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  • Introduction of the National Health Service early medical abortion service in Northern Ireland – an emergency response to the COVID-19 pandemic

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Introduction of the National Health Service early medical abortion service in Northern Ireland – an emergency response to the COVID-19 pandemic
  1. Siobhan Kirk1,
  2. Leanne Morgan2,
  3. Sandra McDermott3,
  4. Laura McLaughlin4,
  5. Caroline Hunter5,
  6. Tara Farrington6
  1. 1 Sexual and Reproductive Health, Belfast Health and Social Care Trust, Belfast, UK
  2. 2 Obstetrics and Gynaecology, Belfast Health and Social Care Trust, Belfast, UK
  3. 3 Sexual and Reproductive Healthcare, Western Health and Social Care Trust, Londonderry, UK
  4. 4 Obstetrics & Gynaecology, South Eastern HSC Trust, Dundonald, UK
  5. 5 Genitourinary Medicine, Southern HSC Trust, Portadown, UK
  6. 6 Sexual & Reproductive Health, Northern HSC Trust, Ballymena, UK
  1. Correspondence to Dr Siobhan Kirk, Sexual and Reproductive Health, Belfast Health and Social Care Trust, Belfast BT1 6BT, UK; siobhan.kirk{at}belfasttrust.hscni.net

https://doi.org/10.1136/bmjsrh-2020-200920

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    Key messages

    • UK lockdown and travel restrictions introduced in March 2020 limited access to abortion as no local services existed despite abortion being decriminalised in 2019.

    • An emergency regional early medical abortion (EMA) service was quickly established, is working well and patient feedback is excellent.

    • The future of abortion in Northern Ireland (NI) including EMA is uncertain without funding from the Department of Health NI.

    Background

    The 1967 Abortion Act establishing legal abortion in the rest of the UK has never applied in Northern Ireland (NI). With few exceptions, abortion has remained illegal and unavailable. Women have had to travel to Great Britain, funding treatment themselves until 2017 when the UK Department of Health and Social Care agreed to fund abortions provided by the main UK private abortion providers via a Central Booking System.

    Abortion was decriminalised in NI on 22 October 2019 under the Northern Ireland (Executive Formation etc) Act 2019.1 Regulations have been introduced; however, services have yet to be commissioned.

    Why was this emergency service needed?

    The legal framework, The Abortion (Northern Ireland) (No. 2) Regulations 2020,2 came into effect on 31 March 2020 just after UK lockdown due to the COVID-19 pandemic, ‘stay home’ advice and the introduction of travel restrictions within the UK. Flights were cancelled, meaning accessing abortion in England involved an 8-hour ferry trip each way. Two women attempted suicide after flights were cancelled and they were unable to travel. Accessing abortion was problematic despite it being recognised as an essential service during the pandemic by the Faculty of Sexual & Reproductive Healthcare (FSRH)3 and the Royal College of Obstetricians & Gynaecologists (RCOG).

    What is the law regarding EMA in NI?

    Abortion is decriminalised and allowed …

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    Footnotes

    • Twitter @sandradww46

    • Contributors All the authors contributed to providing and analysing data and writing this article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.