Women are to be offered faster, easier terminations under government plans to make the 'abortion pill' widely available throughout Britain.
For the first time, family planning centres will be allowed to offer so-called medical abortions, which until now have been available only in hospital wards and special day units.
Ministers believe this will reduce distressing waits of up to five weeks to end a pregnancy. The 'abortion pill', as it is known, avoids the need for surgery. It involves taking two doses of separate drugs which trigger a miscarriage. This is less traumatic, letting women recover quickly. It can be used only in the first nine weeks of pregnancy.
The plans to make it more freely available have infuriated the anti-abortion lobby. 'The more it's available, the less choice a woman has to say, "Hold on, I must think about this",' said Nuala Scarisbrick of the charity Life. 'It is a sort of DIY abortion and I would have thought its effects on a woman psychologically are pretty dire because she is going to have to watch the whole procedure.'
The British Pregnancy Advisory Service (BPAS), the country's biggest provider of abortions, welcomed the move.
'Early medical abortion is safer and there's less risk of complications,' said a spokeswoman. 'Women find it a lot more acceptable and less traumatic.'
Although the technique has been available in Britain for a number of years, up to two-thirds of NHS clinics do not offer, it and many women do not know there is any alternative to surgery, which can be painful and cause far-reaching complications. Medical abortion accounted for only one in 10 terminations in 2000, and BPAS says provision is 'patchy' across the country.
The promise to provide the abortion pill in 'non-traditional settings' was announced in the Government's sexual health strategy implementation plan, published on its website.
One in three British women is likely to have an abortion before she is 45, says the Royal College of Obstetricians and Gynaecologists: in 2000 there were 188,000 of the procedures, with more than one in five conceptions ending in one. The Government says its plans are not likely to increase that number but are aimed at increasing the speed with which terminations are carried out.
Medical abortion works in two stages: first, women are given a tablet of the drug mifepristone (also known as RU486) which blocks a hormone needed to make a fertilised egg cling to the womb lining. After 48 hours, patients are given a dose of a different drug, triggering contractions and bleeding, and causing the foetus to be lost. It is said to be mildly uncomfortable, similar to period pains.
Family planning clinics offer advice and contraceptives but cannot carry out abortions. Anti-abortion campaigners said letting them do so would raise pressure on women to end pregnancies.
The Department of Health yesterday stressed that any changes would be within the current legal framework, which requires two doctors to agree that a woman meets legal criteria for an abortion, and all providers to be licensed.
'Women can wait up to four or five weeks [for an abortion] in some parts of the country. This can have particularly serious implications for pregnant teenagers, who tend to seek professional advice later than older women,' said a spokeswoman.
'Through the Sexual Health Strategy we will attempt to ensure that women who meet the legal requirements are offered a choice of surgical and medical abortions.
'Within the NHS abortions have traditionally been carried out in gynaecology wards and day care units. We intend to run a limited pilot programme to explore whether other settings would be suitable for early abortions.'
The Department of Health is also considering proposals from the BPAS for what have been dubbed 'bedroom abortions', with women allowed to take the second drug at home, and only attending the clinic for the first dose. The BPAS says that would make it more 'convenient and accessible', and more private.
No decision has been taken yet amid fears the idea could contravene legal requirements for doctors to supervise abortions.
The Government has promised that by 2005 women who are legally entitled to an abortion should get it within three weeks of requesting it.