LBJ School of Public Affairs professor and CHASP faculty fellow Dr. Abigail Aiken studied women in England, Scotland, and Wales who requested at-home medication abortion through online telemedicine initiative Women on Web (WoW).
She and her colleagues examined the characteristics and circumstances of these women and published the findings in new paper, Barriers to accessing abortion services and perspectives on using mifepristone and misoprostol at home in Great Britain in the peer-reviewed journal, Contraception. See below for full abstract.
- BuzzFeed – Women In Britain Say They Are Are Turning To Illegal Home Abortions Because They Can’t Get To Clinics
- The Independent – Women seeking abortions in UK outside formal healthcare system due to ‘insurmountable’ barriers, finds research
- The Guardian – Make access to abortion easier, UK’s top gynaecologist demands
- 10/11/17: Dr. Abigail Aiken to Appear Before the Joint Oireachtas Committee on the Eighth Amendment of the Irish Constitution
- Contraception Accepted Manuscript/Commentary: Self-Sourced Online and Self-Directed at Home: A New Frontier for Abortion in the United States (PDF)
Barriers to accessing abortion services and perspectives on using mifepristone and misoprostol at home in Great Britain
Contraception (September 2017)
To examine reasons for seeking abortion services outside the formal healthcare system in Great Britain, where abortion is legally available.
We conducted a mixed-methods study among women resident in England, Scotland, and Wales who requested at-home medication abortion through online telemedicine initiative Women on Web (WoW) between November 22nd 2016 and March 22nd 2017. We examined the demographics and circumstances of all women requesting early medication abortion and conducted a content analysis of a sample of their anonymized emails to the service to explore their reasons for seeking help.
Over a 4-month period, 519 women contacted WoW seeking medication abortion. These women were diverse with respect to age, parity, and circumstance. 180 women reported 209 reasons for seeking abortion outside the formal healthcare setting. Among all reasons, 49% were access barriers, including long waiting times, distance to clinic, work or childcare commitments, lack of eligibility for free NHS services, and prior negative experiences of abortion care; 30% were privacy concerns, including lack of confidentiality of services, perceived or experienced stigma, and preferring the privacy and comfort of using pills at home; and 18% were controlling circumstances, including partner violence and partner/family control.
Despite the presence of abortion services in Great Britain, a diverse group of women still experiences logistical and personal barriers to accessing care through the formal healthcare system, or prefer the privacy of conducting their abortions in their own homes. Health services commissioning bodies could address existing barriers if supported by policy frameworks.
The presence of multiple barriers to accessing abortion care in Great Britain highlights the need for future guidelines to recommend a more woman-centered approach to service provision. Reducing the number of clinic visits and designing services to meet the needs of those living in controlling circumstances are particularly important goals.