{"id":2270,"date":"2020-04-09T06:56:08","date_gmt":"2020-04-09T06:56:08","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmjsrh\/?p=2270"},"modified":"2020-04-08T10:26:00","modified_gmt":"2020-04-08T10:26:00","slug":"normalising-abortion","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmjsrh\/2020\/04\/09\/normalising-abortion\/","title":{"rendered":"Normalising abortion: How do we get there?"},"content":{"rendered":"

By Carrie Purcell1<\/sup>, Fiona Bloomer2<\/sup>, Lesley Hoggart3<\/sup>, Karen Maxwell1<\/sup>, Sam Rowlands4<\/sup><\/em><\/p>\n

The COVID-19 pandemic, and current \u2018lockdown\u2019 situation in the UK, have seen unprecedentedly fast-paced reorganisation of healthcare services, with many exploring the potential offered by telemedicine. Until this week, abortion care seemed to be an exception to this, with women still being legally required to attend clinics in person for early medical abortion, despite this being medically unnecessary. The two-drug regimen currently used in early medical abortion uses mifepristone and misoprostol. While home use of misoprostol has been permitted in Scotland, Wales and England since 2018, women were still being asked to attend clinics to receive mifepristone, in direct conflict with government advice against all but essential travel. This requirement also put SRH professionals at unnecessary risk as they continued to carry out face-to-face consultations. It was therefore a relief when home use of mifepristone was eventually permitted in late March 2020 in England, shortly followed by Scotland and Wales, facilitating a shift to telemedicine in early abortion care. Although part of the UK, the only option available in Northern Ireland at the time of writing is telemedicine facilitated by the volunteer\/activist group Alliance for Choice, in partnership with Women Help Women and Women on Web. With new regulations yet to be operationalised, women in Northern Ireland have no alternative, since travel to England \u2013 the nominal state-funded option \u2013 is not currently possible.<\/p>\n

This exceptionalisation of abortion<\/strong> \u2013 that is, abortion being marked out as something different to all other forms of healthcare \u2013 is indicative of the stigma with which it continues to be marked. Abortion is bracketed, in a way upheld by the law and processes controlling its availability, as requiring special consideration. This relates very closely to the issue of abortion stigma, and our recent paper in BMJSRH<\/a> examines the ways in which stigma manifest for health professionals involved in provision.<\/p>\n

The paper presents findings from the Sexuality and Abortion Stigma Study<\/a>, a Wellcome Trust-funded project which is using secondary qualitative analysis to re-examine a broad dataset on abortion in the UK spanning the last decade. Specifically, the paper looks at ways in which health professionals talked about their involvement in abortion provision. Our analysis identified four main themes:<\/p>\n