- Government currently refusing to follow advice from scientific and professional bodies to enable telemedicine for early medical abortion so women can be cared for in their own homes to protect their health, reducing the pressure on already buckling services with an upsurge anticipated in unwanted pregnancies
- A quarter (23%) of abortion clinics run by bpas, which cares for 100,000 women per year, were closed on Tuesday due to staff sickness and isolation, with further closures expected across NHS funded services today
- Despite instruction to avoid unnecessary travel by the Prime Minister, in the next 13 weeks as the pandemic reaches its peak, at least 44,000 women will have to leave their homes needlessly to access care, with clinic closures forcing them to travel across the country for care and to mix in cramped NHS waiting rooms where distancing is impossible
- Women with severe health issues who have been told to self-isolate say they are being forced to choose between risking their health by leaving their house and being compelled to continue an unwanted pregnancy that also threatens their health
- Vulnerable women are already turning outside the regulated healthcare system for help from online providers, breaking the law and without the inbuilt safeguarding and support provided by regulated services
- Abortion providers say services are “at risk of collapse” if the Prime Minister does not act swiftly
Healthcare professionals today implored the Prime Minister Boris Johnson to “listen and act on the scientific evidence” and bring forward regulations that will enable all the medications needed for Early Medical Abortion to be used by women in their own homes during the Coronavirus outbreak to protect their own health, that of their families, and the doctors, nurses and midwives who care for them.
Comprehensive regulations to do so were introduced by the Department of Health on Monday, on the advice of healthcare bodies including the Royal College of Obstetricians and Gynaecologists (RCOG), the Faculty of Sexual and Reproductive Healthcare (FSRH) and the Royal College of Midwives (RCM), and then inexplicably retracted the by the Secretary of State for Health and Social care, Matt Hancock, the same evening. Telemedicine for abortion has been recommended by evidence-based bodies such as NICE.
It is estimated that some 44,000 women will need abortion care in the next 13 weeks, meaning tens of thousands of women making a needless journey and exposing themselves and others to infection. As services close around the country due to staff sickness and isolation, women are being forced to travel increasing distances – often on public transport and sometimes with severe health conditions – to seek care and sitting in often cramped NHS waiting rooms where distancing is impossible.
Women whose health conditions are already exacerbated by an unwanted pregnancy and who have been told to self-isolate are asking for urgent help and clarification following the Government U-turn.
“I’m a high risk individual due to my previous medical history and asthma. This has left me in a dire situation and when the temporary measures came about [to enable telemedicine] I definitely saw light at the end of the tunnel. Without provision of measures like this, I will either risk myself to COVID-19 while attempting to make my way to an appointment, have to resort to illegal practices outside of the healthcare system or keep the pregnancy for longer which is harmful both to me and the child as it grows and develops.”
Other women explained how their own child had underlying health conditions and so any journey to a clinic threatened not just their health, but that of their child too.
“My daughter is at risk of life-threatening complications from this virus… We have been advised for some time to practise social distancing to minimise risk, it is unfair to be put in this type of position…Given the severity of the situation and the current health advice there must be some type of provision for accessing the treatment without the need to physically attend the clinic.”
And women already in vulnerable situations are already seeking help outside of the regulated healthcare system, with the online provider Women on Web, an international organisation that provides abortion care on- line to women who live in countries where early medication abortion is not accessible, reporting an increase in Covid-related pleas from the UK for help.
“This way of abortion is the only route I have as I am not allowed out due to the coronavirus…My parents would disown me and kick me out if they were to find out or they may even harm me and I have so much ahead of me. I cannot afford to have a child right now at such a young age with no financial help as the person whom I conceived the child with is no longer in my life. I beg you to please help me this is my only option. Please help me.
Ann Furedi, chief executive of the British Pregnancy Advisory Service, said:
“Boris Johnson has told the nation they must stay indoors where possible while his Government has decided to force tens of thousands of women needlessly from their homes. This is a safe and simple measure recommended by all the professional healthcare bodies representing women’s health to ensure continued access to essential services during the pandemic.
“Services are already buckling and at risk of collapse. Women are not getting the care they need. The Prime Minister needs to listen and act on the scientific evidence. With the entire country shut down, why on earth are we forcing women who could safely be treated at home to travel considerable distances – including women with severe health problems who have been told to self-isolate? It is absurd, it’s reckless and it’s easily fixed.”
Dr Jonathan Lord, co-chair of the Royal College of Obstetricians and Gynaecologists (RCOG) Abortion Taskforce and British Society of Abortion Care Providers (BSACP).
“It seems extraordinary how government advice is, quite rightly, to isolate in order to contain the spread of the virus – unless you are a woman requiring essential health care, in which case the Government will force you to go on a completely unnecessary journey to a crowded clinic or hospital. I simply cannot understand why the Government is behaving in such a cruel and reckless manner towards women’s health. To force women to have to come out of self-isolation, mix with others in waiting rooms - and in many NHS waiting areas, distancing is impossible - and potentially infect others and NHS staff is quite extraordinarily irresponsible. Accessing care remotely by telemedicine is already recommended as best practice by the UK NICE guidelines, and joint guidelines from the RCOG, RCM, FSRH & BSACP confirm that this is safe, effective, recommended by many healthcare systems and is the only reasonable way to run services during the pandemic without endangering both women and NHS staff.
“There are widespread reports across the NHS of women being unable to access services and being denied care, leaving them extremely distressed. Many are turning in desperation to internet providers, which means they will be denied the standards they ought to expect, including an expert assessment of safeguarding.
“I am really concerned that having accepted the advice of clinical experts in issuing the emergency regulations on Monday, and then reversing them with no explanation or reasoning, that the government has moved from acting on science and evidence to reacting to extreme pressure groups who have an anti-woman agenda.”
Dr Kate Guthrie, spokeswoman for Women on Web, said:
“We are being contacted by women who cannot leave their home due to the pandemic, despite taking such medication at home being illegal. They are desperate, and their emails are heartbreaking. We call on the Prime Minister to do the right thing by women in the most desperate of circumstances and approve telemedical abortion services as a matter of urgency.”
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BPAS is a charity which sees almost 100,000 women a year for reproductive healthcare services including pregnancy counselling, abortion care, miscarriage management and contraception, at clinics across the UK. It supports and advocates for reproductive choice. BPAS also runs the Centre for Reproductive Research and Communication, which seeks to develop and deliver a research agenda that furthers women’s access to evidence-based reproductive healthcare, driven by an understanding of women’s perspectives and needs. You can find out more here: https://www.bpas.org/get-involved/centre-for-reproductive-research-communication/