Should COVID-specific arrangements for abortion continue? The views of women experiencing abortion in Britain during the pandemic

Author:

Lohr Patricia AORCID,Lewandowska MariaORCID,Meiksin RebeccaORCID,Salaria Natasha,Cameron SharonORCID,Scott Rachel HORCID,Reiter Jennifer,Palmer Melissa JORCID,French Rebecca SORCID,Wellings KayeORCID

Abstract

BackgroundDuring the COVID-19 pandemic, the British governments issued temporary approvals enabling the use of both medical abortion pills, mifepristone and misoprostol, at home. This permitted the introduction of a fully telemedical model of abortion care with consultations taking place via telephone or video call and medications delivered to women’s homes. The decision was taken by the governments in England and Wales to continue this model of care beyond the original end date of April 2022, while at time of writing the approval in Scotland remains under consultation.MethodsWe interviewed 30 women who had undergone an abortion in England, Scotland or Wales between August and December 2021. We explored their views on the changes in abortion service configuration during the pandemic and whether abortion via telemedicine and use of abortion medications at home should continue.ResultsSupport for continuation of the permission to use mifepristone and misoprostol at home was overwhelmingly positive. Reasons cited included convenience, comfort, reduced stigma, privacy and respect for autonomy. A telemedical model was also highly regarded for similar reasons, but for some its necessity was linked to safety measures during the pandemic, and an option to have an in-person interaction with a health professional at some point in the care pathway was endorsed.ConclusionsThe approval to use abortion pills at home via telemedicine is supported by women having abortions in Britain. The voices of patients are essential to shaping acceptable and appropriate abortion service provision.

Funder

National Institute for Health Research

Publisher

BMJ

Subject

Obstetrics and Gynecology,Reproductive Medicine

Reference24 articles.

1. Department of Health & Social Care (DHSC) . Abortion statistics, England and Wales: 2020, 2021. Available: https://www.gov.uk/government/statistics/abortion-statistics-for-england-and-wales-2020/abortion-statistics-england-and-wales-2020

2. National Institute for Health and Care Excellence (NICE) . Abortion care. NICE guideline [NG140], 2019. Available: https://www.nice.org.uk/guidance/ng140

3. Royal College of Obstetricians & Gynaecologists (RCOG), Faculty of Sexual & Reproductive Healthcare (FSRH) British Society of Abortion Care Providers (BSACP) . Clinical Guidelines for Early Medical Abortion at Home--England. Rationale and Scope, 2019. Available: https://www-temp.rcog.org.uk/media/2bhntouz/early-medical-abortion-at-home-guideline-england.pdf

4. Department of Health & Social Care (DHSC) . The Abortion Act 1967 - Approval of a Class of Places; 2020. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/876740/30032020_The_Abortion_Act_1967_-_Approval_of_a_Class_of_Places.pdf

5. Scottish Government . Abortion: Covid-19: Approval for Mifepristone to be Taken at Home and Other Contingency Measures, 2020. Available: https://www.sehd.scot.nhs.uk/cmo/CMO(2020)09.pdf

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