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The end of home abortions

‘Pill by post’ legislation had been introduced in March 2020 in response to pandemic

The government is scrapping home abortions this autumn, ending the temporary legislation introduced as a result of the coronavirus pandemic. The law change had enabled women in their first ten weeks of pregnancy to carry out an abortion at home without having to physically attend a hospital or clinic.

Since March 2020, women have been able to secure two abortion pills through the post after undergoing a video or telephone consultation with a clinician. Previously only misoprostol, the second of the two pills needed for an early abortion, was permitted to be taken at home.

The “pill by post” legislation was introduced by former health secretary Matt Hancock under the 1967 Abortion Act in response to Covid-19, with the Department of Health and Social Care describing it as a “temporary” measure. 

Data from the Department of Health showed that 43% of medical abortions in the UK were administered at home between April and June 2020.

Move ‘empowered’ women

The government’s March 2020 legalisation of home abortion was welcomed by several clinicians and women’s groups, with the British Pregnancy Advisory Service (BPAS) describing it as “the silver lining of the pandemic”. 

Vivienne Rose, clinic manager at the BPAS clinic in Cardiff, said the legislation had “empowered” women. She told the BBC that the provision of “telemedical abortion care” had led to a reduction in waiting times, meaning abortions were being carried out at an earlier gestational stage.

According to NHS guidance, “abortions are safest, and happen with less pain and bleeding, when carried out as early as possible in pregnancy”.

Kerry Abel, the chair of Abortion Rights UK, told The Guardian that the legislation had broken down some of the barriers women face when accessing abortion services in this country. “More than 50% of women who have an abortion have children already,” she said. “Telemedicine avoids paying out for childcare and even missing potential work if someone has to give up a shift and they have a zero-hours contract.”

Religious opposition 

Religious groups expressed opposition to the temporary legislation, citing concerns about a lack of safeguarding or on-hand doctors and nurses in the case of something going wrong. In September 2021, The Mail on Sunday reported that three out of five ambulance services that responded to Freedom of Information requests had recorded “sizeable increases in abortion-pill-related calls or responses since April 2020”.

In London, the number of ambulance dispatches related to abortion pills doubled from about seven to 14 a month after the “pills by post” system was introduced. 

Andrea Williams, chief executive of the advocacy group Christian Concern, described the increase in 999 calls as “highly concerning, but sadly unsurprising”. “Women deserve better than to be left in such a vulnerable situation without proper care or medical supervision,” she told the paper.

Legislation ending in autumn

The legislation is now set to expire at the end of this month, but ministers are providing a six-month extension which will end in autumn, The Daily Telegraph reported today. 

The temporary extension has been allowed “amid concern that abortion clinics would be unable to cope with demand if asked to suddenly return to old ways of working”, said the paper.

The Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives and the British Medical Association have made an urgent plea to the prime minister to retain the current system, saying that revoking home abortion “would indicate a deep distrust of women and an institutional disregard for their reproductive rights”.

A letter written by the leading reproductive healthcare providers in England and Wales earlier this year claimed that stopping the legislation would “cause a significant strain to healthcare providers and the NHS, increase waiting times, and increase the numbers of women having to undergo surgical procedures at later gestations”.

But a Whitehall source told The Times that it felt “right” to make a “safe return to the policy that was in place pre-pandemic”.

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