We need you! Lobby your MP for the last chance to retain the right to telemedical abortion.

[JuliaMumsnet]

You may have heard that earlier this month in spite of support for the service from BPAS, the Royal College of Obstetricians and Gynaecologists, the Royal College of GPs, the Royal College of Midwives, the British Medical Association, the Academy of Medical Royal Colleges, Women’s Aid, Rape Crisis and many other organisations, the Government announced that telemedical abortion will come to an end in England in six months time. This service, which allows women to have a telephone or video consultation with a qualified nurse or midwife and – where eligible – have abortion medication posted to them to use, has been available throughout the pandemic.

Telemedical abortion is a safe, effective, and accessible option for accessing abortion care in the first ten weeks of pregnancy, and means that women who struggle to attend an in-clinic appointment - because of a lack of childcare, transport issues, domestic abuse or any other reason - are able to obtain care.

When we asked Mumsnet users in January, nearly 80% of you told us you supported the retention of telemedical abortion. And now, thanks to an amendment by Baroness Liz Sugg, we have one last chance to keep this provision. On March 16th, Baroness Sugg proposed an amendment to the Health and Social Care Bill as it passed through the Lords to keep telemedical abortion in place in England. The amendment passed, which means it now goes back to the House of Commons for another vote (most probably during the w/c 28th March).

The amendment will be a free vote, which means MPs won’t be instructed how to vote by their political party - they will choose themselves whether to vote in favour of or against the amendment, or, to abstain. We know that MPs’ inboxes are filling up with emails from the anti-abortion lobby - and we want to make sure that they understand the strength of feeling amongst women in favour of keeping this provision. So we’re asking Mumsnet users to contact their MP and encourage them to vote in favour of the amendment.

Here’s how you do that:

1. Find your MP's contact details here.
2. Write them an email about why you care about this issue, and why you want them to vote for the amendment. You can use the template we have provided below, but if you have time please consider personalising your message - it will make it more effective!
3. Tweet and tag your MP (and @MumsnetTowers) in some of the graphics on our twitter page with the hashtag #KeepTelemedicalAbortion. You can copy and paste the images. We'll be retweeting!

Let’s mobilise the power of Mumsnet and help retain what has been a real step forward for women’s reproductive rights.

p.s. If you’d like to support our campaigning work, sign up to Mumsnet Premium here. Sign up to the campaigns mailing list here.

TEMPLATE EMAIL
Subject: Please vote FOR retaining telemedical abortion in the Health and Care Bill

Dear [YOUR MP’s NAME]

I’m emailing as your constituent about the upcoming vote in the House of Commons on an amendment by Baroness Liz Sugg to the Health and Care Bill to support the retention of telemedical abortion.

The largest study of telemedical abortion in the world found that telemedicine is safe, effective, and improves care, and in a Mumsnet poll of more than 8,000 users in January 2022, more than 77% of users said they were in favour of retaining this service. Telemedical abortion means that women who struggle to attend an in-clinic appointment - because of a lack of childcare, transport issues, employment or any other reason - are able to obtain safe, timely and effective care. It also provides an accessible way for women in abusive and controlling relationships to access abortion care

Removing the provision of telemedical abortion would be a backwards step for women’s health and reproductive choice. It must be retained. Please vote for Baroness Liz Sugg’s amendment.

Best wishes
[YOUR NAME]

Something has been puzzling me about Lambkin's 'data'. Most of it comes from FOI requests to acute NHS trusts, citing that a particular percentage of women who underwent medical terminations were treated for complications. Burton and Derby for example apparently had a complication rate of 2.3%

In order to calculate a complication rate, you'd need to know the size of the original cohort. So let's take Burton and Derby (which is an acute NHS trust as mentioned). They aren't the provider of the medical terminations, women will have received the tablets from a whole range of private, NHS and charitable providers. In order to calculate a complication rate, you'd need to ensure that every single person who received a tablet was counted.

Then of course there's the question of who you'd count. Do you make your cohort of women who have had terminations from people who live in Derbyshire, or should Staffordshire be included since Burton is in Staffordshire? What about the large student population of Derby who may have had a termination, are they included, or shall we count them at their home postcode?

