This is such a valueable analysis of what's really happening behind these numbers. The point about pills by post potentially including unused prescriptions is completly absent from mainstream coverage and changes everything. I've noticed younger women in my circle viewing early medical abortion as less risky than daily hormonal contraception. We need to seperate reproductive autonomy from demographic panic.
The deeper issue is cultural: we’ve detached sex from its meaning and purpose and then offer violence or chemicals as the clean-up. Real freedom would rebuild responsibility, commitment, and support for women so that ending a child’s life is never presented as empowerment.
Calling abortion “risk management” reframes a new human life, a girl or a boy as a problem to be eliminated. And many contraceptives are not morally neutral either: they can be abortifacient by preventing implantation, treating the earliest human life as disposable. Freedom isn’t the power to dodge consequences by hurting ourselves and others and calling it "choice". Sex has consequences, and pregnancy isn’t a pathology — it’s a natural human cycle.
I agree there are important cultural questions to confront about committment, and what our societies are valuing. There are core values you are disregarding though, to do with auronomy and privacy which are very real for women and families. The fact is, millions of women now, and for as long as we can know about history, do not see matters the way you do. The demand for effective means to 'risk manage' pregnancy is powerful and old. And women really do make choices, just ones you do not agree with. To me, the greatest harm is to deny that and then continually override it through State power (which I assume you think is legitimate. I do not).
Ellie, I appreciate your willingness to engage. We agree that culture, commitment, and the limits of State power are serious matters.
On numbers, I don’t ground my thinking in popularity. “Millions think so” can’t decide what’s true — and millions of women and families also oppose abortion.
With regards to autonomy and privacy -they cannot be respected by deliberately taking innocent human life. Whatever weight my autonomy carries, it cannot extend to my authorising the destruction of another human being — whose autonomy, privacy, and future are therefore erased.
Do we see autonomy as absolute, or as having moral limits? And if it has limits, how do we weigh the baby’s life — say, for our discussion, a baby girl — against the claim that it’s acceptable to destroy her body for the perceived higher value of her mother's privacy and freedom?
Thank you for an informative and interesting piece. It makes sense that women may order pills by post and keep them unused.
On a tangent....
Is there any analysis of the ease of obtaining such pills with potential abuse and coercion? Such as a father / step-father sexually abusing a teenage daughter and using the pills as a way to avoid pregnancy and hence the abuse coming to light?
I'm just wondering how healthcare practitioners may pick up on signs of abuse or coercion if there isn't any face-to-face interaction and assessment.
Very thought provoking especially the changing expectations of motherhood. My mother, born in the 1940s, was one of seven and says she was a teenager before an adult asked her opinion on anything. Also children of that generation may have been expected to play outside all day. Compare this with today when many parents seem to negotiate with their child's every whim and tolerate misbehaviour like running around in restaurants. Recently my friend was called in by the school in Spain because her daughter of about six didn't have her water bottle, seems crazy that the school didn't consider that they could simply provide water in a beaker.
Thanks. "...taking the leap to embrace an unplanned pregnancy flies in the face of our risk-averse, hyper-planned, all-about-me modern culture" I agree! Particularly when women are less likely to be married, or have a partner who can manage to support her and a baby financially.
I didn’t not see the harmful aspects to a woman’s reproductive system caused by a carcinogen. (Birth control pills known carcinogen by WHO), abortion, breast cancer -especially the first pregnancy termination (100% causal there there is any familial breast cancer), coercive or forced abortions.
An illuminating analysis. I would be interested in Dr Lee's thoughts on why the postal abortion has remained on offer after the end of the pandemic. Is it simply bureaucratic inertia, the ratchet effect, or is there a deliberate policy thrust in play?
Hi. Well before the pandemic, Britain was playing catchup with providing EMA at home because the law presented home use through it’s class of place clause. Home use has been established as safe, effective, acceptable to women well before the pandemic. This changed in law in 2022 with an amendment to the Health and Care Act. So the issue is only about how the woman gets the pills. This on telemedicine (there are other papers looking at it). Women can of course attend a clinic if they prefer, or have a non-medical abortion. The latest figures show a relative increase in the latter on last year. https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.16668
In case of interest, I wrote this with some collegaues; focus not only on EMA, but the problems when women has to attend a clinic were raised by the doctors we interviewed
This is such a valueable analysis of what's really happening behind these numbers. The point about pills by post potentially including unused prescriptions is completly absent from mainstream coverage and changes everything. I've noticed younger women in my circle viewing early medical abortion as less risky than daily hormonal contraception. We need to seperate reproductive autonomy from demographic panic.
