Aborting Bad Data: Medical abortion is quick, easy, and safe

Medical evidence, personnel in reproductive health services, and patients continue to testify to the safety of telemedical early medical abortion (TEMA). As former President of the Faculty of Sexual and Reproductive Healthcare, Dr Asha Kasliwal stated, “The evidence shows that telemedicine is safe, effective, timely, more accessible than the alternative and preferred by most women”. 

However, on Sunday Morning Live (25 February 2024), Madeline Page from Right to Life UK, claimed that 10,000 women had been treated for complications that arose from medical abortions. These 10,000 women were allegedly treated for complications in an 18-month period from 2020 to 2021, after the introduction of TEMA services within England and Wales.  

This data was said to be based on a series of Freedom of Information requests issued to the Care Quality Commission in 2020. However, the 10,000 women do not exist in the data. The 10,000 women are a figment of extrapolation and imagination to fuel an anti-abortion agenda.  

Bad Data and Abortion Narratives 

Infodemics, as defined by the World Health Organisation (WHO), is the intentional dissemination of bad data to confuse and confound the public. Bad information on abortion has “dire consequences” for people that want an abortion. It obstructs a patient from finding accurate information about their healthcare information and misleads policymakers on the efficacy of healthcare procedures.  

Misinformation campaigns by the anti-choice movement attempts to define abortion as an inherently dangerous medical procedure. However, in the UK, childbirth is inherently more unsafe than abortions. Deaths that result from abortion from to 2020 2021 is 0; whereas childbirths that occurred in the UK from 2020-22 had a mortality rate of 13.41 deaths in every 100 000.  

Further, the anti-choice movement has made allegations that abortion complications have increased since the introduction of TEMA. However, there has been an overall decrease of abortion complications since the introduction of TEMA. Complications from abortion did rise in 2021 – but this was after the rate of complications fell in 2020.  

“Prior to 2020, the ANS complication rate remained stable at around 1.6 to 1.7 per 1,000 abortions. In 2020, the ANS complication rate fell to 1.2 per 1,000 abortions before rising slightly to 1.4 in 2021”. 

Extrapolated Data and Abortion Narratives 

Extrapolation of data and a typification of anecdotes as evidence is a common feature of the anti-abortion movement. The data from the anti-choice movement is rife with speculation of conspiracies and censorship on the data about the safety of TEMA. Anti-choice campaigners claim that healthcare professionals are purposely misleading when reporting data. Their analysis assumes women cannot be trusted to provide their own testimony about their reproductive health i.e. they have had an abortion and are pretending it is a miscarriage.   

Claims of hospitalisation from complications that arise from abortion is also a vague characterisation of adverse outcomes. It is purposely alarmist and does not identify causes for hospital visits post-abortion. (I.e. Is it bleeding? Is it a bad headache?)  Anti-choice “analysis” on data on abortion outcomes often includes exaggerated assumptions or misinformation.  

Apparent scientific claims are also casually referenced to misinform and distract from the data on the actual medical efficacy of abortion. Scientific evidence cited by anti-choice campaigners is often non-specific,  for example,  

“members of the Alliance of Pro-Life Students, who had a number of placards at the 2019 March for Life making scientifically focused rights-based claims, including the phrase “Pro-life because the embryology textbook says so”. In this case, neither the sign nor the activist holding it referred to a specific book”.  

Abortions and Complications    

Self-managed abortions via TEMA are safer than self-managed abortions via non-medical or established routes of service.  

Additionally, prior to the introduction of TEMA, people illegally procured abortion pills in the UK. As mentioned in a previous Abortion Rights blog,  

“since the implementation of TEMA, illegal transactions to procure abortion pills online “ha[ve] fallen by 88%” in the UK. The uptake in using legal avenues to procure abortion pills has been attributed to the flexibility and safety provided by remote consultations”.    

Abortions are safe as Dr Sonia Adesara, an NHS doctor and campaigner, has stated: 

“The medication used to terminate a pregnancy is very safe. Serious problems related to the medicine are extremely rare. Like all medications, there can be side effects or risks associated with having a medical abortion – 10% of people will experience nausea, vomiting, diarrhoea, headache, dizziness, fever/chills and 0.2% of people will experience heavy bleeding or infection following an abortion. But medical or surgical abortions are very safe procedures and are significantly safer than childbirth.” 

How to reduce complications?  

Abortions are safer, the earlier they occur. The ease of access to TEMA enables abortions to happen sooner rather than later – for safer abortions. Since the introduction of TEMA, abortions have been occurring earlier. According to the Office of Health Improvement and Disparities, “In 2021, 89% of abortions were performed under 10 weeks, increasing from 88% in 2020 and 78% in 2011”.   

Earlier medical abortions and the ease of access via TEMA means that the risk of complications decrease. “The total complication rate is 0.4 per 1,000 abortions where gestation is 2 to 9 weeks and rises to 23.8 where gestation is 20 and over weeks”.     

Access to TEMA is especially crucial as sexual and reproductive health services throughout the UK are struggling to meet the high demand across the population.  

Appointments for surgical abortions and in-person abortion services are sometimes difficult to obtain. This is because immediate in-person services require being placed on waiting lists, or extensive travel and flexibility from the patient. TEMA is still subject to waiting lists but there is an ability to meet the needs of population faster with telemedical consultations.    

Anti-choice protestors outside clinics can compound the stigma of people seeking urgent and immediate abortion care. Although there was an introduction of buffer zones around abortion clinics in 2023, “campaigners could still be allowed to conduct silent prayers and approach women attending clinics to discuss the issue”. TEMA allows patients to bypass the potential of harassment of anti-choice campaigners.     

As Maya Oppenheim detailed in a personal essay about her abortion, abortion in the UK is sometimes unnecessarily difficult. This difficulty is not because of TEMA but because “this critical aspect of healthcare [abortion is] being neglected by the powers that be”.   

Manna Mostaghim is a PhD Candidate in the Health Policy Department at the LSE. Her PhD thesis is on the provision of publicly subsidised IVF for women with a high BMI in the U.K. 

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