What IS the truth about abortions by post? They got rushed approval for lockdown, but from the woman who used one at 28 weeks to the mother who is horrified she's STILL pregnant, troubling stories are emerging

  • Emergency pandemic legislation says woman can get abortion pills by post
  • Courtney Barnes, 27, was posted the necessary kit to terminate her pregnancy
  • This was after her telephone consultation with abortion clinic Marie Stopes UK
  • Many worry about psychological issues of getting an abortion without support 
  • Here’s how to help people impacted by Covid-19

The package landed on Courtney Barnes's mat on May 1. Inside, were two packets of pills, a strip of the painkiller codeine, a pregnancy test and an instruction leaflet — the basic kit for a so-called 'DIY' abortion.

Under emergency legislation quietly passed in March in response to the pandemic, women are no longer required to attend a clinic before undergoing a termination, but can instead seek treatment over the phone, and then have the necessary medication sent to them to take at home.

The measures — put in place so women don't have to visit a hospital or clinic — will last two years or until the coronavirus pandemic ends.

Courtney Barnes, 27, (pictured) from Kent, was sent the kit necessary to terminate her pregnancy with no medical supervision at all on May 1 as emergency coronavirus pandemic no longer requires woman to attend a clinic prior to a termination

Courtney Barnes, 27, (pictured) from Kent, was sent the kit necessary to terminate her pregnancy with no medical supervision at all on May 1 as emergency coronavirus pandemic no longer requires woman to attend a clinic prior to a termination

A woman must still give a nurse or midwife her reasons for wanting an abortion. Once agreed, it must be signed off by two doctors. 

So, after her telephone consultation with abortion clinic Marie Stopes UK, Courtney, 27, was sent the kit necessary to terminate her pregnancy with no medical supervision at all.

She and her 29-year-old partner, Jamie, a crematorium operative, have three young daughters aged five, three and one, and Courtney was shocked to discover she was pregnant, despite being on the Pill.

She says she and Jamie agreed they simply could not afford a fourth child. 

She had worked out the dates and says she was certain she was seven weeks' pregnant.

Courtney, a full-time mum who lives in Kent, took the first pill, Mifepristone, which blocks the hormone progesterone

Courtney, a full-time mum who lives in Kent, took the first pill, Mifepristone, which blocks the hormone progesterone

Courtney, a full-time mum who lives in Kent, took the first pill, Mifepristone, which blocks the hormone progesterone, causing the lining of the uterus to break down and the pregnancy to cease to be sustainable, on the day she received the pills.

The next evening, she took the second set of pills, Misoprostol, which causes the uterus to contract and expel the pregnancy.

'I'd been warned it would be painful, so I did it after I'd put the children to bed,' she says.

Four pills are taken, followed by another two a few hours later. 'It kicked in straight away and was all over and done with within a few hours,' she says. 'It was quite painful — really strong cramping.

'You do pass a lot of blood and I was warned I might see the foetus, so I sat on the toilet and didn't look.

'I ended up lying in the bath trying to keep the pains at bay and I didn't get much sleep that night. It was a lot worse than I'd expected. The pain, the physical process was horrible.

'Although I didn't want to continue the pregnancy, I hated the thought of just flushing it away. Once it was all over with, however, I felt it was the right decision.'

There was no routine follow-up call with a doctor or nurse to check how things had gone, just a text a couple of weeks later reminding her to use her pregnancy test.

And that, unfortunately, has led to a terrible new problem.

Three weeks after taking the pills, in accordance with the instructions on the leaflet, Courtney took a pregnancy test and was alarmed when it showed up positive.

She reassured herself the result was simply a result of 'pregnancy hormones knocking around'. 

Women can seek treatment over the phone, and then have the necessary medication sent to them to take at home under the new legislation, which was quietly passed in March (file image)

Women can seek treatment over the phone, and then have the necessary medication sent to them to take at home under the new legislation, which was quietly passed in March (file image)

But after a second pregnancy test last weekend was also positive, she began to feel rising panic.

'I got in touch with Marie Stopes and I'm booked in for an ultrasound next week,' she says.

'I was warned the pregnancy could continue, but I hadn't considered that as a possibility, and because of the pain and blood, I'd felt that the procedure had been successful.

'I'm feeling very anxious and just want to know what's going on.'

It's not a position any woman would want to be in. Is Courtney still pregnant and, if so, what effect has the procedure had on the foetus?

These are distressing questions. Courtney says if she is still pregnant, she will have a surgical termination.

A woman must still give a nurse or midwife her reasons for wanting an abortion in a telephone consultation. Once agreed, it must be signed off by two doctors (file image)

A woman must still give a nurse or midwife her reasons for wanting an abortion in a telephone consultation. Once agreed, it must be signed off by two doctors (file image)

Her DIY abortion, euphemistically termed 'pills by post' by the British Pregnancy Advisory Service (BPAS), is not the only one to have turned into a nightmare.

