Abortion care during the COVID-19 pandemic.

posted by: Don Leslie

As a response to the current Covid-19 pandemic, the government has temporarily approved the use of telemedicine in some situations to allow safe abortion care to be provided in the home. This means some abortion care services are able to provide an initial consultation over the phone, and if it is safe to do so they can either send out medicines, or they can be collected, to be taken at home without the need to see a healthcare provider face to face.
It is only safe to do this if the pregnancy is under 10 weeks in duration (Up to 9 weeks and 6 days since the first day of your last normal period) and you have not been on any hormonal methods of contraception which could make it difficult to accurately date the pregnancy. Also if you are unsure when your last period occurred, or it was unusual in any way you may need a scan first to determine how far the pregnancy has progressed.

If you are unsure about your dates, over 10 weeks pregnant or feel you would not be suitable for a “telemedicine at home abortion” you may still obtain an abortion in the usual manner as detailed below.

What does a medical abortion involve?

A medical abortion involves taking 2 tablets. The first tablet is called mifepristone. This blocks the hormone needed for the pregnancy to grow. The second tablet is called misoprostol, this should be taken 24-48 hours after the first tablet. This causes the body to expel the pregnancy from the womb. It causes a softening and opening of the cervix and contractions of the womb so you may need to take some painkillers at the same time.
More information will be given to you by your abortion provider.

What does a surgical abortion involve?

If it is not safe to provide a medical termination, or you prefer a surgical procedure you can have a surgical abortion. This usually takes place under general anaesthetic when you are asleep, although some services may offer a local anaesthetic for pregnancies under 12 weeks. It involves removing the pregnancy through the cervix and the vagina, usually using a suction method. It is a relatively quick procedure and can usually be done as a day case.

Due to the COVID-19 pandemic, there is very limited capacity for surgical abortion procedures and you may not be offered this option at present.

Do I have to pay for an abortion?

No. An abortion is provided free under the NHS. If you are registered locally with a GP you can access free services by either getting a referral via your GP or Sexual Health Service (during the current pandemic situation this would usually be via an initial telephone consultation), who will discuss your options and discuss ongoing contraceptive needs and STI testing. They can then refer you to the NHS provider at your local hospital. These services are trying to develop a remote prescribing service where possible and appropriate, or they offer a surgical abortion service where needed.

Alternatively you can self-refer, free of charge, to Marie Stopes UK which has a branch in Exeter. This service offers medical abortions up to 10 weeks and surgical abortions in Bristol.
The 24 hour advice line is 0345 300 8090. They offer an “at home abortion pills” service or a face to face service, whichever is most appropriate.
It is also possible to self-refer to BPAS (nearest branch is in Taunton). However this will incur a fee as they are not able to offer an NHS service to non-local residents. To contact BPAS call 03457 30 40 30.
If you are a resident in the Torbay area you can self-refer to the Torbay Pregnancy Advisory Service (ToPAS). This is an NHS service, that offers medical abortion up to 10 weeks and surgical abortions in Torbay (usually) or Exeter (during the pandemic). We also offer an “at home abortion pills” service or a face to face service, whichever is most appropriate. You can access ToPAS by calling 01803 656500.

How quickly can I get an appointment?

If you self-refer to either Marie Stopes UK or ToPAS they will offer a telephone consultation within 24 hours. If you call your GP or Devon Sexual Health Services they will try to book you a hospital appointment as soon as possible. Most abortions occur before 13 weeks of pregnancy but some do take place after this. It is important that you contact a healthcare professional as soon as possible to discuss your options.

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Accessing our service during the COVID pandemic

How to access our service:

We have now implemented a telephone triage system for all of our clinics. This system will be in place for the duration of the pandemic. Please contact our services to access this triage system. Our central telephone number is 0300 303 3989.

If you are experiencing symptoms of Coronavirus please do not attend the clinic. Clear advice for people with symptoms of coronavirus is available at nhs.uk/coronavirus .

Advice from our service:

We have updated information on the provision of routine contraception during this pandemic here.

We are currently prioritising these groups for coil and implant (LARC) fits:

  • Those with vulnerabilities including but not limited to those who are: <18, attending abortion and maternity services, homeless, sex workers, victims of sexual assault, people with language barriers, drug and alcohol problems, learning disability, serious mental illness
  • Those aged <30 years

More details on LARC fittings at our service are found here

There is also specific advice on coronavirus available for People Living with HIV here, and for pregnant women here

Self-requested Sexual Health screening by post is available for for under 25s only - more info here

For others with testing requirements please contact the service on 0300 303 3989.

Information is now also available to advise on sexual contact during a time of social distancing here.

Alternative provision:

Please be aware that we may have to cancel, rearrange or shut clinical services in response to changing clinical and staffing pressures created by the Coronavirus pandemic. 

If you are struggling to access sexual health services, alternatives may be available:

  • Emergency Contraception - at your local pharmacy - more info
  • Contraceptive pills and LARC procedures - obtained from your GP
  • HIV postal testing - available to at-risk groups for a small fee -  more info
  • HIV PEPSE - available via A+E departments - more info
  • Condoms by post (for gay and bisexual men only) - more info