Women seeking abortions in UK outside formal healthcare system due to 'insurmountable' barriers, finds research

Women in the UK are seeking abortion services outside the formal healthcare system due to access barriers, privacy concerns and controlling circumstances, research has found.

New findings indicate that despite it being legally available in Britain, some women find it challenging or at times “impossible” to access abortion care through current service models.

Research from the University of Texas reveals that nearly half of women who sought abortions outside the formal framework cited long waiting times, distance to a clinic, work or childcare commitments and prior negative experiences of abortion care.

Privacy concerns including lack of confidentiality of services, perceived or experienced stigma and preferring the privacy and comfort of using pills at home also deterred women from the statutory healthcare system, with 30 per cent citing this as the reason.

Nearly one in five women (18 per cent) meanwhile said the reason involved controlling circumstances, including partner violence and partner or family control.

The peer-reviewed study, published in Contraception, an international reproductive health journal, examined the demographics and circumstances of all women requesting early medication abortion through the online telemedicine initiative Women on Web (WoW) over a four-month period.

It then analysed a sample of their anonymised emails to the service to explore their reasons for seeking help. During that time, 180 women reported 209 reasons for seeking abortion outside the formal health care setting.

Abigail Aiken, author of the report and an assistant professor at the LBJ School of Public Affairs at The University of Texas at Austin, said current provision of abortion services in the UK made it “almost impossible” for women to access it.

“These are some of the most vulnerable women. Many of them have got a violent family or partner that controls them, which can make it almost impossible for them to get an abortion through the formal system,” she told The Independent.

“These are barriers that for some women are insurmountable. Many are in desperate situations. And there is a risk that these women resort to unsafe methods. We know from global studies that women who want and need abortions aren’t going to give up, and it could be dangerous.

“In the four months since I conducted the research, the number of women accessing the service has risen to 1,032. That’s a striking number of people given that we think we have a safe method for women. And these are only the ones we know about.”

Ms Aiken said that in order to ensure the most vulnerable and marginalised women are able to access safe abortions, a new approach is needed that will see the service delivered to them.

“This study shows that making health care services available does not automatically make them accessible or acceptable. To close the health care gap for the most vulnerable and marginalised, we need to find innovative ways to bring services to people where they are,” she said.

“We have to find some other way of providing for them from home – a more women-centred approach, which could see the service delivered to them.

“Our findings show that many women have already identified telemedicine as a viable way of obtaining early medication abortion. Making these services a reality would require a policy change to allow new models of service delivery.”

Clare Murphy, director of external affairs at the British Pregnancy Advisory Service (BPAS) described the figures as “staggering” and called for a “thorough overhaul” of abortion laws to ensure women are able to access the relevant care.

“The numbers of women in Britain seeking abortion pills online documented in this study are quite staggering‎, particularly given that it covers just one service over a four month period,” she said.

“It really underlines the need for a thorough overhaul of our abortion laws so that no woman faces clinically unnecessary obstacles in accessing care. It also concerns us deeply that women using pills bought online are at risk of life in prison if caught.

“Ultimately if we do not think that a woman who turns to online pills to end her own pregnancy should go to prison, we should no longer accept a law that says she should.

“As we prepare to mark the 50th anniversary of the 1967 Abortion Act next month, it’s high time to create a framework that meets the needs of women today, respects their ability to make their own decisions about their own pregnancies, and provides them with accessible high quality healthcare services to exercise that choice.”

A spokesperson for Marie Stopes International added: “In every country where we work, we are seeing increasing numbers of women buying abortion pills, either from pharmacies or online. Britain, where women have benefited from access to safe, legal abortion services for 50 years, is no exception to this global trend.

“In Britain, the number of women buying pills online remains a fraction of the 190,000 women each year who have an abortion through the NHS. However, any insight into the reasons why women are choosing a less safe method is valuable.”

Responding to the findings, a Department of Health spokesperson said: “All women who require abortion services should have access to high quality and safe care.

“It is a widely available procedure that is safe and regulated, with around 180,000 women accessing abortions a year. All abortion providers must have protocols in place for helping vulnerable groups. In addition to information on NHS Choices, there are also helplines set up to provide advice.”