Rules introduced because of the pandemic mean that terminations can now happen at home.
Within a week of discovering she was pregnant in late April, Justine (not her real name) knew she wanted an abortion. The pandemic had made her the sole breadwinner, and she had a young daughter to look after. She called Marie Stopes, a charity, which arranged a phone consultation with a representative from BPAS, another charity, at her local hospital. Four days later a packet of medicine arrived through the letterbox, and she terminated her pregnancy at home with the support of her partner. Abortion is a “horrible thing,” she says. But “in terms of how it was handled, it couldn’t have gone better”.
Justine is one of 23,000 women in England and Wales who had an abortion at home between April and June. That this was possible was due to a temporary change in the rules introduced as the country went into lockdown. In normal times, the first of the two pills required for a medical abortion must be taken at a hospital or clinic. But emergency measures, introduced on March 30th to avoid unnecessary hospital visits, designated women’s homes as another place where the pills could be taken, at least until ten weeks of gestation.
As a result of the change, abortions are now happening earlier. Data published on September 10th show that between January and June this year, there were 109,836 abortions in England and Wales. Some 50% of these, including Justine's, were performed before seven weeks, compared with fewer than 40% during the same period in 2019. The proportion performed before ten weeks rose from 81% to 86%. There was also a small uptick in the overall number.
Abortion is usually a safe procedure, but there is a direct correlation between the risk of complication and weeks of gestation, says Sam Rowlands, a doctor at the British Society of Abortion Care Providers, a representative group. That means easing access to early terminations has increased the safety of abortion care, says Edward Morris of the Royal College of Obstetricians and Gynaecologists. Both groups have called for the changes to be made permanent. The government has said it will launch a public consultation on the matter.
The picture is gloomier in those parts of Europe where politicians did not do much to ease access to abortion. Recent research by Abigail Aiken of the University of Texas at Austin looked at enquiries to Women on Web, a Canadian charity that provides pills to women in countries where at-home abortions are illegal. She found that during the pandemic they shot up in Italy (by 68%) and Portugal (by 139%). In Britain they fell to negligible levels.
Justine says the new way of doing things also reduced the psychological toll of the procedure. In 2011 she had to wait five weeks for an abortion, by which point she was nearing her second trimester. She lives in rural Cornwall, an area she says is “lacking in health care [providers] and forward-thinking”. She remembers being passed “from pillar to post” while attempting to get an abortion. The experience was so bad she made a formal complaint. This time, however, she says the process was “respectful”, “compassionate” and, crucially for her, “private”.