According to the BPAS, three in 100 pregnancies of up to nine weeks' gestation require a follow-up surgical abortion after the 'pills by post' method; this rises to seven in 100 for gestation of nine to ten weeks.

This latest relaxation of abortion regulations has caused profound disquiet among pro-life organisations.

In previous years, women have had to undergo so-called early medical abortion at an approved clinic.

In 2018, however, the first step towards full DIY abortion was taken when Matt Hancock, the Health Secretary, passed legislation enabling women to take the second pill, Misoprostol, at home, although they would still be required to undergo assessment at a clinic first and would have to take the first pill, Mifepristone, under medical supervision.

Health experts and abortion providers had argued that the second pill was safe to take at home and would avoid the possibility of the trauma of women starting to bleed on their way home from the clinic.

Then, at the start of the Covid-19 crisis, concerns were raised by abortion providers that women travelling to clinics for terminations risked contracting Covid-19 and that clinics were operating at reduced capacity.

The new regulations permitting DIY abortion were initially published on the Government's website on March 23, but were pulled hours later, with an explanation that they had been 'published in error'.

The measures, put in place so women don't have to visit a clinic in case it put them at risk of contracting coronavirus, will last two years or until the pandemic ends (file image)

The measures, put in place so women don't have to visit a clinic in case it put them at risk of contracting coronavirus, will last two years or until the pandemic ends (file image)

Apparently, officials believed Matt Hancock had approved them, but he hadn't. The following day, Mr Hancock told the House of Commons there would be no change to abortion procedures. 

Over that weekend, however, abortion providers and lobbyists challenged the Government for withdrawing its original decision, culminating in an open letter to Mr Hancock.

It requested the immediate introduction of 'telemedical abortion services to reduce coronavirus transmission' and was signed by 50 eminent medical experts. 

They wrote: 'Vulnerable women are already turning . . . for help from online providers, breaking the law and foregoing the inbuilt safeguarding and support provided by regulated services.'

On March 30, the Government officially approved 'pills by post' abortions in England; Scotland and Wales have approved similar new rules.

BPAS says it has issued more than 8,000 postal kits since the new rules were introduced, while according to the latest Department of Health & Social Care statistics, in 2018 there were 205,295 terminations carried out in England and Wales. A box of mifepristone tablets is pictured above

BPAS says it has issued more than 8,000 postal kits since the new rules were introduced, while according to the latest Department of Health & Social Care statistics, in 2018 there were 205,295 terminations carried out in England and Wales. A box of mifepristone tablets is pictured above

The move was welcomed by the British Pregnancy Advisory Service, Marie Stopes UK and the Royal College of Obstetricians & Gynaecologists. 

But pro-life groups persisted through the courts, seeking a Judicial Review to challenge the Government's decision.

On Tuesday of last week, pro-Life campaign group Christian Concern lost its claim at the High Court against the Department of Health & Social Care. 

Its lawyers had argued the decision-making process was unlawful, made without proper parliamentary scrutiny and unsafe for pregnant women.

They also said the Government had failed to take into account physical and psychological risks for women, the risk of women being co-erced into an abortion, the risk of a woman taking abortion drugs prescribed for another person or taking them outside the ten-week gestational limit.

On March 30, the Government officially approved 'pills by post' abortions in England. Scotland and Wales have also approved similar new rules amid the coronavirus pandemic (file image)

On March 30, the Government officially approved 'pills by post' abortions in England. Scotland and Wales have also approved similar new rules amid the coronavirus pandemic (file image)

Tragically, that has happened.

This week, it was reported that a woman has taken advantage of the lax new rules to terminate a pregnancy at 28 weeks — four weeks past the legal limit and 18 weeks past the ten-week limit for at home abortions. (After ten weeks, a surgical procedure is usually recommended).

After taking the pills, the woman's child was stillborn. Babies born at 28 weeks typically have a 90 per cent chance of survival.

BPAS confirmed it is investigating the case, along with eight others in which women have taken abortion pills after the ten-week limit. 

The organisation seems to be putting it down to collateral damage.

'The swift establishment of an early medical abortion service at the start of this crisis has been a phenomenal achievement in women's healthcare, enabling women to safely access the care they need at home', says Clare Murphy, Director of External Affairs at BPAS.

'We are aware of a vanishingly small number of pregnancies which were treated beyond the ten-week gestational band, with one over 24 weeks.

'While we are investigating all nine cases, it is clear this framework provides huge health benefits to women, with minimal associated risks.'

It is certainly true that 'pills by post' abortions remain only a small percentage, set against the number carried out in a normal year.

According to the BPAS, three in 100 pregnancies of up to nine weeks' gestation require a follow-up surgical abortion after the 'pills by post' method. This rises to seven in 100 for gestation of nine to ten weeks (file image)

According to the BPAS, three in 100 pregnancies of up to nine weeks' gestation require a follow-up surgical abortion after the 'pills by post' method. This rises to seven in 100 for gestation of nine to ten weeks (file image)

BPAS says it has issued more than 8,000 postal kits since the new rules were introduced, while according to the latest Department of Health & Social Care statistics, in 2018 there were 205,295 terminations carried out in England and Wales. 

