The Royal College of Obstetricians and Gynaecologists (RCOG) and the Faculty of Sexual and Reproductive Healthcare (FSRH) are concerned that the UK Government is considering stopping the use of telemedicine services for early medical abortion in England.
The two organisations have previously written to the Prime Minister and the Secretary of State for Health, urging them to make the telemedicine service permanent in line with medical evidence and the wishes of the women who use these services. Before the pandemic, NICE (the National Institute for Health and Care Excellence) had recommended that the NHS should offer abortion assessments by phone or video call for women who prefer this option in recognition of the vulnerabilities that some patients face.
Since the beginning of the pandemic, over 100,000 women in England and Wales have had an early medical abortion at home and data shows that complications related to abortion have decreased since this service was introduced.
There is overwhelming evidence that allowing women to use the two pills required for an early medical abortion at home has created a safer and more effective service.
The largest ever study of UK abortion care analysed the outcomes of more than 50,000 early medical abortions that took place in England, Scotland and Wales between January and June 2020 and found that with the introduction of the telemedicine service:
- Waiting times for abortion treatment improved from 10.7 days to 6.5 days
- Women were able to receive care much earlier in their pregnancy, with 40% of abortions provided at less than six weeks.
- 98.8% of women were able to end their pregnancies without any further intervention and less than 0.05% experienced a serious complication.
While the option of face-to-face consultation must always be available to women, the choice to use telemedicine for early medical abortions allows people seeking an abortion to take control of their own reproductive choices, which can help to remove any stigma around abortion care.
Recent research published by the British Medical Journal looking at women’s experiences of using telemedicine has shown that 83% of women who have used a remote consultation for an early medical abortion found it 'very acceptable' and 89% said that they would opt to have treatment at home again if they needed another abortion.
On 26 January 2022, the UK’s leading abortion care providers wrote to the Minister for Vaccines and Public Health issuing a stark warning that if the telemedicine service were to end in England, they wouldn’t be able to cope with the demand. Bpas stated that if everyone was again required to attend for face-to-face treatment when it was not clinically necessary, the charity alone would be providing 190 fewer abortions every week.
Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologist, said:
“We have been clear with Government that there is no medical justification for withdrawing this service and would be utterly dismayed by this decision.
“This is not in the interests of women and girls, and will be devastating for women trying to access an abortion in England. It will not only cause untold amounts of distress for women but also punish the most vulnerable by making it more difficult for them to access care.
“Withdrawing the service will lead to increased costs, wasting NHS resources, and ultimately increased waiting times for women which will lead to later abortions and the known risks associated with this.
“The decision to force women to go into clinics to have a face-to-face consultation, when the NHS is already struggling to cope with patient demand, will only exacerbate this further.
“If providers are unable to cope with running a face-to-face service, women and girls will be unable to access the vital health services that they need and this could force them to access illegal methods of abortion.
“Early medical abortions at home have proven to be a safe and effective way of widening access to essential healthcare during the pandemic and we urge the Government to make this service permanent.”
Dr Asha Kasliwal, President of the Faculty of Sexual and Reproductive Healthcare, said:
“We are deeply disappointed that the Government is considering ignoring clinical evidence and the experiences of thousands of women who have found telemedicine for early medical abortion to be their preferred method of abortion care.
“It is highly concerning that a well-established, evidence-based clinical care pathway could be withdrawn for non-clinical reasons, which is not in keeping with patients’ best interests.
“There is no medical reason not to make the current telemedicine service permanent. More than that, withdrawing care that is evidence-based and preferred by many women amounts to a threat to their fundamental right to Sexual and Reproductive Healthcare.
“Evidence shows that allowing women to use the two pills required for an early medical abortion at home has created a safer and more effective service. More than 100,000 women in England and Wales have now had an early medical abortion at home, and data shows that waiting times for abortion care have reduced significantly. Women have been able to receive compassionate care much earlier in their pregnancy.
“We urge the Government to ensure that telemedicine for early medical abortion in England is made permanent.”
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