This is a very interesting analysis, raising a lot of points which are often overlooked – thank you.
The deeper issue is cultural: we’ve detached sex from its meaning and purpose and then offer violence or chemicals as the clean-up. Real freedom would rebuild responsibility, commitment, and support for women so that ending a child’s life is never presented as empowerment.
Calling abortion “risk management” reframes a new human life, a girl or a boy as a problem to be eliminated. And many contraceptives are not morally neutral either: they can be abortifacient by preventing implantation, treating the earliest human life as disposable. Freedom isn’t the power to dodge consequences by hurting ourselves and others and calling it "choice". Sex has consequences, and pregnancy isn’t a pathology — it’s a natural human cycle.
I agree there are important cultural questions to confront about committment, and what our societies are valuing. There are core values you are disregarding though, to do with auronomy and privacy which are very real for women and families. The fact is, millions of women now, and for as long as we can know about history, do not see matters the way you do. The demand for effective means to 'risk manage' pregnancy is powerful and old. And women really do make choices, just ones you do not agree with. To me, the greatest harm is to deny that and then continually override it through State power (which I assume you think is legitimate. I do not).
Ellie, I appreciate your willingness to engage. We agree that culture, commitment, and the limits of State power are serious matters.
On numbers, I don’t ground my thinking in popularity. “Millions think so” can’t decide what’s true — and millions of women and families also oppose abortion.
With regards to autonomy and privacy -they cannot be respected by deliberately taking innocent human life. Whatever weight my autonomy carries, it cannot extend to my authorising the destruction of another human being — whose autonomy, privacy, and future are therefore erased.
Do we see autonomy as absolute, or as having moral limits? And if it has limits, how do we weigh the baby’s life — say, for our discussion, a baby girl — against the claim that it’s acceptable to destroy her body for the perceived higher value of her mother's privacy and freedom?
Thank you for an informative and interesting piece. It makes sense that women may order pills by post and keep them unused.
On a tangent....
Is there any analysis of the ease of obtaining such pills with potential abuse and coercion? Such as a father / step-father sexually abusing a teenage daughter and using the pills as a way to avoid pregnancy and hence the abuse coming to light?
I'm just wondering how healthcare practitioners may pick up on signs of abuse or coercion if there isn't any face-to-face interaction and assessment.
Very thought provoking especially the changing expectations of motherhood. My mother, born in the 1940s, was one of seven and says she was a teenager before an adult asked her opinion on anything. Also children of that generation may have been expected to play outside all day. Compare this with today when many parents seem to negotiate with their child's every whim and tolerate misbehaviour like running around in restaurants. Recently my friend was called in by the school in Spain because her daughter of about six didn't have her water bottle, seems crazy that the school didn't consider that they could simply provide water in a beaker.
You might find this article interesting: https://www.spiked-online.com/2026/02/02/whats-driving-the-huge-rise-in-abortions/
Thanks. "...taking the leap to embrace an unplanned pregnancy flies in the face of our risk-averse, hyper-planned, all-about-me modern culture" I agree! Particularly when women are less likely to be married, or have a partner who can manage to support her and a baby financially.
I didn’t not see the harmful aspects to a woman’s reproductive system caused by a carcinogen. (Birth control pills known carcinogen by WHO), abortion, breast cancer -especially the first pregnancy termination (100% causal there there is any familial breast cancer), coercive or forced abortions.
Women are the vilest of creatures. Period.
An illuminating analysis. I would be interested in Dr Lee's thoughts on why the postal abortion has remained on offer after the end of the pandemic. Is it simply bureaucratic inertia, the ratchet effect, or is there a deliberate policy thrust in play?
Hi. Well before the pandemic, Britain was playing catchup with providing EMA at home because the law presented home use through it’s class of place clause. Home use has been established as safe, effective, acceptable to women well before the pandemic. This changed in law in 2022 with an amendment to the Health and Care Act. So the issue is only about how the woman gets the pills. This on telemedicine (there are other papers looking at it). Women can of course attend a clinic if they prefer, or have a non-medical abortion. The latest figures show a relative increase in the latter on last year. https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.16668
Thank you very much for that explanation.
In case of interest, I wrote this with some collegaues; focus not only on EMA, but the problems when women has to attend a clinic were raised by the doctors we interviewed
https://www.sciencedirect.com/science/article/pii/S0277953618303666?casa_token=HBD8perGfBkAAAAA:ShmLifk35jy0m9fXjyIVYJG84GKTF4anH3T5W3xYst6cgazekvOv8MmiFjuO2o2a1nw2JPtO