For the majority, it remains a safe way to seek help in desperate times.

As the Royal College of Obstetricians & Gynaecologists says: 'Expert consensus is that it is safer, more effective and better tolerated for women to administer the drugs in the privacy of their own residence — this avoids the risk of distressing bleeding and pain on the journey home'.

Jonathan Lord, Medical Director for Marie Stopes UK, adds: 'Telemedicine is recommended as best practice to improve access for women, especially those in vulnerable groups or who may face coercion from abusive partners to continue an unwanted pregnancy.'

But that doesn't mean it is without risks, or that medical supervision would not be preferable. 

Another woman the Mail has spoken to says she went through 'hell' after taking the pills prescribed at a clinic, but subsequently sent to her to take at home. She says they left her in such pain she was convinced she was going to die.

The 39-year-old, who has three children from a previous relationship, has been with her current partner for three years. She says he is 'very controlling' and she cannot see a future with him. 

She spoke to us on condition of anonymity because he does not know she has had a termination.

Like Courtney Barnes, she was on a progestogen-only 'mini Pill' — and was shocked to discover she was pregnant.

'I don't know if I'm going to stay with my partner, and the bottom line is I can't afford it,' she says. 

'I'm self-employed and I've had no work since the pandemic started. Abortion was my only option.' 

BPAS says it has issued more than 8,000 postal kits since the new rules were introduced, while official statistics state that in 2018, 205,295 terminations were carried out in England and Wales (file image)

BPAS says it has issued more than 8,000 postal kits since the new rules were introduced, while official statistics state that in 2018, 205,295 terminations were carried out in England and Wales (file image)

Since she had no idea how many weeks pregnant she was, her GP put her in touch with a private clinic with NHS funding for an ultrasound scan, which established she was seven weeks pregnant.

The woman says she was surprised by just how relaxed the abortion process was.

'I was asked on the phone before I went to the clinic what my reasons were for having a termination, but that was it,' she says.

'At the clinic, they offered me the tablets to take away, but I said to send them through the post. I wasn't ready. It all seemed so fast. I was expecting to speak to lots of people, to be offered counselling.

'It didn't feel like a medical procedure. It took me less time to sort out than to do my Asda shopping.'

She took the first Mifepristone tablet on May 9. The next day, she took four Misoprostol tablets.

'I understood I was going to have cramps, but I didn't realise just how bad it was going to be,' she says. 

'Two hours after I took the tablets, I started bleeding. I didn't look because I knew it would really upset me.

'About six hours later the pain was unbearable. I was lying on my bathroom floor, curled in a ball. I was sweating, my temperature was 39.8, I couldn't move.

'I had diarrhoea, I was being sick, I was shivering, shaking, sweating. I thought I was going to die.

'The next day I felt really sick, faint and dizzy. I'm still bleeding even now, a few weeks on. Because my partner is here and doesn't know what I did, I've not been able to ring anyone for any advice.

'I felt ill or four or five days afterwards. My partner thought I had Covid. I dread to think of how many teenage girls have gone through this during the pandemic.'

While the physical effects can be debilitating, others are worried about the long-term psychological consequences of those who seek terminations without proper support or guidance. 

For whatever your view, abortion is a serious moral question that evokes high passions on both sides.

In 2018, Matt Hancock passed legislation enabling women to take the second pill, Misoprostol, at home, but they still had to undergo assessment at a clinic first and take the first pill, Mifepristone, under medical supervision (file image)

In 2018, Matt Hancock passed legislation enabling women to take the second pill, Misoprostol, at home, but they still had to undergo assessment at a clinic first and take the first pill, Mifepristone, under medical supervision (file image)

Lynn Large, a 63-year-old retired midwife who had an abortion when she was 20, has become involved with Christian Concern in spreading the pro-life message. 

She fears for those who may underestimate the emotional turmoil an abortion can leave, even decades later.

'Women are told that abortion is as easy as taking a few pills, but it's much bigger than that, and once you have made that decision, you are never free of it,' she says.

'The thought of women having to go through an abortion alone during this time of lockdown is disturbing and will be, I believe, a huge burden for them to carry throughout their lives.'

Set against that, of course, is the emotional trauma, not to mention the practical implications, that can come from raising a child from an unwanted pregnancy.

And given the practical difficulties of seeking help during the pandemic, many would argue that giving women the option to seek help from home is a sensible temporary measure. But will it just be temporary?

Christian Concern are deeply worried that abortion providers will lobby for the new rules to become permanent. It says it won't give up its fight, and on Tuesday it filed papers to the Court of Appeal.

Following her own 'DIY' abortion, Courtney Barnes, meanwhile, anxiously awaits her appointment next week to find out if she is still pregnant. For her, the whole experience is not yet over.

And that is perhaps the saddest situation of all.