What about people who live in Nottinghamshire, had their original termination there, but were treated for complications in Derby? Would you count them?

I simply do not see how an FOI request to an acute trust can give you robust data on outcomes and complications. You need certainty of numerators and denominators.

Oh and I will be emailing my MP.

I can't believe anyone thinks a foetus isn't alive What do they think abortion is, if not killing a foetus? How can you kill something that's not alive?

@mellongoose

There is too much emotion on this thread for me to make a clear decision.

I would like to know more about the process. How often does a woman get contact with a health care professional during this process?

I am inclined not to support this, since there would still be the usual ways to access an abortion if needed where a woman definitely does have contact with a health care professional.

I feel uncomfortable about her doing this alone, scared, possibly through coercion.

I am usually pro-choice. I had to terminate my own second baby late in the pregnancy for medical reasons and it devastated me.

I would love someone sensible to take the sting out of this thread and let me know a woman is not doing this alone.

Thanks

@mellongoose I am so sorry for the loss of your baby.

I had a medical abortion for similar reasons. This was done 'in a clinic in a hospital'. I think you raise a valid point but I wanted to point out that I received minimal care whilst the medication took effect and afterwards.

I was left alone in a cubicle for hours and hours in awful pain and was told that unfortunately I was one of the few whose body reacts very strongly to the medication but it would wear off.

I was in a great deal of pain, and when I asked for help (by physically going to find a nurse), I was told that I needed to wait and no one came back to me for a very long time. I was given paracetamol which obviously I would have had access to at home.

There was a wait for the toilet which was appalling given what this does to your body. Using a hospital toilet during the process felt difficult and this was exasperated by knowing others needed to use it too.

It was a physically very painful process for me, but being in a hospital environment didn't mean I was offered any extra assistance or care than I would have had at home.

I was still suffering when the clinic came towards closing time. My options were a taxi home or walk over to A&E. I took a taxi home.

I was one of the unlucky few who had retained products after the medical abortion ended. It took about a week for me to realise that I had an ongoing problem and sought help. Being in-clinic did not help me or anyone else know that the process was not complete.

I had then a surgical D&C.

I support this bill because I am pro choice and I believe that access to abortion clinics is often difficult and involves an inappropriate wait. From my experience I also don't think that the clinic environment necessary offers a level of care or supervision that you don't already have at home, even if you are alone provided you are aware of what to expect and what to do if you experience any issues.

@freckles20 excellent post, thoroughly explained and thank you so much for posting about what must have been a distressing experience.

I'm afraid I have grave concerns r.e. this and think the "pills by post," system needs to be stopped ASAP now covid is over.

I am pro-choice and think women should be able to access termination on the NHS, as the alternative, ( illegal and unsafe pills brought online/ backstreet abortions carried out by unqualified "medics" is unthinkable).

My concerns:

1. Women and girls being coerced/ pressured into obtaining these tablets by parents/ partners/ husbands who want to coerce/ bully them into abortion. A BPAS nurse/ midwife is not, however well meaning, going to be able to tell if the girl/ women they are speaking to over the phone is able to speak freely or has abusive parents/ partner in the room with her. At a face-to-face consultation BPAS can, ( and do) , insist the girl/ women is on her own and able to speak privately.

2. The lack of "dating scan," means highly distressed/ vulnerable women may give false LMP dates in order to obtain medication, and then face the danger of going through stillbirth/ late miscarriage alone, which is medically a disaster for both physical and mental health. BPAS themselves have already admitted they are aware of cases reported to them where the medication has been falsely obtained over the legal limit.

3. Again, without a scan, there is no mitigation whatsoever to ensure the female requesting the tablets is actually pregnant. Whilst spiking is a small risk, it is a very real and dangerous risk that non pregnant women can simply phone these numbers and confidentially obtain medication that could be administered to others. Given the consequences of this, I think it's horrendous these are being posted without scans/ proof of pregnancy etc.

4. As BPAS and MSI will post these to girls from the age of 13, there is a risk that girls will take this and then not call for help if they experience an emergency, ( e.g. haemorrhaging), as they don't want to get into trouble. If they were administered in a clinical setting, at least there would be doctor's etc on hand who could provide medical assistance, whilst protecting their privacy from families.

