Early medical abortion at home: consultation

1. Introduction

Why we are consulting

1. The Scottish Government believes women in Scotland should be able to access an abortion, within the limits of the law, should they require this. Abortion services should be accessible and free from stigma. Due to the COVID-19 pandemic, the Scottish Government has put in place an approval which allows women to take both pills required for an early medical abortion (mifepristone and misoprostol) in their own homes after a telephone or video consultation with a doctor or nurse, without the need to first attend a hospital or clinic for an in person appointment. This approval has been put in place to minimise the risk of transmission of COVID-19 and ensure continued access to abortion services without delays.

2. Now that the new arrangements have been in place for six months, the Scottish Government is seeking views through this consultation on whether or not to make permanent the current arrangements, allowing for home use of both pills for early medical abortion for those women who are considered eligible in line with Scottish Abortion Care Providers (SACP) guidelines. Please note that in this consultation we refer throughout to 'women' accessing abortion, but this is intended to refer to any patient who may seek an abortion, regardless of their age or gender identity. We know, for example, that some trans men will require access to abortion services.

3. The Scottish Government recognises that there are a range of strongly held views on this issue, with many people welcoming the current arrangements, but others raising concerns about the physical or mental health risks of not seeing women in person. This is why we wish to consult on this issue to allow abortion providers and other health professionals, women who have accessed abortion services and the general public the opportunity to comment and submit evidence. The responses and any evidence provided will help to inform the Scottish Government's decisions on whether the current arrangements should be allowed to continue once there is no longer a significant risk of COVID-19 transmission. At the moment, the current approval arrangements will remain in place as long as COVID-19 remains a risk; however, given current uncertainties around the coronavirus, there is no defined end date for this approval.

What this consultation covers

4. This consultation is seeking views on whether or not to make permanent the current COVID-19 arrangements allowing for home use of both pills for early medical abortion in Scotland. In particular, we are keen to receive responses from those who have direct experience of early medical abortions. This includes women who have had a medical abortion (either under the current Covid-19 arrangements or under previous procedures) and NHS or other staff involved in providing abortion care or other support for women who have abortions. We are also keen to understand how the current arrangements have impacted or could impact on different groups of women should they be continued, including women who share a protected characteristic as defined by the Equality Act 2010^[1], including disabled women, younger women, minority ethnic women and women who share a particular religion or belief, and other groups of women, including those with childcare or other caring responsibilities and women who live in rural areas. We are also keen to understand how the current arrangements have impacted or could impact on trans men accessing early medical abortion. Impacts could be positive or negative.

5. This consultation does not cover other abortion-related matters so we are not seeking views on the wider legal framework governing abortions in Scotland.