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Contemporary issues in abortion

Michael Nevill 1 Dec 2022

This blog aims to consolidate some important changes to abortion legislation that has happened in 2022 and describes how this will affect practice.

2022 has seen some of the most fundamental changes to abortion service provision that has happened for many years. The abortion act was introduced in 1967 and up until this year very little had changed with regards to that act despite many campaigning for change.

It was in fact the covid pandemic that paved the way for some of these changes. At the start of the pandemic, Abortion was classed as a critical service which was to be kept running. Whilst people were expected to isolate and stay at home a temporary measure for the allowance of both medications for Early Medial Abortion (EMA) to be taken at home was granted by the Secretary of State for Health and Social Care. This meant that people seeking abortion could have their consultation undertaken over the phone or via video call, and if they were assessed as being sure that the dates of their last menstrual period determined they were under 10 weeks pregnant, they could have their pills posted to their home for administration, with a simple follow up questionnaire and pregnancy test to ensure the treatment was successful.

During the period of the pandemic many thousands of people undertook Early Medical Abortions at home safely and effectively. Of course there are risks and complications associated with Abortion and so explaining these risks and consenting the clients was an essential part of service provision, alongside appropriate safeguarding.

Due to the success of at home EMA, or pills-by-post as it has become known, organisations and the public campaigned for it to be made permanent and a public consultation undertaken by the Department of Health and Social Care was completed. This was then further debated and voted on in Parliament, who subsequently passed the permanent allowance of home EMA in August 2022. Some additional documentation is now required by the Doctor who prescribes the medications to ensure they believe in good faith that the pregnancy will not have exceeded 10 weeks at the time the medication is administered.

Another huge change that has happened this year is legislation regarding buffer zones around abortion clinics to protect people from harassment and intimidation. It is not unusual for people to stand in the street outside abortion clinics handing out anti-abortion leaflets and displaying graphic images of abortion. In some areas this had become so problematic that local councils had already introduced buffer zones around their local clinics, meaning people could not protest within a certain distance from an abortion clinic. In October of this year this was debated in Parliament with MPs backing an abortion clinic buffer zone law in England and Wales, meaning that from early 2023 it will be illegal to protest against abortion within 150 meters of an abortion clinic.

I hope you can see that these changes are huge steps which have been taken to ensure abortion is evidenced based, accessible, and undertaken without fear of intimidation and harassment. I believe however that there are still further changes required, such as decriminalisation of abortion and the removal of the requirement for two Doctors to decide if a person can have an abortion or not.

The RCN Women’s Health Forum continues to support advances in abortion care by attending the RCOG abortion task force and providing guidance on abortion service provision.
Michael Nevill

Michael Nevill

Women's Health Forum Committee Member

Clinical Director , NUPAS

Responsible for ensuring evidence based and compassionate clinical care is provided for the people seen at NUPAS.

Page last updated - 01/05/2023