5. The real risk that ectopic pregnancies could go undetected in some very vulnerable individuals.

6. I understand BPAS were also able to fit implants etc at the clinic where girls/ women took the first pill, ( a LARC which would almost entirely prevent the women/ girl having a repeat of what must be a horrendously distressing experience). Obviously , if people aren't attending clinics, then this opportunity to fit LARC and avoid repeat abortion is being missed.

I do not see how the "advantages," outweigh the very, very serious risk of abuse in this case.

chattycaterpillar have you looked at the research at all?

And as I posted upthread, the number of women being coerced into an abortion is roughly equal (but slightly lower) than the number of women being coerced into keeping a pregnancy they do not want. It cuts both ways.

You make it sound as if the telemedicine process is completely without safeguards or supervision. I suggest you read what freckles20 posted - the process is not that different.

@pointythings, my problem is, I feel there is a gap in the research.
Because people who have been pressured/ controlled into obtaining the medication by a parent / partner, people who have illeagally obtained the medication to administer to others, people who have illeagally obtained the medication to complete illegal abortions after the cut off date, are not going to be free to admit this on surveys etc.

You only have to look at the amount of Mumsnet threads r.e. forced/ pressured/ coerced into termination happens to women to know it is a real and very distressing problem.

chattycaterpillar why are you only looking at this from the pov of women who are being coerced into terminating and totally ignoring the pov of women who are being forced by abusive partners to be pregnant and stay pregnant?

I have seen this on MN also - and yet your focus is only on one side of the issue.

@chattycaterpillar have you read my post below? I can add that I wasn't given or offered a scan either.

[quote pointythings]**@freckles20 excellent post, thoroughly explained and thank you so much for posting about what must have been a distressing experience.[/quote]
Thank you. It's something I don't talk about, but it feels very relevant to this type of discussion because people are making a lot of incorrect assumptions about the care given during a medical abortion which is carried out in a hospital setting.

It was distressing, but I think maybe that is to be expected. The lack of compassion or supervision was really difficult though, as was being stuck in a horrid little cubicle without any comforts or easy access to a vacant pleasant toilet. In so many ways it would have been easier at home.

[quote chattycaterpillar]@pointythings, my problem is, I feel there is a gap in the research.
Because people who have been pressured/ controlled into obtaining the medication by a parent / partner, people who have illeagally obtained the medication to administer to others, people who have illeagally obtained the medication to complete illegal abortions after the cut off date, are not going to be free to admit this on surveys etc.

You only have to look at the amount of Mumsnet threads r.e. forced/ pressured/ coerced into termination happens to women to know it is a real and very distressing problem.[/quote]
But just because some women are living with abusive partners who force them to do things they don't want to do shouldn't mean that the 90+% of women not living in those circumstances shouldn't have access to a telemidical abortion.

Pluvia it's worse than that. For every woman being coerced into a termination she doesn't want (which is appalling) there is 1 (or 1.1, to be strictly accurate) who is being coerced into continuing a pregnancy she does not want. And yet chattycaterpillar and others are perfectly OK with that.

Yes, I get that, I was just trying to keep my response short.

Pro-lifers will try and force a woman to continue her pregnancy by any means they can come up with.

@pointythings

Pluvia it's worse than that. For every woman being coerced into a termination she doesn't want (which is appalling) there is 1 (or 1.1, to be strictly accurate) who is being coerced into continuing a pregnancy she does not want. And yet chattycaterpillar and others are perfectly OK with that.

Where on earth are you getting that idea from?

Thinking pills by post is too dangerous to continue as it puts vulnerable women at risk of coerced/ pressured termination from bad and abusive parents/ partners/ husbands does not in any way make me think that a man who tried to prevent a women getting a wanted termination isn't scum.

I would, for instance, be disgusted at proposals that the biological father had to consent to an abortion; as it would open up women to the type of abuse/ pressure you discuss.

I can only say that anecdotally it appears to be a lot more common for abusive parents/ family members/ partners/ babyfather's to demand/ pressure/ emotionally blackmail the mother into an abortion they don't want.

