Ending access to at-home abortions puts women in danger

During the pandemic, the government approved the use of abortion pills at home. Lottie discusses how this decision may have changed the outlook for pregnant victims of domestic violence and abuse.

On Tuesday 15 November 2022, a leaked email revealed the government’s plans to tighten access to home abortions, putting vulnerable women in the UK at risk. 

Emergency coronavirus legislation allowed women to take abortion pills at home after early medical abortions were proven to be of no higher risk than those carried out in a hospital. Since then, patients could have telephone or video-call consultations rather than face-to-face appointments, and could undergo their abortion at home. This policy alleviated the stress of unwanted pregnancies, particularly for women suffering abuse. In a place of their choosing, those clients were able to have a safe abortion without having to inform their abuser. Experts praised the decision for making the abortion more accessible and safe for women in unsafe home situations. Despite this, it appears that the introduction of telemedicine services and the apparent improvement in womens’ reproductive healthcare as a consequence, may be short-lived. 

If access to at-home abortions is limited further, vulnerable people seeking abortions would either be forced to return home to an unsafe environment or travel twice to a clinic and risk starting to bleed before they get home, according to an expert that spoke to The Independent. While abortions are incredibly safe, the process involves very heavy cramping and bleeding usually lasting a week or two. Because of this, it’s safe to say that it is difficult, and sometimes impossible, to hide. For the last two years, women stuck in abusive relationships or young girls with unsupportive families at home have been able to take the pills wherever they feel most safe and comfortable, such as a friend’s house or a hotel. 

Living Without Abuse reports that 1 in 4 women will be in an abusive relationship at some point in their lives. British Pregnancy Advice Service reports that 1 in 3 women will have an abortion. The option to have abortion pills delivered to a safe location gives women with abusive domestic circumstances the ability to protect themselves. 

The telemedicine services that were adopted during the pandemic also exposed several issues with the previously existing system. Women in the first trimester of pregnancy often experience nausea, vomiting and fatigue, and being able to attend appointments from wherever they were most comfortable over phone or video call was a significant benefit. Dr Jonathan Lord, Medical Director for MSI UK, also claimed that the organisation has “seen a 77% increase in the number of safeguarding cases identified,” since the introduction of telemedicine. This means more protection for vulnerable women and girls who can now access help in private without the need to inform their partner or family members. Furthermore, the MSI website says that since April 2020, 46% of clients were able to have a consultation with a clinician within just one-day, compared to just 9% before, as clients who might be too afraid to attend an in-person appointment are much more likely to be honest with a clinician over the phone.

The first trimester of pregnancy is defined as from the first missed period to 12 weeks, and the policy for home abortions included medical abortions, which is an abortion induced by pills, of up to 10 weeks. The risk is already incredibly low for early medical abortions, with any complications being generally non-urgent, but the sooner the abortion is completed, the less the risk of complication. The at-home abortion rules helped to significantly reduce waiting times, so that 56% of women were able to have their abortion before they reached 6 weeks compared with the prior 37%, not only minimising the length of experienced pregnancy symptoms for women, but also minimising the risk of complication even further. 

Over a third of the current cabinet voted against the at-home measures rolled out in 2020 being made permanent. The relaxation of abortion policy was intended as a temporary reaction to a lack of face-to-face appointments during the pandemic, but as the change saw unprecedented success, experts were hoping that the changes would be adopted permanently. Sarah Salked, Associate Clinical Director of MSI UK told The Glasgow Guardian, “At the moment, we can offer alternatives, such as surgical abortion, or taking both sets of pills in a clinic either simultaneously, or over two visits, and our safeguarding leads will support clients to ensure they can access the best option for them. Everyone chooses abortion for different reasons and under different circumstances. It is important that we can offer options that take into account personal circumstances.” 

In light of the recent, and deeply upsetting news that the US Supreme Court had voted to overturn Roe v. Wade, the debate over the at-home abortion pills makes me wonder: why are our world leaders so intent on moving backwards when it comes to reproductive rights? 

All women should have access to abortion regardless of their home life, and the government should be listening to experts on the safest ways to perform this absolutely essential procedure to implement policy accordingly. Limiting access to abortion pills – particularly so soon after the rules were changed for the pandemic – poses a threat to the lives of women that are already in dangerous situations. If at-home abortion pills are once again discontinued, the government will have done a massive disservice to women across the UK.