• Official figures suggest that success rates for both medical and surgical abortions are over 99%.
  • Both RCOG and the UK Department of Health say that abortions have a 6-7% risk of complications – but this does not mean the abortion did not work. 
  • Complications do not equate to failure, and instead relate to issues that arise out of the procedure and which may or may not require further treatment.

On 19 October, Pro-Life campaigner Kevin Duffy claimed on social media:

“[The Royal College of Obstetricians and Gynaecologists] wants women to know there’s a 1-in-17 risk that early medical abortion will fail, requiring further medical intervention – see its online patient information.”

Mr Duffy also made the same assertion on the same day in an article published by Christian Concern.

The claim is inaccurate. 

The Royal College of Obstetricians and Gynaecologists’s [RCOG] own advice for people who might be seeking an abortion states:

“All methods of early abortion carry a small risk of failure to end the pregnancy and therefore a need to have another procedure. This is uncommon, occurring in fewer than 1 in 100 women.”

The one-in-17 figure relates to the potential risk of complications during or following an abortion. This can mean a range of things, which may or may not require further treatment.

Complications arising from a procedure do not mean the procedure itself hasn’t worked. Complications should not be conflated with failure.

  • Figures

RCOG provides professional advice to obstetricians and gynaecologists about best practice in their work.

According to evidence-based clinical guidelines from RCOG:

“Women should be informed that surgical and medical methods of abortion carry a small risk of failure to end the pregnancy (less than 1 in 100), necessitating another procedure.”

This comes from a section of the clinical guidance that is titled Failed abortion and continuing pregnancy and cites a variety of evidence in support of this position.

  • Wider commentary

Mr Duffy made this claim in an article published on 19 October by Christian Concern and repeated it in a series of social media posts between 19 and 21 October discussing his article.

A 20 October post claimed:

“Abortion Pills Complications

  • DHSC reports 0.03%
  • RCOG counters with 6%, informing women there is a 1-in-17 chance of failure needing further medical treatment at their local NHS hospital.”

A post on 21 October claimed:

“The Royal College of Obstetricians and Gynaecologists, a leading pro-choice expert in abortion care says

  • Medical abortion fails in 6% of all cases
  • 30 failures per day at home
  • 11,000 per year
  • DHSC reports <50 pa”

Mr Duffy’s 19 October article, published by Christian Concern, claimed:

“Official abortion statistics for England and Wales in 2022, show a complication rate for early medical abortion… of 0.03%…

“The Royal College of Obstetricians and Gynaecologists (RCOG) provides information for those who are considering an abortion. Under the section, ‘What is the risk of the abortion failing?’, it states: “All methods of early abortion carry a small risk of failure to end the pregnancy and therefore a need to have another procedure. This is uncommon, occurring in fewer than 1 in 100 women.”

“In a following section, ‘Are there risks after the abortion?’, RCOG states: “The uterus may not be completely emptied of its contents and further treatment may be needed. This happens in fewer than 6 in 100 women having a medical abortion. An operation may be needed to remove the pregnancy tissue within the uterus.”

“So RCOG, the leading expert organisation on women’s reproductive care, knows that medical abortion treatment can fail to end a pregnancy, sometimes the woman remains pregnant, sometimes she has retained products of conception, and when this happens, she will need another procedure, an operation to complete the abortion. The rate for these complications is stated by RCOG to be about 6%, about 1-in-17.

“On its website, the NHS states: “the main risks of medical abortion are needing another procedure to remove parts of the pregnancy that have stayed in the womb: this happens to about 70 out of 1,000 women.” (7%)

“There is a very significant difference between the complications rate reported in the official statistics, 0.03%, and these rates stated by the RCOG and NHS of about 6%. Applying this rate to the 92,159 at-home abortions in the first six months of 2022, there may have been as many as 5,500 women needing further medical treatment at their local NHS hospital, a far cry from the 28 indicated in the official government statistics.”

What is going on here?

There are two strands to this commentary: the rates of complications and failures in abortion procedures; and possible underreporting of complications.

  • Rates

With one eye on the central claim, it’s important to note that none of this commentary outlines the difference between a procedure leading to complications and the procedure itself failing.

In fact, in both the article and the accompanying tweets, the author conflates these two separate things. We highlighted one example in the central claim – another is here:

“So RCOG, the leading expert organisation on women’s reproductive care, knows that medical abortion treatment can fail to end a pregnancy, sometimes the woman remains pregnant, sometimes she has retained products of conception, and when this happens, she will need another procedure, an operation to complete the abortion. The rate for these complications is stated by RCOG to be about 6%, about 1-in-17.”

Leaving the tone and language used here aside, it is true that both surgical or medical abortions come with a risk that another procedure will be needed “to remove parts of the pregnancy that have stayed in the womb”.

This does not mean that the pregnancy continues (i.e. that the abortion has failed). Instead, it means a further procedure is needed to treat complications arising from the abortion.

  • Underreporting

Mr Duffy claims that:

“There is a very significant difference between the complications rate reported in the official statistics, 0.03%, and these rates stated by the RCOG and NHS of about 6%.”

The official statistics discussed here are the UK Government’s Abortion statistics for England and Wales: January to June 2022.

Those figures state that complications “were reported in 161 out of 123,219 cases” in that period.

This does not equate to 0.03%, instead it is around 0.13%. However, miscalculation aside, there remains a large difference between this data and the rates of complications specified by the NHS and RCOG (which are around 6% or 7%).

On this basis, it is fair to say there is a risk that significant underreporting of complications is a real problem.

However, it is important to note that the government has acknowledged this problem and says it is under review. In fact, its England and Wales abortion statistics for January to June 2022 states:

“Data on complications should be treated with caution. It is not possible to fully verify complications recorded on HSA4 forms and complications that occur after discharge may not always be recorded. This means that for medical terminations where either both or the second stage was administered at home, complications may be less likely to be recorded on the HSA4. The Office for Health Improvement and Disparities (OHID) is currently undertaking a project to review the system of recording abortion complications.”