The UK’s Department of Health and Social Care has confirmed it will allow women in England temporarily to manage medical abortions at home in light of the lockdown imposed due to the COVID-19 pandemic. Health authorities in Northern Ireland, Scotland, and Wales – and governments across Europe – should swiftly follow suit.
The welcome decision follows outrage and confusion last week after the government announced the change only to reverse it hours later.
Under the new policy women in England can take both medications necessary for medical abortion – mifepristone and misoprostol – at home during the first 10 weeks of pregnancy following a telephone or electronic medical consultation, rather than having to take the first dose at a health facility.
Access to early medical abortion at home lets women end unwanted pregnancies safely and privately, preventing the need for unnecessary surgical procedures. Until now, women in England had to visit clinics to take the mifepristone tablet – nearly impossible during the COVID-19 pandemic given the closure of many clinics and risks of infection. It also runs counter to public health advice on self-isolation.
Rachael Clarke from the British Pregnancy Advisory Service, which has seen a quarter of its clinics close during the outbreak, said women who are vulnerable to COVID-19, or live with someone who is, “have to choose between their own health, or their children’s health, and accessing abortion.”
In Northern Ireland, the situation is especially problematic: new regulations permitting abortion up to 12 weeks will take effect March 31, but women must still visit clinics for the first stage of medical abortion. A reported lack of clinical abortion services could leave women in Northern Ireland without access to the procedure as a result of cross-border travel restrictions due to COVID-19.
In neighbouring Ireland, where abortion was decriminalized in January 2019 but many women still travel to access services, groups have called for availability of at-home medical abortion via telemedicine, in light of the European Union’s COVID-19 travel ban. Ireland’s health secretary said the government is working to revise policy to allow telemedicine consultations for at-home medical abortion.
Expert groups including the Royal College of Obstetricians and Gynaecologists, Royal College of Midwives, and British Pregnancy Advisory Service have called for the shift, saying it is safe and necessary. The UK’s National Institute for Health Care and Excellence and the World Health Organization support at-home management of early abortion where women can access information and medical consultation.
Governments in other European countries, where management of medical abortions at home is currently unavailable, should follow England and ensure early access to abortion as part of the right to comprehensive health care under any circumstances. Women’s health and reproductive rights don’t end during a pandemic.