These Q&As relate to the Coronavirus (COVID-19) Infection and abortion care – information for healthcare professionals: Version 1 - 21 March 2020 published by the Royal College of Obstetricians and Gynaecologists, Royal College of Midwives, Faculty of Sexual and Reproductive Healthcare and British Society of Abortion Care Providers.
Q1. What impact may the COVID-19 infection have on my request for an abortion?
Abortion care is an essential part of healthcare for women, and services must be available even where non-urgent or elective services are suspended. Abortion is time-sensitive, and services should be organised to provide care as early as possible.
We do not know the extent of service disruption, but abortion services are still being provided and all women should be able to access timely care. We would encourage you to contact an abortion care provider as early as possible. We understand for some women a later term abortion is required and this should be discussed with the provider.
Q2. What measures are in place to reduce my risk of exposure to coronavirus
Abortion care providers have infection control measures in place. Current best practice guidance for abortion care already recommends processes such as self-referral and undertaking assessments by phone or video call which will reduce to a minimum the amount of contact you will need to have with other people.
We are also seeking to ensure that services are delivered as remotely as possible.
Q3. Do I have to have a GP appointment and be referred by my GP to get an abortion?
You should be able to request an abortion directly from the abortion care provider, rather than having to be referred by your GP. This is known as self-referral and can be done remotely via phone or teleconference. Information about your local service will be available online or can be provided by national abortion care providers via their booking and information lines.
Q4. How do services make sure consent and safeguarding procedures still happen during remote consultations?
You will still be given enough information and time for you to fully think things through and give informed consent to go ahead with the abortion, if that’s what you choose. This includes the opportunity to ask questions. Written information should be provided or available to you before the consultation. This could be through email or links to online sources.
Safeguarding is an essential part of abortion care. In some cases, the clinician may decide that an in-person consultation would be best for you.
Q5. Will I be required to go into an abortion care clinic for a medical consultation or to receive my care?
Early medical abortion care should be provided to you with as little physical contact as possible to minimise any possible risk of transmission of COVID-19.
Different options that have been recommended to abortion care providers include self-referral to abortion care and using remote consultations (e.g. via video or telephone) to give pre- and post- abortion care and assessment.
For example, if you request an early medical abortion (up to 10 weeks), abortion care can be provided safely without the need for ultrasound and blood testing beforehand to minimise any contact. Screening for sexually transmitted infections, if required, can be offered remotely (e.g. via a web-based home testing service) where possible.
We recommend that consultations with healthcare professionals can be done over the phone or via video link where possible. You may still need to attend in person for part, or all, of the procedure.
Q6. If I have an early medical abortion, will I have to go into an abortion care clinic to receive the medication I need for the abortion?
If an unwanted pregnancy is less than 12 weeks of gestation, you will be offered a medical abortion – a combination of two drugs, mifepristone followed by misoprostol.
The first drug used in an early medical abortion, mifepristone, must be taken in the presence of a healthcare professional in the place that provides abortion care. This will be given to you with as little contact as possible and you should be able to go home very soon afterwards. You will not have to stay overnight in the hospital / abortion care clinic.
The second drug, misoprostol, can be taken in your own home. The healthcare professional will give this to you with written advice and information, and a plan for a remote follow up assessment, and will be able to answer any questions that you may have.
Q7. What happens after a medical abortion?
You will receive information on what to expect before and after your abortion online, via e-mail, via post and through phone conversations where possible.
For all types of abortion, it is likely you will experience some stomach cramps and vaginal bleeding, that may last a week or up to a month. Please see our information about abortion care for patients and the public for more information on what to expect.
Q8. If I cannot have an early medical abortion because I am over 10 weeks, will I be able to still get an abortion, and will I have to go into hospital / abortion care service?
Access to abortion care is an essential part of women’s healthcare. Surgical and medical treatment is available up to 24 weeks’ gestation based on your preference, medical needs, and how many weeks along the pregnancy is.
To receive an abortion after 10 weeks, initial consultations may be provided over the phone or via video link where possible in order to limit physical contact. However, you will still have to go into the abortion care service to have your procedure.
Q9. What can I do to reduce my risk of catching coronavirus?
The most important thing to do is to wash your hands regularly and effectively as soon as you come from public places to your home or workplace. There is useful advice on the NHS UK Coronavirus web pages on the best way to reduce any infection risk, not just for coronavirus, but for other things like colds and flu.
The Government has also advised all citizens to reduce social contact as much as possible through social distancing measures. This means that you should work from home if possible and avoid public and crowed places as much as possible.
Q10. What should I do if I think I may have coronavirus or been exposed and require abortion care?
- Have a high temperature
- Have a new, continuous cough
- Are living in a household with someone who shows these symptoms
You should stay at home for 7 days. Do not go to a GP surgery, pharmacy or hospital. You do not need to contact NHS 111 to tell them you are staying at home. You do not need a test for coronavirus. At the present time, only people with severe symptoms who require overnight admission to hospital will be tested.
You should contact your abortion care clinic to inform them that you have symptoms of coronavirus, particularly if you have any routine appointments booked in the next 7 days. They will inform you of next steps with regards to your abortion care and whether or not it will have to be delayed.
You should use the NHS 111 online coronavirus service, or call NHS 111 if:
- you feel you cannot cope with your symptoms at home
- your condition gets worse
- your symptoms do not get better after 7 days
Q11. Are pregnant women at greater risk of contracting coronavirus or developing severe symptoms?
There is no evidence that pregnant women are at any greater risk of contracting coronavirus or developing severe symptoms if they are infected.
If you seek treatment or are admitted to hospital as a result of contracting coronavirus, you should tell the people treating you that you are pregnant – even if you are planning on seeking an abortion.
Q12. Will being in self-isolation for suspected or confirmed coronavirus delay my abortion?
You should contact your abortion care clinic to inform them that you have symptoms of coronavirus, particularly if you have any routine appointments booked in the next 7 days and are currently in self-isolation. They will inform you of next steps with regards to your abortion care.