You only have to look at Mumsnet to notice the threads saying, " my husband/partner/ex is pressuring me to have an abortion I don't want,2 far outnumber the threads, ( which are a lot rarer but I fully admit exist), where the women says "my husband/ partner/ ex is trying to pressure me out of an abortion I want."

I would be genuinely interested, if, pre-the 2020 pandemic, there was a large cases of women who wanted abortion in the U.K being unable to access this as pills by post didn't exist ?

Furthermore, whilst I admit the instances would be rare, I am very concerned over the fact there are no checks and balances over who is receiving this medication, (you do not need to verify identity, you are able to opt out of your GP being informed and you do not need to provide any proof you are actually pregnant), that this does open very vulnerable girls and women open to spiking.

news.bbc.co.uk/1/hi/england/london/8361922.stm

oxfordshireguardian.co.uk/man-jailed-for-buying-abortion-pills-and-pressuring-ex-to-end-pregnancy/

In the first case above, the abuser was only able to access abortion pills to spike the women's drink as he worked in a hospital as a doctor and had access to medication.

Can you understand, why I'd be very concerned that opening this up and sending the pills to anyone who claimed to be pregnant without any verification opens women and girls up to abuse ?

This doesn't in any way alter my belief that those who need one should be provided an abortion via the NHS with confidentiality and respect.

As an aside, I have a friend who very sadly experienced two missed miscarriages, ( the treatment for which is the same as abortion). The first time she was offerred the pills to take at home, the second surgery. She is of the opinion that the extreme pain, bleeding, faintness and seeing retained products made the first miscarriage 100x more traumatic than the second; and that for both miscarriage and abortion these pills are being pushed on women because they are cheaper for the NHS, when she found surgery a lot less traumatic. So yes, I also have concerns the pills are being pushed onto vulnerable women as it is cheaper for the NHS, when surgery appears to be less traumatic for my friend who went through both.

Being anti-abortion and being anti pills by post as you think it puts vulnerable women at risk of abuse are two very different things.

chattycaterpillar I note that you are still not addressing the issue of women who are being coerced into keeping pregnancies they do not want - as I posted upthread, this cohort of women is slightly larger than that of women who are being forced into terminations they do not want. Telemedicine gives them options they did not have before.

Furthermore I note you are not addressing freckles20's post setting out that abortion in person services are not the gold standard of personalised care and safety that people think they are.

Pills by post may put some women at risk. It takes a similar number of women out of risky situations by giving them options. I choose the women who are already living, and the children they may have.

@pointythings the women a risk of coerced/ pressured termination are already living ?

And I was never arguing that women should have to undergo the whole medical termination process in a clinic, ( @freckles20 experience sounds appalling, and makes me doubt the providers claims to have "th best intrest of women," at hear even more).

Prior to the Covid-19 pandemic, women would have to attend for a private/ individual consultation, a scan to confirm the pregnancy, take the mifepristone in clinic, ( which in itself does not induce abortion), and then given the misostropol to take at home). I think a return to that system would minimise the risk to abused women.

You're still not addressing the women at risk of being forced to continue a pregnancy they do not want - women who will find it very difficult to access a clinic in person. Women for whom this is a lifeline. Why do they matter less?

At freckles20's experience of in person termination as being appalling (I agree) and how it makes you not trust the providers in terms of telemedical abortions, and then two sentences later trot out the assumption that in person they will get a scan and bla bla bla - clearly that isn't necessarily the case. Which is it?

@pointythings

You're still not addressing the women at risk of being forced to continue a pregnancy they do not want - women who will find it very difficult to access a clinic in person. Women for whom this is a lifeline. Why do they matter less?

At freckles20's experience of in person termination as being appalling (I agree) and how it makes you not trust the providers in terms of telemedical abortions, and then two sentences later trot out the assumption that in person they will get a scan and bla bla bla - clearly that isn't necessarily the case. Which is it?

Replace "would," with "should."

The fact they would administer those drugs to @freckles20 without conducting a scan to confirm she was actually pregnant, ( some women believe they are pregnant after seeing an Evap line), or that she was not experiencing an ectopic pregnancy, is grossly medically irresponsible,.

