How the pandemic forced long-overdue abortion law reform

The current crisis places us in an extraordinary state of flux and society may never return to normal. Post-Covid-19, employers may struggle to talk employees back onto their commutes and into the office, certain industries may never recover, and the government’s generous financial support packages may be hard to row back. Indeed, the changes initiated are proving highly disruptive to norms, some which have evolved over time to become meaningless shibboleths.

One such reactionary norm is that, under English law, women seeking to abort an early pregnancy (prior to ten weeks) must take the first of the two pills necessary for the termination in an abortion clinic, and only the second pill may be taken in the comfort of their own homes. Women also need the approval of two doctors to access the medication—telephone consultations are not permitted.

Prompted by coronavirus social-distancing measures, a new government policy on early abortions has been adopted. The Department of Health and Social Care has announced that for a two-year period, women needing the two pills necessary for an early termination will be posted them to be taken at home, following a simple telephone or online consultation, with only one doctor.

In fact, all three of these changes had already been called for by expert bodies, pre-Covid-19. In November 2019, the Royal College of Obstetricians and Gynaecologists published a new report, “Better for Women," which recommended the government consider allowing women to take both pills at home. 2019 saw the National Institute for Health and Care Excellence recommend greater use of telephone and online consultations to increase access to and streamline abortion care. In 2018, the British Pregnancy Advisory Council highlighted a study which found doctors felt the legal requirement that two doctors approve every request was responsible for delays and “creating an access problem.”

Depressingly, it has taken a public health crisis for all three of these sensible reforms to be adopted, and then after what can only be described as an omnishambles.

Initially, government guidance published on 23^rd March provided that women and girls would temporarily be allowed to take both pills at home, without the need to attend a hospital or clinic first. Doctors would be allowed to prescribe the medications from their own homes. But by 8pm, hours later, the guidance was deleted, and it was claimed that it had been published in “error.” After significant pressure, the government U-turned and on 30^th March  announced the reinstatement of the new policy.

England could have a better track record in improving access to abortion. It was only in 2018 that reforms were made which allowed women to take the second pill necessary for an early abortion at home, with Scotland leading the way in 2017. This simple reform has not only saved women the inconvenience of making two visits to hospital, but more importantly the indignity, pain, and stress commonly suffered in having to deal with the swift onset of a miscarriage while travelling back home after taking the second pill, in a taxi or on public transport.

The introduction of the new early abortion policies—with their practical reforms—show that measures which streamline and ease access to abortion can be implemented quickly and easily when government has the will to do so.

Indeed, their swift introduction may well show that the previous set of policies amounted to little more than meaningless barriers to abortion access, without medical merit or the best interests of women at heart.

At the very least, when this current crisis is over, the government should consult on whether to remove the new policies before doing so, and thus re-restricting access to early abortion services.