Removing choice for women is a rollback of rights

Cllr Lucy Caldicott is the joint-Cabinet Member for Health and Adult Social Care and a councillor in Stockwell ward.

As we emerge from, or learn to live with, the pandemic, it is important to keep the changes that were made out of necessity but have been proven to be working well. One of these is continuing to permit telemedical abortion care at home for early medical abortion. The current approval is used by 2000 women a week who require an early medical abortion, and is working well according to all the evidence from clinicians, patients, and women’s reproductive healthcare organisations.

In March 2020, the then-Secretary of State for Health and Social Care gave permission for the first medication in an Early Medical Abortion (mifepristone) to be taken at home. Our local abortion providers BPAS and MSI Reproductive Choices rapidly reconfigured services to provide the option of telemedical care and made sure women and other people needing an abortion were able to continue to access abortion care throughout the pandemic.

Between April 2020 and February 2022, 86% of women in Southeast London opted to have a telephone consultation over an in-person consultation. Multiple studies have shown that this service is safe, effective, accessible, and is often preferred by women – including the largest study of telemedical abortion care in the world. Offering of telemedical services as a permanent option is supported by clinicians, women’s rights groups, and regulators including NICE, the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives and the Academy of Medical Royal Colleges.

The NHS continues to be tested to its limits and clinicians have adapted swiftly to ensure that patients continue to be provided with the highest quality care. The pandemic has been a tremendously difficult experience for the country, but we should be proud of the way health services responded to the situation, in particular, the rapid innovation of vital health services such as telemedical abortion.

Paradoxically it was announced that this option will be removed after 29 August 2022. Both from a practical and a personal point of view, this doesn’t make sense. The removal of this choice presents a clear and present danger to people’s access to, and confidence in, their abortion care. Moreover, the decision demonstrates that the UK Government has ignored the medical evidence on a key issue affecting women’s health, undermining our right to make decisions about our health and future.

Telemedicine has created a more equitable service which has enabled thousands of people to access the care they need more quickly, and just as safely, while also being a more efficient use of NHS resources. Even before the pandemic, attending a clinic in person was prohibitively difficult for many women for a variety of reasons, including those living with an abusive or coercive partner, those with a disability or those who couldn’t afford childcare or time off work. Removing telemedicine would result in the UK Government re-criminalising hundreds of vulnerable women each year under the Offences Against the Person Act 1861, who will be forced to turn to unregulated abortion pill providers.

The most recent British Social Attitudes study on abortion found that more than 90% of the public believe a woman should be able to end a pregnancy in certain circumstances, and 70% support the right to have an abortion if a woman does not want a child (a more liberal position than the current law). These figures do not vary by party affiliation or vote. Private YouGov polling of MPs in early 2020 found that 78% of MPs describe themselves as ‘pro-choice’, including 70% of Conservative MPs and 94% of the 2019 intake. And 2021 Savanta Com-Res polling from the Faculty of Sexual and Reproductive Healthcare found that only 15% of women do not support the permanent approval of telemedical abortion care.

The Minister noted in her statement on 24 February 2022 that the measure to remove telemedical abortion will be kept under review. As we at Lambeth Council spelt out to the government in response to last year’s consultation, our residents need the Government to continue this safe, effective service, and offer women choice about their healthcare, in line with best clinical practice. And we’ve written to her again reminding her that to remove this service, despite the scientific and medical support it carries, would indicate a deep mistrust of women and an institutional disregard for their reproductive rights.

The Health and Care Bill is coming back to the Commons today for its Final Stages. This version of the bill includes amendments tabled by the House of Lords to maintain the provision of telemedicine for early abortion in England and Wales. At a time when women’s reproductive rights and choices are being rolled back elsewhere in the world, I urge the Government to support these amendments and make the move to offering safe, early medical abortion at home a permanent one.

Cllr Lucy Caldicott