PRESS RELEASE – FOR IMMEDIATE RELEASE
Government review shows abortion complication rates likely much higher than being reported by abortion providers
A Government review has revealed that abortion complication rates are likely much higher than has been previously reported in the annual abortion statistics, which are based on reporting from abortion providers.
The review, undertaken by the Office for Health Improvement and Disparities (OHID), analysed Hospital Episode Statistics (HES) for England from the years 2017 to 2021. They compared the complication rate derived from this analysis to the currently reported complications rate derived from the Abortion Notification System (ANS) based on data provided by abortion providers, which are reported in the annual abortion statistics.
The review has found:
- The ANS-derived data shows an average complication rate over the 5 years from 2017-2021 of 1.52 per 1,000 abortions (table 1, B9-B13) whereas their analysis of HES data over the same period shows a complication rate of 4.06 (table 1, C9-C13), over 2.6 times higher than the ANS data that is reported in the annual abortion statistics. When their HES data analysis also includes incomplete abortions, the complication rate over the same period is 18.16 (table 1, D9-D13), which is over 11.9 times higher than the ANS-derived complication rate that does not include incomplete abortions.
- The difference in reported complications rate is much higher for women under 20 than for the general population. For women under 20, the HES-derived complication rate is 4.43 times higher than the ANS-derived complication rate (table 2, B9-B10), compared to 2.67 times higher for the general population. When the HES data analysis also includes incomplete abortion, for under 20s the HES-derived complication rate is 17.43 times higher than the ANS-derived complication rate (table 2, B9,B11), compared to 11.95 times for the general population (table 1, D9-D13).
- ANS-derived complication rates by gestation show that the complication rate for medical abortions taking place between 10 to 12 weeks compared to 2 to 9 weeks is 18.33 times higher (table 3, B7,B8). This complication rate increased to 110 times higher for abortions at 13 to 19 weeks (table 3, B7,B9) and 160.33 times higher for abortions at 20 weeks and over (table 3, B7,B10) when compared to medical abortions that occurred at 2 to 9 weeks.
- The data from 10 weeks or more is for medical abortions that took place in a clinical setting, since medical abortion outside of this setting is not legal after 10 weeks. The complication rate for women who perform their own medical abortion outside of a clinical setting at 10 weeks or beyond is likely to be much higher than the rates when women are receiving in-person medical supervision.
- This reinforces the urgent need for the Government to reinstate in-person appointments before all abortions take place to ensure that the gestation of babies can accurately be assessed, given that the abortion provider, the British Pregnancy Advisory Service sent out abortion pills to a woman whose baby, Lily, was at least 32 weeks gestation, and given the fact that this does not appear to be an isolated case. It is likely that these cases would not have happened had the gestation of the babies been accurately identified by ultrasound or a physical examination during an in-person appointment.
- The HES-derived data shows the highest complication rate for the 5-year period occurring in 2021, the year after at-home abortions were introduced. The complication rate for 2021 is 4.4 per 1,000 abortions excluding incomplete abortions (table 1, C13) and 19.3 per 1,000 including incomplete abortions (table 1, D13).
- The most common abortion complications reported in the ANS data for 2021 were haemorrhage (65.8%), sepsis (11.4%) and cervical tear (11.1%) and for the HES data, delayed or excessive haemorrhage (81.4%), Other and unspecified (10.6%), genital tract and pelvic infection (8.0%) and embolism.
The review also identified that abortion providers were not recording complications that happened after discharge or after the form that they were recorded on was sent to the Department of Health and Social Care (DHSC). The OHID noted that there was “no evidence” when the review was undertaken in 2022 that abortion providers were informing the (DHSC) to ensure the data was updated when a woman informed the abortion provider about a complication that occurred after the form had been sent.
The review also noted that complications may be less likely to be recorded for terminations where either both or one of the abortion medications is administered at home, because it is unlikely that the person filling in the HSA4 form will know if the woman experienced a complication following an abortion.
This underreporting is a likely explanation for why there was a reduction in ANS-reported complication rates in 2020, the same year that at-home abortion was introduced. This reduction in reported complication rates was referred to by Diana Johnson MP in a speech to Parliament when MPs were deciding on whether to make at-home abortion available permanently. She said that complications from abortion had reduced since the introduction of at-home abortion, without letting Parliament know that this was likely due to underreporting. In fact, the HES-derived data shows the highest complication rate for the 5 year period occurring in 2021, the year after at-home abortions were introduced. The complication rate for 2021 is 4.4 per 1,000 abortions excluding incomplete abortions (table 1, C13) and 19.3 per 1,000 including incomplete abortions (table 1, D13).
Right To Life UK is calling for the Government, based on this review that demonstrates serious underreporting of abortion complications, to urgently introduce new measures to ensure that abortion complications data is accurately collected and reliably reported on. They are also calling for the reinstatement of in-person appointments before abortions take place to ensure that the gestation of babies can accurately be assessed.
A spokesperson for Right To Life UK, Catherine Robinson, said:
“This Government review reveals that abortion complication rates are likely much higher than has been previously reported in the annual abortion statistics, which are based on reporting from abortion providers”.
“We are calling on the Government to urgently introduce new measures to ensure that abortion complications data is accurately collected and reliably reported on”.
“ANS-derived complication rates by gestation show that the complication rate is 160 times higher for abortions at 20 weeks and over when compared to medical abortions that occurred at 2 to 9 weeks. The data from 10 weeks or more is for medical abortions that took place in a clinical setting, since medical abortion outside of this setting is not legal after 10 weeks. The complication rate for women who perform their own medical abortion outside of a clinical setting at 10 weeks or beyond is likely to be much higher than the rates when women are receiving in-person medical supervision”.
“This reinforces the urgent need for the Government to heed calls to reinstate in-person appointments before all abortions take place to ensure that the gestation of babies can accurately be assessed, given that the abortion provider, the British Pregnancy Advisory Service sent out abortion pills to a woman whose baby, Lily, was at least 32 weeks gestation, and given the fact that this does not appear to be an isolated case. It is likely that these cases would not have happened had the gestation of the babies been accurately identified by ultrasound or a physical examination during an in-person appointment”.
ENDS
- For additional quotes and media interviews contact press@righttolife.org.uk or 07774 483 658.
- For further information on Right To Life UK visit www.righttolife.org.uk
- The report and data tables are available here.