Calls for at-home abortion treatments to continue after government consultation

Deciding whether or not to continue a pregnancy is stressful at the best of times

The government has consulted into continuing the Pills by Post treatment for terminations, which was introduced in the pandemic. - Credit: BPAS/GETTY

The pandemic changed every area of society, including options for women seeking an abortion. Abigail Nicholson looks at what impact it had in Norfolk.

Deciding whether or not to continue a pregnancy is an already difficult decision, but the isolation and practicalities of the pandemic added an extra weight.

In some countries, hospitals stopped abortions as their health systems battled the pandemic, but England went in the opposite direction, instead enabling 'Pills by Post', or telemedical abortions.

On March 30, 2020, with the UK in a national lockdown and abortion services at risk of collapse, the Department of Health and Social Care (DoH) published a new policy allowing women to take prescribed abortion medication at home after a phone or video consultation with a doctor.

It gave doctors and charities such as the British Pregnancy Advisory Service (BPAS) the power to keep delivering its services.

Women have been unable to access face-to-face appointments at GPs or sexual health clinics during lo

Women have been unable to access face-to-face appointments at GPs or sexual health clinics during lockdown, resulting in a limited range of contraceptive care being available to them. Picture: BPAS - Credit: Archant

But with the government now considering whether to revoke the service, and set to publish a response to a consultation later this year, it has sparked a debate over whether it should stay.

BPAS says scrapping it would increase waiting times and mean women would be forced to have abortions at later gestations.

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Sue, who works as the treatment unit manager in the Norwich clinic and has chosen not to give her surname, started working for the charity in May 2017 after training as a nurse and working for the NHS since 1978.

She said: "Safety for women is paramount to the service we provide, and evidence shows that this is an effective and safe service that for many women will be preferable to having to attend in-clinic appointments.

"The service is more accessible to clients who previously may have struggled with childcare or transport. Norfolk covers a large geographical area, so for most women this has been a success."

In its first three months, 16,910 women had telemedical abortions nationwide, and in Norfolk 79pc of the 562 abortions carried out in that time period were done via the method, according to BPAS.

Figures from the first three months of Pills by Post in Norfolk

Figures from the first three months of Pills by Post in Norfolk - Credit: Archant

In Norfolk, the pandemic meant that the King's Lynn and Thetford BPAS clinics were closed, meaning some women would have needed to travel further to visit a centre in person.

The government has closed a consultation into its future use, with bodies including the Royal College of Obstetricians and Gynaecologists urging it to make the service permanent.

The DoH said: "Safe and continued access to key services has been and remains our priority during this unprecedented period. The current temporary measures allow eligible women to take both pills for early medical abortion up to 10 weeks’ gestation at home, following a telephone or e-consultation with a clinician.

“The government’s consultation on whether to make the current measure permanent has now closed. We will carefully consider all of the responses received, and plan to publish the government’s response later this year.”

Sue said: "Telemedicine should be made permanent, and at the same time we will work to ensure that any woman who needs an in-person appointment can access care locally.

"The pandemic has seen the whole country go through a huge transition, so all the changes are fairly new for everyone, not just BPAS.

"Like anything new, it is constantly under review and the service will adapt and change to suit the needs of the clients and the environment we find ourselves in."

Less women under 30 are having babies which is good news, says Rachel Moore, for it means they are n

Less women under 30 are having babies which is good news, says Rachel Moore, for it means they are not being defined as only having one purpose in life - Credit: Getty Images/iStockphoto

Beth*, 27, discovered she was pregnant in April 2020, when coronavirus deaths in the UK topped 1,000 in one day for the first time.

"It was the last thing I needed," she said. "I had just broken up with my long-term partner and was trying to juggle homeschooling my boy, work and sorting through a divorce.

"I was so scared, and the pandemic just made me terrified. Where would I get help? Could I get help? I had no idea."

For Beth, the pills arrived a couple of days after her consultation. It meant she could take time off work and sort childcare for her son.

Woman holding hanky during online consultation with doctor. Photo: Getty Images

Woman holding hanky during online consultation with doctor. Photo: Getty Images - Credit: Getty Images/iStockphoto

Data from the DoH shows 3,956 women in Norfolk and Suffolk had abortions in 2019, up slightly from 3,869 in 2018.

Women aged between 25 and 29 had more abortions than any other age group, with the numbers counting for almost 1,000. This is a change from the year previously when women aged between 20 and 24 had the most abortions.

*Name changed upon request

Working in the Norwich BPAS clinic during Covid

The pandemic didn't just change how women sought help, but also how staff went about their day-to-day jobs.

Kathy, lead midwife at the Norwich clinic on the grounds of Norwich Community Hospital, said some days were "overwhelming" but said colleagues stuck together.

She said: "We continued to work from clinic throughout, however, with the introduction of early medical abortion Pills by Post, we see fewer clients within the clinical setting... It has been challenging as the amount of face to face clinical hours has been reduced and the majority of staff now have a significant proportion of their work time working from home."

Consulting with women over the phone or via video call brought new hurdles.

"Some clients, not all, are not always fully engaged when completing a phone call and have to be asked numerous times to stop washing up, driving, watching TV etc," Kathy said.

"It is difficult to fully engage at times as staff are unable to pick up on body language but if staff have any concerns regarding a client then a face-to-face appointment can be arranged."

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