Miriam Cates is MP for Penistone and Stocksbridge
Almost two years ago, suddenly and without scrutiny, the Department of Health and Social Care (DHSC) announced the biggest change to abortion law in this country since 1967.
At the start of the pandemic and ensuing lockdown, the DHSC granted emergency measures to allow medical abortions to be self-administered at home without any in-person consultation. Now, the Government is mulling over whether to end this temporary policy in line with the cessation of other Covid emergency measures.
In practical terms, the changes in March 2020 have meant that a single phonecall currently suffices for women and girls to be sent abortion pills. This was no small alteration to abortion provision. The knock-on effects of this ill-judged change have since emerged, with the experiences of women revealing concerning issues.
In removing the requirement for an in-person consultation prior to abortion, there is no guarantee that the woman requesting the pills is doing so for her own legal use within the medically accepted time limit (10 weeks gestation in England and Wales). Nor is there any guarantee that she is doing so freely, without coercion. There is no way to ensure that the patient is alone. Without a face to face consultation, there are fewer or no visual markers (such as eye contact or body language). This disjuncture of care is exacerbated in cases where the woman has limited English-speaking abilities and poor computer access.
The circumstances that surround a woman’s reasons to seek abortion are complex and individual. Often victims of domestic abuse do not even realise that what they are experiencing is, in fact, coercion. For example, pressure from well-meaning parents to abort so that a student finishes her studies, a partner citing economic pressures or threatening to walk out, or teenagers encouraging their friend to just do it and swallow the pills are all instances of pregnancy coercion. How can a healthcare professional possibly certify over the phone that a woman is making the decision to abort freely?
We have seen an appalling rise in domestic abuse during the pandemic. Over 40,000 calls and contacts were made to the National Domestic Abuse Helpline during the first three months of the lockdown alone. The charity Refuge reported a 61 per cent increase in calls to its 24-hour helpline and online chat service in the past year, and a shocking 81 per cent of callers in 2020 described being “controlled” by their partner. As Lisa King from Refuge summarised: “Lockdown measures, where women have been isolated and confined with their perpetrators more than ever, have compounded their exposure to violence and abuse.”
Moreover, Refuge’s figures show that domestic violence worsens during pregnancy; 20 per cent of women using the organisation’s services are pregnant or recently gave birth, whilst studies show that four to nine per cent of women experience abuse during their pregnancy or afterwards. The most common age bracket contacting Refuge’s helpline were women aged 30-39. It is no coincidence that they are women of childbearing age.
As such, parliamentarians should be doing all we can to prevent domestic abuse situations from escalating, and ensure the highest level of support services for women. I am certain the Government does not want to put women at risk from coercive control nor put in place measures that risk aiding their abusers.
As a 2019 article in a leading medical journal states, “Potential for misuse and coercion is high when there is no way to verify who is consuming the medication and whether she is doing so willingly. Sex traffickers, incestuous abusers, and coercive boyfriends will all welcome more easily available medical abortion.”
Notably, polling of clinicians supports these concerns. Around six in seven GPs were found to be concerned that the “at-home” abortion policy could see more women being coerced into abortion, whilst 87 per cent were concerned that women were at risk of unwanted abortion arising from domestic abuse by partners controlling or monitoring their actions.
The Conservative Party manifesto in 2019 pledged “to fight crime against women and girls” and provide support for “individuals, most often women, trapped with coercive partners.” Indeed, Home Office Ministers have reassured us that the Government has “remained resolute in our commitment to tackling abuse that takes place behind closed doors and out of sight”; a commitment which has been evident through the passage of the Domestic Abuse Act 2021.
As the Government makes its decision about the long-term future of the home abortion policy, I urge the DHSC to prioritise the security and welfare of women facing unplanned pregnancies. Coerced abortion is widely held to be a “brutal form” of “discrimination”. It is our duty to prevent it.