The impact of COVID-19 on health services has been immeasurable, with the consequences expected to extend many years into the future. One area which has seen a change in legislation due to the ongoing crisis is that of medical abortions: a controversial issue even without the added complications of a global pandemic. Laws in England were relaxed on a temporary basis on 31st March amidst the pandemic, allowing women to receive abortion pills by post and manage an abortion at home up to ten weeks of pregnancy, following a video or phone consultation with a health professional.
This change in policy was welcomed by health officials, who praised its role in reducing face to face contact and thus protecting both women, and health professionals, from the virus and reducing its overall spread. The British Pregnancy Advisory Service (BPAS), which is the leading provider of abortion services in the UK, also welcomed the move, confirming that the procedure can safely be managed by women at home, without the need to attend a clinic.
Although abortion was decriminalised in Northern Ireland in October 2019, this essential access to abortion pills by post is yet to reach the region. Access to abortion in Northern Ireland has always been a contentious issue, with a strong Catholic opposition believing it to be immoral, a stance also adopted by the DUP. Until last year, abortion was only permitted in Northern Ireland under the most extreme circumstances, such as where the mother’s life would be endangered by the birth, and women risked life imprisonment for accessing this vital treatment, even in unprecedented circumstances such as rape, incest and in the diagnosis of fatal foetal abnormality.
Abortion is now legal in Northern Ireland, but there are no clinics that currently provide the service there, meaning that women have still been having to travel to England, or to the Republic of Ireland, to access the treatment which they desperately need. This practice is clearly at odds with social distancing rules and has been made logistically difficult due to flight cancellations. However, in a move welcomed by Amnesty International, four days ago it was announced that local health trusts in Northern Ireland would begin to offer terminations for women up to their ninth week of pregnancy, led by the sexual health charity Informing Choices NI. This would involve women attending a clinic to take the first abortion pill, and then returning home to take the second set of pills.
This is a step in the right direction of improving access to this basic form of healthcare, but Northern Ireland is still being left behind: attending the clinics rather than being sent the pills in the post, as has now become possible in England, puts women at risk of catching or transmitting the virus on the journey or in waiting rooms, and still contravenes social distancing guidance. Questions also arise about women who cannot travel to clinics due to the fact that they are self-isolating, or are in difficult situations such as facing domestic abuse or with unconfirmed immigration status. Amnesty International has called upon people to email the Secretary of State for Northern Ireland demanding access to home abortions, describing the current situation as ‘unfair, dangerous and needlessly putting women and girls at risk’. The charity also expressed concern that the current lack of access means that women will attempt unsafe abortions. The consequences of unsafe abortions and unwanted pregnancies place a further strain on the health service, at a time when it is facing the biggest challenge in its existence.
Accessing both sets of abortion pills at home is the only safe option during this pandemic. Clinic closures and staff shortages have meant that women have had to make longer journeys to access terminations, putting more people at risk and directly opposing government guidance. With a third of women having an abortion during their lifetime, it is paramount that all women in the UK are given access to this vital service, in a way which minimises the spread of COVID and reduces the burden on health services.