Advocacy and opinions

Two years ago, Early Medical Abortion at home (telemedicine) was made permanently legal, following advocacy from MSI Reproductive Choices UK together with our partners and allies.

As we reach the two-year anniversary of this safe, popular service being made permanently available, we reflect on why offering this option is so important, with examples of the clients who have benefitted most.

With 50% of abortion procedures still involving some face-to-face care, it’s critical that we continue to offer as many access options as possible, so that everyone, no matter their personal circumstances or clinical needs, can get the high quality care they deserve.

Read our Early Medical Abortion At Home: Two-Year Success Analysis Report (2024)

Safe access zones around abortion clinics were signed into law in May 2023, but they are yet to be implemented. We have recently seen a spike in hostile anti-choice activity outside our clinics, affecting people accessing abortion care, and those providing it.  
  
With a new parliament following the General Election in July 2024, it is important that the Home Office implements abortion clinic safe access zones without delay. Our joint letter with the British Pregnancy Advisory Service (BPAS), the Royal College of Obstetricians & Gynaecologists (RCOG) and the Faculty of Sexual and Reproductive Healthcare (FSRH) outlines our asks.  
  
Read the joint letter to the Home Secretary (July 2024)

There is no evidence base for reducing the abortion time limit and the clinical and ethical consensus, supported by the World Health Organisation (WHO), is that the current UK abortion time limit of 24 weeks should not be reduced.

In this position statement, we set out why there should be no reduction in the abortion time limit, and why reducing the time limit would risk criminalising the most vulnerable and marginalised women.

Read our Position paper – Why there is no case for reducing the abortion time limit (March 2024)

Safe access zones around abortion clinics in England and Wales were signed into law in May 2023, but they are yet to come into force. As anti-choice harassment and intimidation around clinics continues, it is of paramount importance that these safe access zones are implemented as soon as possible.

Read our letter to the Home Secretary (November 2023).

Since the government permitted telemedicine abortion in March 2020, the service has been a success. It has reduced waiting times, brought down the average gestation at which abortion is carried out, and allowed clinicians to make the safest decisions for the individual, instead of forcing everyone to follow a one-size-fits-all model.

This briefing sets out the main reasons why offering the option of telemedicine for early gestations, where it is safe and clinically appropriate, is regarded as best practice by experts around the world, regardless of whether there is a global pandemic.

Read the briefing here: Briefing – Telemedicine Abortion Beyond COVID-19 (2022)

Over the past 25 years many of our centres and clinics have been targeted by anti-abortion individuals and groups gathering outside. We need Safe Access Zones around all premises which are registered to provide abortion care services with the Department of Health and Social Care.

Read our Position Paper – The need for Safe Access Zones (March 2020)

The Home Office is holding a public consultation on the implementation guidance for abortion clinic Safe Access Zones.

Summary of our position
While we welcome the government finally enforcing this crucial legislation, we have concerns that the proposed guidance undermines the will of Parliament, will cause confusion, and will not protect those accessing our services.

Read our Consultation Response: Abortion Clinic Safe Access Zones: Non-statutory Guidance

MSI Reproductive Choices UK experience of providing telemedicine in England has shown the current arrangements to be safe, convenient, accessible and to have reduced waiting times.
 
Summary of our response and recommendations
We strongly recommend abortion via telemedicine is kept as an option after the COVID-19 pandemic is over. Indeed, the body of evidence in favour of telemedicine is now so robust that it is difficult to see how removing this option could be justified on clinical or scientific grounds.

Read our Consultation Response: Early Medical Abortion at home – UK Government (2021).

While it is widely recognised that false medical information is extremely serious, there appears to be a lack of dedicated focus or resource given to tackling misinformation and disinformation which relates specifically to Sexual and Reproductive Health and Rights (SRHR). Within the global approach to tackling false information, MSI UK considers there should be a dedicated focus on false information which relates to SRHR, especially abortion.

Read our Submission – UN Office of High Commissioner- false information

Our clinic in Ealing made history on the 10th April 2018 by implementing the first ever Safe Access Zone around an abortion clinic in the UK.
The PSPO was made for the maximum three-year period allowed by the legislation and is due to expire on 10 April 2021.
We strongly recommends the renewal of the Public Service Protection Order (PSPO) on Mattock Lane for the full three years.

Read the Public Consultation Response on Mattock Lane Safe Zone- Ealing Council.

MSI Reproductive Choices UK (MSI UK)’s experience of providing telemedicine in England has shown the current arrangements to be safe, convenient, accessible and to have reduced waiting times.
 
Summary of our response and recommendations
We strongly recommend abortion via telemedicine is kept as an option after the COVID-19 pandemic is over. Indeed, the body of evidence in favour of telemedicine is now so robust that it is difficult to see how removing this option could be justified on clinical or scientific grounds.

Read our Consultation Response: Early Medical Abortion at home – UK Government (2021).

We call for government to mandate co-commissioning of sexual health services, to end fragmentation of services and allow patients to have all their contraceptive needs met following this pandemic and throughout their lives.

Read the Inquiry Response – APPG SRH Access to Contraception in England (2020).

Assessing the impact of a routine requirement for in-person abortion care for adolescents in England and Wales: A pre-post evaluation (2025) was published in the Journal of Adolescent Health and co-authored by Dr Sarah Salkeld, MSI Reproductive Choices UK’s Associate Medical Director. 
 
The paper explores Early Medical Abortion at home (telemedicine) for younger people. The findings support offering EMA at home for young people and cannot find any evidence that access should be determined or restricted by age. 

Read the paper here: Assessing the impact of a routine requirement for in-person abortion care for adolescents in England and Wales: A pre-post evaluation

We have collaborated on the largest ever study of abortion care with researchers at the University of Texas, the British Pregnancy Advisory Service and National Unplanned Pregnancy Advisory Service: “A telemedicine‐hybrid model for medical abortion that includes no‐test telemedicine and treatment without an ultrasound is effective, safe, acceptable, and improves access to care.”

Read the study “Effectiveness, safety and acceptability of no‐test medical abortion provided via telemedicine: a national cohort study” published in BJOG International Journal of Obstetrics & Gynaecology.

An accessible 2-pager the national cohort study’ authored by researchers at the University of Texas at Austin, MSI Reproductive Choices, the British Pregnancy Advisory Service and National Unplanned Pregnancy Advisory Service.

This analysed the outcomes of more than 50,000 EMAs between Jan and June 2020 both before telemedicine was introduced and after to compare data.

Read the 2-pager policy brief “Evidence From Over 52,000 People in England and Wales Shows Telemedicine Abortion Without Ultrasound Is Safe, Effective and Improves Care.“

An article by Louise McCudden, Advocacy and Public Affairs Advisor for MSI Reproductive Choices UK, for BMJ Sexual & Reproductive Health’s blog on the new telemedicine abortion research and evidence.

Read the article at this link: “New telemedicine abortion research puts patient voices front and centre“