Remote access to early abortion medicine is a lifeline for women - it must continue post-Covid
Telemedicine has provided accessible, safe and effective abortion care during lockdown and has been a step forward in creating abortion services centred on the needs of women in 2020, writes Diana Johnson MP | PA Images
Throughout the Covid-19 pandemic women up to 10 weeks gestation could access abortion services through telemedicine. The case to retain this change is overwhelming; resulting in shorter waiting times and creating greater capacity.
Since March, Covid-19 has dominated all that we do and resulted in huge changes to the healthcare landscape.
The NHS has re-engineered many services to focus on the priority of combatting this deadly virus and keep other vital services going.
The NHS should be congratulated for adapting and making necessary changes so swiftly and keeping patients safe. I have heard several times of positive changes that would have normally taken years to introduce have been introduced quickly and safely, including the wider use of telemedicine.
One area where there was deep concern about the possible effect of the Covid-19 lockdown was around women’s access to abortion services.
The 1967 Abortion Act still requires the physical presence of a woman at a clinic to comply with the law, otherwise it is a criminal offence with a punishment up to life imprisonment under The Offences Against the Persons Act 1861.
The Abortion Act is now 53 years old and in my view is no longer fit for purpose. Medical practice has moved on and social mores about abortion have changed. Most abortions are now Early Medical Abortions and involve taking tablets rather any surgical procedure.
Prior to Covid-19 the need to attend a clinic could require a woman to take time off work, sometimes travel large distances – particularly if they lived in rural areas. There are also access concerns for women who may have childcare problems and difficult home circumstances – including domestic abuse.
Appointments at clinics can often be lengthy because of the legal requirement, also outdated, for two doctors to authorise an abortion. Moreover, requiring Mifepristone to be taken in the clinic, and then the taking of second pills 24-48 hours later, means that a woman cannot choose when to terminate her pregnancy.
A different approach was needed during lockdown. After some initial confusion from the Government, but with strong clinical voices speaking up, ministers announced that for the period of the Covid-19 pandemic women up to 10 weeks gestation could access abortion services through telemedicine.
However, they made it clear that this was directly as a result of Covid-19 and the 1967 Act would be back in place once the pandemic was over.
As someone who has campaigned to reform outdated abortion laws, this temporary change was welcome. The requirement for physical attendance was based on how abortions were performed in the 1960s – through surgical procedures – and there is no clinical need today for a woman to attend a clinic. The reality of abortion in 2020 is that 82% of abortions are within the first ten weeks of pregnancy and the vast majority Early Medical Abortions induced by the two pills.
For many women in abusive relationships telemedicine could be a lifeline and should now be available permanently for women seeking an abortion
What has happened since March? Early evidence shows that telemedicine has resulted in shorter waiting times and created greater capacity. BPAS who are the largest provider of abortion services have reported that women to whom they provide abortion care are now on average below seven weeks gestation.
Having early access to services is very important. There have been reports of a small number of cases of women outside the 10-week limit. More work needs to be undertaken on this. However, scurrilous claims of women dying by accessing telemedicine are wrong.
During the course of the Domestic Abuse Bill before the Summer Recess, I tabled an amendment to recognise that for many women in abusive relationships telemedicine could be a lifeline and should now be available permanently for women seeking an abortion.
In response these points I was pleased that the Government agreed to a public consultation on whether the new regulations enabling telemedicine for abortion care should remain in place once Covid-19 arrangements expire.
The case to retain this positive change for women accessing abortion services is overwhelming. It is supported by clinicians, regulators and providers.
Telemedicine has provided accessible, safe and effective abortion care during lockdown and has been a step forward in creating abortion services centred on the needs of women in 2020. It would be worrying to revert back to a legal regime that is no longer fit for purpose.
Diana Johnson is the Labour MP for Kingston upon Hull North.
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