Approval for Home Use of Misoprostol in England from 1 January 2019

The British Society of Abortion Care Providers (BSACP) welcomes the approval for home use of misoprostol which will improve the care for over 100,000 women who require an early medical abortion each year. Provision of this service can start as soon as the approval order is signed, which is expected with effect from 1 January 2019 and will be published on the gov.uk website on 27/28 December. Until it is published by the government please note that this is embargoed and should remain confidential to be used for planning purposes within individual services.

It is important to note that the approval permits the use of misoprostol by the woman where she “usually resides”. Whilst it will continue to remain lawful for all women (who fulfil the grounds under the Abortion Act) to administer misoprostol within the boundary of a licensed premises (e.g. hospital or clinic) prior to her then returning home to expel the pregnancy, there are almost no scenarios other than patient choice where this would be clinically preferable to her taking misoprostol at home. New guidelines are available on the BSACP (RCOG – BSACP – FSRH early medical abortion at home guideline) and RCOG websites.

The law requires health professionals to act “in good faith” but they are not expected to have legal knowledge as to what may constitute “usually resides”, nor to have any need to confirm the woman’s residential status or to police its use. They simply need to act in good faith based on what they know of the woman’s history and circumstances. The government have pledged to hold a consultation once the outcome of the appeal in Scotland is known to review whether the approval could be modified to further improve the care for women.

Jonathan Lord and Jo Fletcher (BSACP Co-Chairs)