Abortion was decriminalised in October 2019 and since then the failure of Robin Swann and the Department of Health to commission services has seen women and pregnant people continuing to travel to seek abortion care that is legal here.

10 out of 26 areas in Northern Ireland have no access to early medical abortion services. The Northern Trust is the largest geographical health trust in NI and is also the most recent to have ceased provision of clinic-based early medical abortion services. Women and pregnant people in this trust now face further barriers to access will have to travel to seek the legal abortion that they could have had at home.

The current situation in Northern Ireland sees early medical abortion services only available up to 10 weeks gestation (9 weeks 6 days) despite the law stating it should be available on request up to 12 weeks gestation and the World Health Organisation recommending 13 weeks. No commissioned services mean that there has been no information published by health trusts on how and when to access services leaving women and pregnant people in the dark when it comes to making healthcare decisions.

The World Health Organisation have recognised that abortion services are essential healthcare and have stated that “abortion provision in a global pandemic should minimise facility visits and provider-client contacts through the use of telemedicine and self-management approaches.”

During the COVID-19 pandemic the rest of the U.K. has seen improved access to abortion through telemedicine and pills-by-post services. Northern Ireland has yet again been left behind despite being the only part of the U.K. that has fully decriminalised abortion. This is due to the continued obstruction to access by the NI Executive including prominent anti-choice politicians.

Telemedicine is safe and effective and has proven to be a vital service, providing people with safety and reassurance during the ongoing pandemic. Telemedicine would allow a medical practitioner to have a consultation with the pregnant person either over the phone or online. If eligible they will be prescribed mifepristone and misoprostol which can be collected at a pharmacy, alongside instructions for how to take the medication and information on who to contact if additional support is needed.

The Department of Health has advised the public to stay at home, however, women and pregnant people are being forced to travel to a clinic to take a single pill, when they can take the further 4 pills at home 24 hours later. Travelling in a pandemic puts the pregnant person and health professionals at risk of contracting COVID-19.

Beyond the context of the COVID-19 pandemic, telemedicine will provide the modern and compassionate support which is crucial to accommodating women and pregnant people from marginalised groups. Asylum seekers, ethnic minorities, sex workers, the travelling community and LGBTQIA+ people are all disproportionately impacted by barriers to abortion services. Moreover, women and pregnant people may also have caring responsibilities, no access to transport, limited access to finances or are the victims of domestic abuse and coercive control which reduces their ability to access clinic-based care.

Alliance for Choice believes that everyone should have the right to choose, this extends to deciding between clinic-based care and self-managed abortions. Self-managed approaches use the same safe medications that are prescribed in clinics by healthcare professionals. Mifepristone and misoprostol are effective up to 98% of the time and this approach is used by millions of people around the world to safely end pregnancies up to 13 weeks with no long-term effects.

Self-managed approaches will allow us to be our own service providers removing many of the barriers to services that we currently face. Care at home enables us to have more control over our own bodies so we can be supported in ending our pregnancies safely, effectively and privately at home. Alliance for Choice have provided self-managed abortion workshops to empower, educate and inform activists and others in Northern Ireland. These workshops outline where to access the safe and legal online pills, how to take them, what to expect and who to call if there are any complications or worries.

Free, safe, legal and local abortions mean accessible services for everyone who needs them, and the continued obstruction of abortion access and reproductive justice is impacting the lives of women and pregnant people across the North.

Over the next two weeks we will be sharing how telemedicine prevents and ameliorates the impacts of gender-based violence… please link, like and share across our website and social media platforms.