Should COVID-specific arrangements for abortion continue? The views of women experiencing abortion in Britain during the pandemic
Abstract
Background
During the COVID-19 pandemic, the British governments issued temporary approvals enabling the use of both pills for medical abortion at home. This permitted the introduction of a fully telemedical model of abortion care with consultations taking place via phone or video call and medications delivered to women’s homes. The approvals in England and Wales will expire at the end of March 2022, while that in Scotland remains under consultation.
Methods
We interviewed 30 women who had undergone an abortion in England, Scotland or Wales between August and December 2021. We explored their views on the changes in abortion service configuration during the pandemic and whether abortion via telemedicine and use of abortion medications at home should continue.
Results
Support for continuation of the permission to use mifepristone and misoprostol at home was overwhelmingly positive. Reasons cited included convenience, comfort, reduced stigma, privacy, and respect for autonomy. A telemedical model was also highly regarded for similar reasons but for some its necessity was linked to safety measures during the pandemic and an option to have an in-person interaction with a health professional at some point in the care pathway was endorsed.
Conclusions
The approval to use abortion pills at home via telemedicine are supported by women having abortions in Great Britain. The respective governments in England, Scotland, and Wales, should be responsive to the patient voice and move to make permanent these important advances in abortion care.
What is already known on this topic
During the COVID-pandemic, specific permission to use both pills for medical abortion at home was granted in England, Scotland and Wales leading to the widespread implementation of a telemedical model with direct-to-patient delivery of medications. The safety, effectiveness, and acceptability of this model of care had been well-documented prior to and during the pandemic.
What this study adds
This study adds the voices of women undergoing abortion during the pandemic regarding the specific changes that led to the transformation of medical abortion care in Britain. Amongst 30 women interviewed, there was endorsement for the continuation of permissions to use medical abortion pills at home via telemedicine.
How this study might affect research, practice, or policy
The UK government’s vision of health provision puts patients and the public first, where “no decision about me, without me” is the norm. Our findings support law and policy makers in applying this principle to recent developments in abortion care by making the permissions permanent.
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