"I had a 'pills by post' abortion during lockdown"
The day after lockdown was announced, Rebeccca*, 33, from Margate, discovered she was pregnant with a baby that she didn’t want. Thankfully, she was able to access a ‘pills by post’ procedure – a measure introduced temporarily by the government to ensure women were able to access abortion care during the pandemic. Here, Rebecca tells her story – and explains why she thinks this new method should be made available once we return to normal…
"I began to suspect I might be pregnant in early March. My period was nine days late, which never happens. But I’d taken the morning after pill the month before and knew that doing so could change my usual cycle so, for a while, I put my lack of period down to that. I kept waiting and hoping that it might show up, but a couple of weeks later, there was still no sign.
On the day after the UK went into lockdown, on 24 March, I took a pregnancy test. When it was positive, I was disappointed but, more than anything, annoyed at myself. I have a daughter from a previous relationship and had no desire to have another child, and even though I’m in a long-term relationship, I’m a single parent and don't live with my partner. Having more children wasn’t something we had discussed.
I had all the usual feelings you get when you find out you’re pregnant but don’t want to be – panic, fear, worry – but on top of that was a layer of concern about how I was going to manage it with the added complication of lockdown. There was no question I wanted an abortion, but the focus of healthcare was on coronavirus and GP surgeries weren’t taking non-essential appointments. I was worried about abortion clinic staff being seconded to the NHS and I knew that the cervical screening programme had been paused, too. I went into panic mode, afraid that I wouldn’t be able to access an abortion at all. At the time, the government hadn’t confirmed women would be able to access ‘pills by post’ abortions.
I knew I needed to call the British Pregnancy Advisory Service (BPAS) as soon as possible, because I’d had one other abortion a decade ago. At the time, the next appointment wasn’t for another three weeks, at 7:30am on 14 April, over an hour’s drive from my house. I was told I would have to drive there on my own. I wasn’t happy, but I didn’t see what other option I had.
But as the weeks went on, I heard MPs including Jess Phillips talking about ‘telemedical abortions’, which would enable women to take abortion pills at home, rather than having to travel to a clinic. It was a ray of hope. Then, the week before my appointment, the government confirmed plans to allow women access to so-called ‘pills by post’ abortions up to ten weeks’ gestation. It was a huge relief. I was already suffering with pregnancy symptoms, and the thought of driving to the appointment alone while enduring morning sickness and fatigue was horrendous. I wanted to deal with it in the least complicated, most private and straightforward way.
The process entailed three telephone calls – a screening call, a conversation with a nurse, and then a thorough, 45-minute appointment with a consultant, where we went through a detailed form. At the end, she explained that the abortion pills would arrive in plain packaging the next day, and the parcel would fit through my letterbox. She also told me what to look out for, in case something wasn't right, and how to get in contact with them if I had any concerns. The conversation was just as rigorous as if I had been sat in a doctor's room. They’d thought of everything: I got a phone notification to say the parcel had been posted, just to reassure me that it hadn't got lost on somebody's desk. It arrived the next day, as promised, with a relief-inducing thud on my doormat. They’d even included pain relief, so that I didn't have to go to the chemist myself.
"I was concerned about doing it on my own, because I knew that I would feel terrible while it was happening, and then pretty wretched afterwards too."
As it was a Wednesday, I didn't take the pills that day. I had to take one tablet and then wait a period of time before taking the next one. I didn't want to take them until the end of the week, in case it meant I couldn’t work. In the end, I took the first pill on the Thursday, and the second set of medication on the Friday. It meant I could go through the worst over the weekend, and be back at work on Monday.
Although I knew wholeheartedly that I was doing the right thing, my emotions were mixed. I was concerned about doing it on my own, because I knew that I would feel terrible while it was happening, and then pretty wretched afterwards too. I also went to a dark place in my mind – if something did go wrong, I’d be on my own, and it would be the worst time possible to go to hospital.
The abortion was both worse and better than I remembered. On the Friday night, the pain was severe, much worse than I recalled, and I was up all night. Because I didn’t know how much more painful it would get, I didn’t take the pain medication, codeine, until quite late on. I probably made it worse for myself by toughing it out. I thought I’d feel terrible for days, but by the Saturday afternoon, the pain was manageable. It didn't last as long as I was expecting and although you bleed for a number of days afterwards, my overwhelming emotion was relief. It was a weight off my mind; when you're pregnant and you don't want to be, you don't feel like your body is your own. The symptoms are a constant reminder of what’s going on inside your body. It wasn't pleasant, but it was what I wanted.
"It came back negative. It was all over."
I couldn’t have anyone with me, but I told one friend what I was going through, and she checked in throughout the Friday evening. The package also contained information about aftercare support and counselling, but because everything worked exactly as they said it would, I didn’t feel I needed it. They also supplied a pregnancy test to check the abortion had been successful, which I did two weeks later. It came back negative. It was all over.
Had I needed an abortion before the pandemic, I would have had to go to a clinic, but now, I think telemedical abortions should be offered permanently when it’s appropriate for the patient. Abortion clinics aren’t the nicest places to go to, in no small part because of the protestors who show up and make a difficult decision even harder.
I think ‘pills by post’ abortions should at least remain an option for women who want to go through the procedure in a private way, at a time and in a place that suits their needs. Doing it this way gave me so much more autonomy over my own body, and I think every woman should have that choice. In normal times, women would take their first abortion pill at the clinic, which removes their ability to choose when and where they want the process to start, confronting them with the possibility that they may have to deal with symptoms while travelling home from the appointment. Whereas if they arrive in the post, it's down to you to decide when you want to take that first tablet and manage your own time.
Now, I feel reflective about my experience. Nobody wants to have an abortion. It’s not in anybody's plan, but sometimes things don't go the way you want them to and it's nice to be able to have the choice."
What’s next for telemedical abortions?
BPAS’s Katherine O’Brien explains:
“We are continuing to provide telemedical abortion care for women who are clinically suitable and who want to access abortion care from the privacy of their own home,” says Katherine. “Telemedicine was introduced as a temporary measure during the COVID-19 pandemic. Currently, there is no guarantee that telemedical abortion care will be in place permanently. However, the government is planning a public consultation on retaining the legal basis for the service. We are expecting this to be launched in September, with a view to running for 12 weeks and closing before Christmas.”
From BPAS’s point of view, it would make no sense for the government to revoke permission for telemedicine. “It is safe and effective. Telemedicine has led to a significant fall in waiting times, and the gestation at which women are ending pregnancies has also fallen.” What’s more, telemedicine gives clinic staff greater capacity to provide other reproductive healthcare services that have been put on hold due to the pandemic, including STI testing and contraception.
“Telemedicine is of huge benefit to women: for many, being required to take medication in a clinic is difficult,” continues Katherine. “Clinics can be far from a client’s home, they need to take time off work, associated travel and childcare costs can be high. For women in abusive or controlling relationships, it can be incredibly difficult to attend a clinic for treatment without risking their partner discovering that they are pregnant.”
*Names have been changed
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