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Pandemic early abortions access changes to be scrapped by Autumn

early abortion scheme

Several medical organisations have issued strongly-worded objections to a Government decision to scrap temporary pandemic rule changes allowing at-home early medical abortions without being seen in a clinic.

Women requiring a medical abortion before 10-weeks’ gestation had been able for the past two years to take both pills at home through a telemedicine service.

After a lengthy consultation, the Government said it would extend the measures for another six months but after that would return to the pre-pandemic system of having to attend in person.

In a written statement, minister for vaccines and public health Maggie Throup confirmed the temporary approval would end on 29 August 2022.

She said: ‘This temporary measure was put in place at the start of a public health emergency, to address a specific and acute medical need, reducing the risk of transmission of Covid-19 and ensuring continued access to abortion services.’

She added that after careful consideration, the Government’s view had been to return to pre-Covid arrangements.

‘The wellbeing and safety of women requiring access to abortion services has been, and will continue to be, our first and foremost priority,’ she said.

In the consultation responses published last month, a number of concerns had been raised about safety, the Government said.

But medical colleges and other organisations including the British Pregnancy Advisory Service and the BMA issued strongly-worded statements disagreeing with the decision, which would impact the most vulnerable.

They pointed to research from February 2021 showing that the temporary approval for the telemedicine service had provided safe and effective care.

In a statement, the Council of the Academy of Medical Royal Colleges said it supported the permanent implementation of telemedicine for early medical abortion and called on the UK Government to continue provision indefinitely alongside face-to-face appointments.

It said: ‘The telemedicine service, which has been recommended by NICE as best practice in abortion care, has proven to be a safe and effective way of allowing women to have more control and choice in accessing an early medical abortion.

‘Women have also clearly indicated their support for the service to be a permanent option in their healthcare, with research published in the British Medical Journal showing that 89% of women who have used the telemedicine service would choose to have treatment at home again if they needed another abortion.’ 

The service has enabled increased access to abortion services, improved waiting times and a more accessible pathway for those in vulnerable situations including abusive relationships, the Academy added.

The statement added that safeguarding women and girls who are seeking to access an abortion was of ‘paramount importance’ to healthcare providers.

It said: ‘Telemedicine care for [early medical abortion] has been one of the few success stories of the pandemic, where barriers have been removed to allow women to access an essential form of healthcare.

‘Failure to renew this service will lead to longer waiting times for women and added unnecessary pressure on healthcare providers.’

Clare Murphy, chief executive of the British Pregnancy Advisory Service, BPAS, said they and others would continue to reiterate to the Government that removing access to at-home early medical abortion care would be disastrous for women and willfully ignores the vast body of clinical evidence that demonstrates that it is safe and effective.

‘The revocation of telemedical abortion care would force vulnerable women in the most difficult of circumstances, who cannot access in-clinic treatment, to resort to illegal methods again and face criminal sanction as a result,’ she said.

Dr Zoe Greaves, BMA medical ethics committee chair, said the decision to end the option of telemedicine for abortion but the wellbeing and safety of women at risk. 

She said: ‘Telemedicine has improved the clinical safety of abortion services by reducing waiting times and by ensuring that difficulties women experience in accessing services do not delay care.

‘Those most affected by this change will be those who are at greatest risk of harm, including women who are victims of sexual violence or domestic abuse, and the financially vulnerable. It is a decision which puts politics before women’s health.’

In October, a large UK study found that women suffering from hyperemesis in pregnancy are struggling to access treatment, with 52% driven to consider terminating the pregnancy and more than a quarter to consider suicide.

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