There are calls for at-home early abortion care to be made permanent - is the process safe?
Some health organisations have called for the arrangements that have been made for early medical abortions at home during the Covid-19 outbreak to be made permanent.
At the start of the pandemic, temporary legislation was implemented which allowed women to more easily access medical terminations at home.
After what researchers have called the largest ever study of UK abortion care was undertaken, a number of health organisations have said that there is now evidence that telemedicine (remote care) is safe and effective - and that the Government should make it a permanent option.
‘80% preferred the telemedicine method’
Before the pandemic swept across the UK, people seeking abortions were required to attend an in-person appointment to get an ultrasound scan, and take medication within the clinic.
Alternatively, using the telemedicine approach, consultations were carried out via telephone or video calls, and medication could be administered at home, with an ultrasound scan only required if needed.
Eighty per cent of women said that telemedicine was their preferred method, and they would choose it in the future, according to a study undertaken by researchers from the University of Texas at Austin, the British Pregnancy Advisory Service (BPAS), MSI Reproductive Choices and National Unplanned Pregnancy Advisory Service (NUPAS).
Lead author Dr Abigail Aiken, associate professor of public affairs at the University of Texas, said the evidence “strongly supports adoption of this patient-centred model as standard of care for early medical abortion”.
Aiken added: “She added: “We found that 98.8% of women were able to end their pregnancies without any further intervention and less than 0.05% experienced a serious complication.
“The outcomes for the traditional in-person model were almost exactly the same.”
‘Valued, private and more accessible’
A study, published by the British Medical Journal Sexual and Reproductive Health journal, found that patients reported “high confidence in telemedicine early medical abortion, and high satisfaction with the convenience, privacy and ease of managing their abortion at home”.
In the conclusion of the study, it states that the at home option is a “valued, private, convenient and more accessible option that is highly acceptable for patients seeking an abortion”, especially for those who might find in-clinic visit logistically or emotionally challenging.
“Evidence that this pathway would be a first choice again in future for most patients supports the case to make telemedicine early medical abortion permanent,” the study says.
‘No medical reason not to make these arrangements permanent’
Waiting times between the consultation and the actual treatment were reduced, from 10.7 days to 6.5 days, according to the researchers, and that patients received care much earlier in their pregnancy.
No cases of significant infection requiring hospital admission or major surgery were reported, and no deaths had occurred from people being able to access early medical abortions at home.
Researchers added that all of the participants were able to successfully attend the consult in private using teleconsultation.
The Royal College of Obstetricians and Gynaecologists (RCOG), which also urged the Government to change the law early on in the pandemic, said that the study supports making these arrangements permanent.
Professor Dame Lesley Regan, chair of the RCOG’s abortion task force, said: “This study proves there is no medical reason not to make the current telemedicine service permanent.”
Regan branded arguments that “changing abortion laws makes it easier to get an abortion and will lead to more women choosing to have one” as “invalid.”
She said: “Everyday, scores of desperate pregnant women put themselves in extreme danger by undergoing illegal and unsafe abortion.
“Reducing access to abortion doesn’t make it any less common, but it does make it less safe.”
‘Clear benefits to the health and well being of patients’
Dr Patricia Lohr, medical director at BPAS, said that access to abortion had actually improved during a time when other healthcare services had to be suspended, or had seen delays.
Lohr said: “At a time when the NHS is under severe strain, the ability to provide a better service that women prefer at a lower cost is rare.
“It would make no sense for the Government to remove a service model that has clear benefits to the health and well being of patients.”
‘A lifeline for vulnerable women and girls’
Dr Jonathan Lord, medical director for MSI Reproductive Choices UK, said that the organisation had seen “a major uplift in safeguarding disclosures” including from survivors of domestic and sexual violence.
Lord said: “Crucially, telemedicine has provided a lifeline for vulnerable women and girls who cannot attend consultations in person during the pandemic.”
Dr Nabanita Ghosh, medical director at NUPAS, said: “We call upon the UK government to realise that if we do not implement this new way forth in abortion care, after the raging tides of Covid-19 have finally subsided, our patients will unfortunately return to potentially reduced access to abortion care for years to come.
“We cannot afford to look back anymore.”