitate urgent review. Copies of these guidance are attached.

It is a legal requirement for two doctors to certify that there are grounds for an abortion before treatment can proceed unless an emergency situation has arisen.

The approval to allow women to take both sets of pills for early medical abortion at home is on a temporary basis only and is limited for two years, or until the COVID-19 pandemic is over. It is not permanent.

The Department is carefully monitoring the impact of home use of the administration of abortion medication which has been introduced as a temporary measure during the COVID-19 pandemic. Complications are recorded on the HSA4 abortion notification form sent to the Chief Medical Officer. In addition, there is a statutory requirement for providers to notify the Care Quality Commission (CQC) in cases of serious injury. Providers should be reporting and escalating issues to the CQC, who will follow up directly with the provider as required. Patients presenting in a National Health Service setting unexpectedly, due to complications, should be highlighted to the relevant independent health provider and all cases should be reported on the Strategic Executive Information System. The CQC engages regularly with the Department and NHS England and NHS Improvement on these matters.

The Required Standard Operating Procedures set out in the Department’s Procedures for the Approval of Independent Sector Places for the Termination of Pregnancy require that all providers should have in place a formal risk management system and keep a risk register to identify and minimise any risks to patients and staff.

The Government’s priority is to ensure that women who require abortion services have access to safe, high-quality care. Abortions in England must be performed under the legal framework set by the Abortion Act 1967. We are not currently in a position to recommend that the home be approved as a class of place under Section 1(3)(a) of the Abortion Act in England. However, we are keeping the position under review, including reviewing the available evidence and having regard to the ongoing legal proceedings concerning home use in Scotland.

The evidence shows that the use of misoprostol is safe for women receiving abortion treatment who have no contraindications. Common physical side effects include abdominal pain, diarrhoea, dizziness, headache, nausea, rash and vomiting. Uncommon side effects are abnormal vaginal bleeding, pyrexia (high temperature) and uterine cramping.

We are not aware of any assessment of the psychological impact of passing a fetus at home but in 2011 the World Health Organization published a systematic review, Comparative effectiveness, safety and acceptability of medical abortion at home and in a clinic. On acceptability, studies were examined that looked at satisfaction with the method, the likelihood of choosing the method again and the likelihood of recommending medical abortion to a friend. For medical abortions completed at home the average satisfaction rate was 88.4% and analysis showed no difference in satisfaction rates between women taking misoprostol at home or in clinic. In England, most women undergoing early medical abortion leave the clinic after taking the misoprostol and complete the procedure at home. A copy of the review can be viewed online at:

http://www.who.int/bulletin/volumes/89/5/10-084046/en/

Information on the net ingredient cost of mifepristone (RU486) used in National Health Service secondary care in England is shown in the table. This may include use in private wards in NHS hospitals and excludes use in military or private hospitals. Mifepristone is not used in primary care.

Source: Hospital Pharmacy Audit Index (HPAI) provided by IMS Health