I would like to respond to the concerns of Mr Esen1 as follows:

1. Mr Esen expresses concern that administering mifepristone on the same day as a hospital assessment may result in women being given mifepristone when they are not certain of their decision and thus consequent distress. However, women that received mifepristone in our study (and continue to do so) are those who are ‘certain’ of their decision, as indicated in our inclusion criteria.2

   The two papers that Mr Esen alludes to actually show that a minority of women were ambivalent, that is, not certain of their decision.3 4 This is consistent with previous research from our abortion service using validated questionnaires that demonstrated that in the majority of cases (70%), the pregnancy was …