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Temporary at home abortions must not be made permanent

4 min read

In the maelstrom of spring 2020, as the terrible dawning of the pandemic became apparent, a number of difficult decisions were understandably taken to protect our health services from being overwhelmed.

One of these was to strongly encourage video or telephone medical appointments with doctors over face-to-face consultations. The government announced this principle would apply to women seeking early abortions and temporary measures were approved which allowed women to carry out their own abortions at home, using pills sent by post or collected from a clinic following a remote consultation.

This enabled women, for the first time to terminate an unwanted pregnancy via abortion without being seen in person beforehand. This amounted to the biggest change to abortion law in this country since 1967 - a change that was ushered in with minimal scrutiny and no public consultation due to the circumstances of the pandemic.

To emphasise, it was, an explicitly temporary measure, introduced with the intention of reducing transmission of the virus and freeing up NHS services.

Nearly two years on, and due to the government’s hugely successful vaccine rollout, we are thankfully in a very different position regarding Covid. In February, the government lifted remaining Covid restrictions and ended emergency measures. This rightly included the end of the temporary approval for ‘at-home’ abortions.

Sending abortion pills by post removes any safeguards over who takes them, where or when they are taken

Specifically, the Health Secretary Sajid Javid announced that the temporary arrangements for the provision of early medical abortions would cease at midnight August 29, following a short phasing out period. From this date, pre-pandemic face-to-face consultations arrangements will return. This was - and remains - a sensible and reasonable decision, based on substantial evidence from a thorough and lengthy public consultation.

Sadly though, abortion campaigners and providers have been pushing for some time to make these arrangements permanent. This campaign has culminated in a recent amendment to the Health and Care Bill in the Lords, seeking to overturn the government’s decision.

Putting aside the troublesome fact that the issue had never been debated at any stage of the Bill in the Commons, the Lord’s amendment flies in the face of the concerns raised about the risks to women from these remote appointments.

Responses to the public consultation on at-home abortions highlighted the very real issue of undetected domestic abuse, and that, most concerning for women’s health, “being certified for an abortion without seeing a doctor in person increases risks of potentially life-threatening conditions being missed, pills being prescribed beyond the 10-week limit, more women being coerced into a home abortion against their wishes and pills being obtained fraudulently.”

There are also highly disturbing testimonies of women who have experienced complications following at-home abortions, including being unable to access necessary treatment or follow-up care. Indeed, it appears that medical complications are being underreported. 

Sending abortion pills by post removes any safeguards over who takes them, where they are taken, for example under the watchful eye of an abuser, or when during the pregnancy they are taken – and even whether the woman has given her informed consent.

This is not a criticism of the NHS, or the clinics involved - it is simply a fact that they cannot ensure the pills are taken at home uncoerced by the individual they are provided to, and within the appropriate time frame.

Furthermore, whatever one’s views on the subject, surely an amendment voted on in the Lords in the early hours of the morning, without prior debate and scrutiny, is not the way to deal with such a sensitive matter.

We are, thankfully, passed the worst of the pandemic. The temporary measures introduced for at home abortions must not be made permanent. The Health Secretary has been steadfast in pushing for GPs to see more patients face-to-face, recognising the benefits for this in-person diagnosis. This principle applies to abortions. Women and girls deserve better, and we hope the Commons recognises this when the matter comes before MPs shortly.


Sally-Ann Hart is the Conservative MP for Hastings and Rye.

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