Therefore, I would propose:

1. End pills by post due to the risk of abuse to women.
2. A mandatory, in-person, face-to-face consultation with nurse/ doctor/ midwife to ensure the women is given a private space to speak up if she is facing coercion/ abuse.
3. Scan to confirm non-ectopic pregnancy before dispensing these pills to any women.
4. Women to be given the opportunity to take pills at home, ( or in clinic if they wish), to avoid appalling experiences like @freckles20).
5. Long-term contraceptive options, ( e.g. the implant)to be strongly encouraged and , ( if taken up), fitted at the termination scan/ private consultation appointment, to ensure women do not need to repeat a distressing experience. 5)The NHS to stop putting profit before women, be honest about how distressing these pills can be, ( regardless of whether used for miscarriage or abortion), and offer women the less distressing surgical option as standard.

I also note you don't answer any of the concerns in my post..

Also, if you are a women who has a controlling partner who wishes you to continue a pregnancy against your will at home with you, then posting these pills out with no safeguards, ( BPAS website say they do not need to be signed for), surely puts you at increased risk of abuse should he discover them/ answers the door to the postman.

Re the concerns in your post I am going to go with the recommendations of the experts listed in the OP. The research is there, the methodology is clear, I'm going to accept it. Abortion by telemedicine is shown to be safe and wanted by the women who have used it. Ultimately women making their own choice is good enough for me.

Nothing is going to be 100% perfect, but your faux concern for abused women being coerced by their partner into continuing a pregnancy is awful - 'oh, but they might be in more danger if he finds out it's in the post' - do you think they haven't considered that? Instead you just propose taking the option away.

Thanks for the template @JuliaMumsnet, really useful and I hope others use it too!

@pointythings

Re the concerns in your post I am going to go with the recommendations of the experts listed in the OP. The research is there, the methodology is clear, I'm going to accept it. Abortion by telemedicine is shown to be safe and wanted by the women who have used it. Ultimately women making their own choice is good enough for me.

Nothing is going to be 100% perfect, but your faux concern for abused women being coerced by their partner into continuing a pregnancy is awful - 'oh, but they might be in more danger if he finds out it's in the post' - do you think they haven't considered that? Instead you just propose taking the option away.

It's not faux concern. Having had people very close to me suffer horrendous domestic abuse, it is very real concern as to what could be a very real risk to some women/ girls.

You, however, do not seem in the least bit concerned about the very vulnerable women, ( including those living with learning disability and mental health problems), who are open to extreme pressure/ coercion/ force, ( and in some cases having drugs administered without their knowledge), that this scheme allows. You genuinely have not shown one iota of concern for women facing this.

chattycaterpillar you're wrong. But there is a choice to be made here: do we prioritise women who are being coerced to remain pregnant by abusive partners (thus bringing a baby into an abusive relationship and making it harder for the woman to leave), or do we prioritise women who are being coerced into a termination they do not want?

I choose the former group, because there are somewhat more of them according to the research, and because bringing a baby into an abusive household is wrong. You choose differently. We can't have both.

I'd go with protecting the majority and not bringing unwanted children into the world.

But the children of women being coerced/ forced/ pressured aren't unwanted by the mother !? That's kind of the point. I am pro-choice. I think the women, and the women alone should get to choose. And I think in a lot of cases, pills by post opens up vulnerable women to coercion/ force / pressure and they end up having that choice taken from them.

If a women genuinely does not want a child I have no moral issue with abortion being provided safely via the NHS.

As an aside, pills by post is being pushed because it's cheaper, not cos it helps women. Most women say the surgery is a lot less traumatic than the pills, but that's not being offerred as standard is it. Cps the less traumatising option is more expensive. Ad yet now, providers want to provide cheaper care whilst dressing this up as being "pro-women's rights."

Abortion clinics don’t just send out abortion pills to just be used by anyone. The chances of a woman with learning difficulties being slipped legitimately sourced pills is slim to none.

Coercion is a problem, and it goes both ways. For women facing unwanted pregnancy in an abusive situation, these pills can be, and are, their only way to assert control over their own bodies.

I don’t know what the solution is to the problem of women being coerced into abortion, but it he solution imo isn’t blocking access to a service that has, overwhelmingly, been a success. Of the women that have actually used it, over 80% found it to be positive for them.