New Legal Requirements from 30.08.22 for Early Medical Abortions (EMAs) where Mifepristone and/or Misoprostol is Taken at Home in England and Wales

9 August 2022

The government have published secondary legislation that adds new regulations for early medical abortions (EMAs) where mifepristone and/or misoprostol is taken at home in England and Wales. This will be a legal requirement from 30.8.22. They have also announced changes to the HSA4 notification forms in England and Wales, and they will notify us when those are ready (these won’t be mandatory until 31.3.23) – basically these are to report where each stage of the care was provided (in person, remote, and where mife and miso were taken).     

The doctor who prescribes mifepristone and misoprostol, where either are to be used at home, must sign a declaration stating:    

“I am of the opinion, formed in good faith, that, if the medicine is administered in accordance with my instructions, the pregnancy will not exceed ten weeks at the time when the medicine is administered.”   

The easiest way to do this is to enter this text on the prescription (depending on your system, this can be appended to the directions or free text part of the script – ideally pre-filled within an electronic system for mifepristone, or perhaps as a label or stamp).   

Alternatively you can fill out a “Certificate C” which states the same thing (see below – unhelpfully only supplied as an image) and at: www.legislation.gov.uk/uksi/2022/811/images/uksi_20220811_en_001 

The legislation itself is at: The Abortion (Amendment) Regulations 2022 (legislation.gov.uk). If you have a desire to wade through this, “Schedule One” means HSA1, “Schedule Two” means HSA4.    

This certification needs to be kept in the notes under the same rules as HSA1 (i.e. for three years).    

Jonathan Lord (BSACP Co-Chair)