The COVID19 crisis has brought with it a lot of alarming news, like that of a young woman who tried to take her own life, when refused an abortion at a local hospital, despite abortion now being legal here. She had been unable to travel to England due to flights being cancelled because of the COVID emergency. The feminist websites that have provided abortion pills for over a decade now report that COVID lockdowns in a number of countries mean they cannot guarantee a service to the island of Ireland at the moment.
The ESRC funded research carried out at Ulster University shows that women in Northern Ireland are able to follow remote instructions and self-manage EMA safely, even when the threat of prosecution was hanging over them. For over a decade, hundreds of women a year have accessed abortion pills from Women Help Women or Women on Web and completed their abortion without the support of any health care professional.
The study also funded a full module on attitudes to abortion in the 2016 NI Life and Times Survey (NILT) and a smaller number of questions in the 2018 NILT survey. This provided strong evidence of public support for the reform of abortion law here. A large majority (82 per cent) of people believe that abortion should be legal where the life or the health of the pregnant woman is at risk. Where there is a fatal or serious foetal abnormality (81 per cent and 75 per cent respectively) are in favour of abortion being legal and 78 per cent believe this should be the cases of rape or incest. A majority (63% in 2016, 71% in 2018) also agree that “It is a woman’s right to choose whether or not to have an abortion”. It is important to note that the NI Life & Times Survey is not another opinion poll as Prof Gillian Robinson explains here.
With the regulations governing the legal abortion service which should be available from 1st April now published, anyone needing an abortion should be able to access an early medical abortion from their GP or family planning clinic or, if over 10 weeks gestation, from a local hospital. But with GP surgeries closed and hospitals overwhelmed with Coronavirus patients, what is someone with an unintended pregnancy to do if they need a termination?
This has highlighted the need for an Early Medical Abortion (EMA) service to be established here as soon as possible. Policy developments in the Republic of Ireland and in England & Wales suggest that such a service ought to be via telemedicine, at least for the duration of the COVID crisis. The World Health Organisation and the Royal Colleges of Obstetricians and Gynaecologists and of Midwives have all produced guidance promoting telemedicine as the safest way for doctors to provide and for women to access EMA during the pandemic.
Scotland has now joined England and Wales and the RoI in making EMA available by remote consultation. Without a similar move here, Northern Ireland will, once again, be the only part of these islands where women who have an unwanted pregnancy cannot access abortion safely. How are those who are self-isolating to access abortions if they cannot travel to England and EMA is not available via remote consultation?
GPs are currently prescribing a range of medications by remote consultation – to protect their own health and that of their patients. Many of the medicines they are prescribing can be dangerous – unlike abortion pills which, according to the World Health Organisation, are extremely safe. Certainly, they are far safer than Viagra which is available over the counter without a prescription.
Unless they are very young or otherwise vulnerable, it is always the case that when someone finds themselves with an unwanted pregnancy, they want to move quickly to end that pregnancy. In our study, almost 4 out of 5 of those contacting Women Help Women for pills were under six weeks gestation when they sought help. They know that an earlier abortion is easier physically and emotionally, as well as much less painful.
As we all follow public health guidelines and stay at home, too many women will be isolated at home with an abuser. They may be coerced into having unprotected sex. Even if they are in happy relationships and having consensual sex, there is expected to be an increase in unintended pregnancies during the lockdown. While some of these will be welcomed, some will not be and we need to make it as easy as possible for anyone wanting an abortion to get it as early as possible. That means allowing our doctors to protect themselves from the virus and to prescribe medication for Early Medical Abortion remotely.
Goretti Horgan, Ulster University, You can follow her on Twitter: @gorettihorgan
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