The Department continues to review the release of abortion statistics, to ensure the trustworthiness, quality, and value of these statistics, and also to mitigate the disclosure of sensitive information. Following the 2023 abortion statistics publication, all data is rounded to the nearest five. This aligns with the Code of Practice for Statistics and enables the Department to release more detailed information to the public.

We apply Statistical Disclosure Control with the aim to prevent the release of data that could identify individuals. This is particularly important when counts are low or zero, as small numbers increase the risk of disclosure. As a result of this change, counts of zero can mean no or a small number of procedures in the given field.

From 2020 to 2023, the number of deaths recorded via the HSA4 form for abortions where either one or both abortion medications were administered at home and had been prescribed by the British Pregnancy Advisory Service was zero, rounded to the nearest multiple of five. Please note that this is the number of cases recorded in the statistical datasets used for publication, which are a snapshot of the data at the time it was compiled, and therefore will not include late submissions or changes.

The Department is unable to provide this information as to do so would risk identifying individuals due to the small numbers involved.

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.

In accordance with the Abortion Act 1967, registered medical practitioners must notify the Chief Medical Officer of abortions within 14 days. The Department collects information on abortions via the HSA4 abortion notification form. The form does not record the number of misoprostol tablets prescribed by the abortion provider nor whether they received a telephone consultation, therefore the Department does not hold this information.

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 the 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 misoprostol from 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 misoprostol is used in combination with mifepristone, 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.

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.

Medical abortion is a two-stage process which requires the administration of Mifepristone followed by Misoprostol to successfully complete the procedure. Misoprostol can only prescribed for home use when the woman has requested an early medical abortion and given her informed consent after being assessed by two doctors as meeting the legal grounds for termination of pregnancy as set out in the Abortion Act 1967. The first stage, Mifepristone, must continue to be administered in an National Health Service hospital or an approved independent sector clinic.

Safeguards are in place under the Department’s required standard operating procedures (RSOPs) for independent sector abortion providers to identify women and young girls who may feel coerced or endangered and enable them to raise their concerns in confidence. Guidance produced by the Royal College of Obstetricians and Gynaecologists outlines best clinical practice for medical abortion at home and safeguarding vulnerable women and young girls and is available at the following link:

https://www.rcog.org.uk/globalassets/documents/guidelines/early-medical-abortion-at-home-guideline-england.pdf

Abortion law has been a devolved matter in Northern Ireland since devolution was established in 1999. The Government recognise that this is a sensitive issue and that views are strongly held by both sides. Any reform in Northern Ireland is rightly one for a restored Northern Ireland Assembly and Executive to debate and to discuss and ultimately to decide what policy and laws are right for the people of Northern Ireland.

In response to the specific question posed by the noble Baroness, she will be aware that my right honourable friend the Secretary of State for Northern Ireland is legally prohibited from making such representations under Sections 58 and 59 of the Offences Against the Person Act and the Criminal Justice Act (Northern Ireland).

To ask Her Majesty’s Government what representations they are making to authorities in Northern Ireland to make the use of Misoprostol legal as is already the case in England, Scotland and Wales.

The noble Baroness makes an important point. We in England are making significant progress with regard to Misoprostol, but the reality remains that Northern Ireland has a number of challenges, all of which require a full and sustainable Executive to be in place. The last time that wider questions on abortion were discussed, only a few years ago, the diversity of opinion within the Assembly was significant. It is right and proper that these matters be addressed by the elected representatives of Northern Ireland. That is why my right honourable friend the Secretary of State for Northern Ireland is working tirelessly to bring about a restored Executive.

I thank the noble Lord for that Answer, although it is not surprising and it is completely disappointing, particularly for the women of Northern Ireland. I congratulate the Government on the fact that after Christmas women in England will be able to take the abortion pill Misoprostol at home; I congratulate the Government on taking that decision. Meanwhile, however, in Northern Ireland women are forced online to purchase these pills. They risk prosecution, and indeed have been prosecuted when they have done so. This is a human rights and equalities issue, and that is not a devolved matter. What steps will the UK Government take to end this inequality and the criminalisation of women in Northern Ireland?

I am fully aware of the opinions that are being expressed in Northern Ireland, not just on abortion but on a range of issues. If only we could see such a unity of purpose and opinion across all the parties in Northern Ireland now, it would bring about a restored Executive and we could

see significant progress on this matter made by the right group of individuals—namely, those democratically elected by the people of the Province. That is the ultimate sensible and sure way of bringing about policies that have the endorsement of the wider population.

Is the Minister aware that on Monday Belfast City Council, which has members from seven political parties, voted for the decriminalisation of abortion in Northern Ireland? Notwithstanding his remarks, does he understand that there is a growing desire to see abortion decriminalised in Northern Ireland, and that at the moment there is no way for that political will to be fulfilled?