England temporarily extends at-home medical abortion pandemic policy

Pregnancy Test Credit Flickr Ernesto Andrade  CNA Pregnancy Test. | Flickr/Ernesto Andrade.

Pro-life critics voiced disappointment after England’s health authority gave a six-month extension to a temporary policy that allows women to self-administer both doses of abortion drugs at home, without visiting a medical clinic.

A government consultation found strong criticism of the policy, including concerns that these “do-it-yourself” medication abortions weakened protections for sexually exploited minors or other women who are manipulated or coerced into abortion.

“It is clear from this consultation that there is very strong support from the public for these dangerous measures to be ended immediately, with 70% of respondents stating so,” Catherine Robinson, spokesperson for Right to Life UK, said Feb. 24.

“It is therefore disappointing that the provision has not been ended on its planned end date of March 30, 2022,” Robinson said. “Nevertheless, we do welcome the government’s decision to ensure that women get an in-person appointment before having an abortion and make sure no more women are put at risk by the temporary provision from 30 August 2022.”

Maggie Throup, Minister for Vaccines and Public Health, announced the extension.

“From this point, the pre-Covid regulatory requirements for the provision of early medical abortion will be reinstated,” she said in a statement, according to BBC News.

“After careful consideration, the government’s view is that the provision of early medical abortion should return to pre-Covid arrangements,” Throup continued. She said the government’s “first and foremost priority” is “the wellbeing and safety of women requiring access to abortion services.”

A medical abortion, sometimes called a chemical abortion, is a two-step process that involves the ingestion of mifepristone and misoprostol.

Mifepristone effectively starves the unborn baby by blocking the effects of the progesterone hormone, inducing a miscarriage. Misoprostol is taken up to two days later and induces labor.

The law had already permitted women to take the second drug at home, after taking the first at a medical clinic with a face-to-face consultation with a doctor.

In March 2020, as the Covid-19 pandemic began, the Department for Health announced it would to allow women to complete medication abortions at home in the first 10 weeks of pregnancy. The temporary rules allowed women to access the drugs without first visiting a clinic. A telephone or online consultation was considered sufficient.

This policy was initially presented as lasting for two years or until the end of the coronavirus crisis. Pro-life advocates said that the move represented the biggest change in the U.K.’s abortion law since the practice was legalized in 1967.

A public consultation, held between November 2020 and February 2021, gathered opinions on whether the measure should be made permanent. Some commentators said the danger of domestic abuse was an issue, BBC News reports.

Right to Life UK said there was “overwhelming support” to end the temporary policy, with 70% of consultation respondents backing an immediate end. Only 22% said the policy should be made permanent.

Both Clinical Commissioning Groups, which are groups of general medical practices, and National Health Service trusts said that “the temporary measure had increased presentations to emergency departments and that other general hospital services, such as ambulance services, had been impacted by the temporary measure.” They also emphasized concerns about risk to safeguarding prospective patients, including people with learning disabilities.  

On the matter of women’s safety, respondents cited the danger of “women being coerced into an abortion when they are not physically being seen in a service.”

Among women who had had a “do-it-yourself” abortion, 45% saw benefits for safeguarding and women’s safety in requiring at least one in-person visit with a clinician, while 22% saw disadvantages.

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The consultation outcome reported that safeguarding organizations see “very significant advantages” for at least one clinician assessment for all women under age 18 and for those under 25 who are now or have been under compulsory supervision or in the foster care system.

Safeguarding organizations “also expressed the view that face-to-face clinical assessment reduces the risk from those who sexually exploit children, manipulate the system or force their victims to obtain an abortion. Some individual health professionals reported that safeguarding is improved when patients are seen in person,” the summary said.

Abortion policy is a devolved issue in the U.K., meaning it is governed by separate laws in England, Wales, Scotland, and Northern Ireland. A Scottish government consultation found only 17% of respondents favored continuing the pandemic policy on medication abortion, according to Right to Life UK.

Backers of abortion access, including the British Pregnancy Advisory Service, have advocated for the relaxed policy on medication abortion to be made permanent.

Other supporters include the Royal College of Midwives, the Royal College of Obstetricians and Gynaecologists, and the British Medical Association, who were joined by some women’s groups in a letter to Prime Minister Boris Johnson. They said that ending the temporary rule shows a “deep distrust of women and an institutional disregard for their reproductive rights,” the U.K. newspaper The Independent reports.

Their letter said about 2,000 women a week secure medication under the current rules.

When the relaxed policy was first announced, it drew criticism from Bishop John Sherrington, Auxiliary Bishop of Westminster and the English and Welsh Catholic bishops’ spokesman on life issues. He said the change was shocking and did not prioritize the wellbeing of women.

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“(T)hese measures further endanger women who, for example, are rushed into decisions by abusive partners and act without any proper consultation,” he said in March 2020. “They diminish the seriousness with which these decisions should be taken and the physical and psychological dangers of the administration of these drugs at home.”