The reproductive health charity the British Pregnancy Advisory service is warning that abortion care services are facing unprecedented demand, with contacts to the charity increasing by around one third between March and September 2021.[i] The reasons for the increase will be complex, but are likely to include greater social mixing, as well as uncertainty about continuing an unplanned, but not necessarily unwanted, pregnancy in the current climate. During the pandemic, women have also experienced difficulties accessing contraception. NHS data released in September shows that during 2020/21, there was 22% fall in contraception-related contacts with Sexual and Reproductive Healthcare services compared to 2019/20 – representing a fall of 288,833 contraception-related contacts.
At the start of the pandemic, the-then Health Secretary, Matt Hancock, granted temporary permission for early medical abortion treatment to be used by women at home following a telemedical consultation to reduce the transmission of COVID-19. This has allowed over 100,000 women to swiftly and safely access early medical abortion before 10 weeks of pregnancy. However, increased need for services has increased waiting times, which increases the gestations at which women can be treated. Women may require later, surgical treatment as a result. The lack of capacity to provide this care up to the legal limit of 24 weeks within the sector, which is affected by the same pandemic-related issues that affect the wider NHS, now means some women are forced to continue pregnancies against their will. These women are overwhelmingly in complex and challenging circumstances.
Following a public consultation, the government is currently considering whether to revoke permission for telemedical abortion care. Legally forcing all women to attend in-clinic appointments to access abortion medication – when it is not clinically necessary for them to do so – would further increase waiting times and lead to an increase in the numbers presenting for later, surgical abortions which the sector will struggle to accommodate.
The Chief Executive of BPAS, Clare Murphy, said:
“Abortion is a safe and straightforward procedure, but the earlier it can be offered the better for women’s health and wellbeing. The current permission for telemedical abortion has enabled access to care at the earliest gestations, and has been particularly beneficial for women in some of the most complex circumstances. These are women who may struggle to access in-clinic care, because of distance and reliance on public transport, who are in abusive relationships where travel to a clinic may be impossible, or with precarious work or childcare arrangements that make taking a day off extremely difficult. In the absence of telemedical care and support, these women present to services later.
“We are already struggling to meet women’s needs as requests for help have grown over the last six months. The need for second trimester surgical services has also increased and these appointments can be increasingly hard to find. It is heartbreaking to turn away women in some of the most challenging circumstances imaginable. We urge the Secretary of State for Health and Social Care to ensure access to telemedical abortion remains an option for women, so we can continue to meet as many women’s needs as early as possible. Women’s health will suffer without it.”
[i] In March 2021, BPAS received 25338 calls. In September 2021, the figure was 35033 contacts.
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BPAS is a charity that sees over 100,000 women a year for reproductive healthcare services including pregnancy counselling, abortion care, miscarriage management and contraception at clinics across Great Britain. It supports and advocates for reproductive choice. BPAS also runs the Centre for Reproductive Research and Communication, which seeks to develop and deliver a research agenda that furthers women’s access to evidence-based reproductive healthcare, driven by an understanding of women’s perspectives and needs. You can find out more here: www.bpas.org/get-involved/centre-for-reproductive-research-communication/
Later in 2021, BPAS will launch England’s first not-for-profit fertility service, to provide ethical, evidence-based, person-centred care that supports patients. We will provide a safe, high-quality, and accessible service, without profiteering from patients. Our service will give those ineligible for NHS funding an affordable option to access the care they need.