In 2020, the total number of abortions performed in the UK reached a record high of 210,860. Most of these – 47 per cent– were early abortions, carried out during the pandemic by women in their own homes, using pills posted to them after a teleconsultation with a doctor.
Prior to the pandemic, those seeking an early abortion could be forgiven for feeling that they were being made to jump through hoops.
The approval of not one, but two doctors was needed and no virtual consultations were allowed. With the approval of both doctors in hand, access to the medication to induce the abortion, two pills, could be secured. The first of these two pills had to be physically taken in an abortion clinic, though the second could be taken later at home. Until 2018 in England and Wales, both pills had to be taken in a clinical setting, leading to reports of women experiencing the beginnings of the abortion itself – pain and heavy bleeding – while travelling back home, often in public places or even on public transport.
In March 2020, prompted by the pressure to provide care during pandemic stay-at-home and social-distancing measures, the Department of Health adopted three major reforms to early abortion in one swoop. Both of the pills needed for early abortion were able to be taken in the privacy of the home, rather than forcing women to attend a clinic setting purely so medical staff could watch them take a pill, consultations could be done virtually, and only one doctor needed to give approval.
The record numbers of abortions reported for 2020, most of them early terminations, show that these reforms have worked. In this context, these figures are excellent news. In the challenging circumstances of the pandemic, through quarantines, reduced public transport services, shielding and stay-at-home orders, access to abortion was safeguarded. This is despite the sharp reduction in many routine medical procedures and appointments seen in 2020 as a result of the pandemic, including GP consultations, referrals and blood tests.
The changes made to early abortion in March 2020 are both functional and necessary, whether or not we are in a pandemic. Expert bodies such as the National Institute for Health and Care Excellence and the Royal College of Obstetrics and Gynaecologists were calling for these reforms long before we had even heard of Covid-19, largely for reasons of accessibility. Despite this, the reforms are temporary, introduced on the proviso that they will expire in March 2022, or when the pandemic ends – whichever comes first.
Late last year, the Government held a consultation on whether to keep the changes that would allow women to take both pills at home, but even on this single element of the reforms, there is no clarity. The snail’s pace approach to these practical, expert-approve reforms is symptomatic of a wider failure to take women’s pain and needs seriously in healthcare settings.
High profile women including BBC presenter Naga Munchetty and Health Minister Nadine Dorries MP have spoken out about traumatic experiences of other gynaecological procedures, particularly contraceptive coil fittings. Such stories are unsurprising given it was only in 2018 that we gave women having an early abortion a repreive from the indignity of beginning to bleed on the bus home.
We need to do much better on women’s healthcare. Retaining the abortion reforms is a risk-free, open goal for the government, but it is just a start for ministers who need to stop dragging their feet and enshrine better access to abortions for women across the country.