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Early telemedical abortion, safeguarding, and under 18s: a qualitative study with care providers in England and Wales
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  • Published on: 12 October 2023
    Early telemedical abortion, safeguarding, and under 18s
    • Peter Green, Co-Chair National Network of Designated Healthcare Professionals for children, Designated Doctor for Safeguarding, Wandsworth National Network of Designated Healthcare Professionals for children (NNDHP)
    • Other Contributors:
      • Helen Daley, Designated Doctor for Safeguarding, Portsmouth

    We welcome research about safeguarding under-18s in early telemedical abortions. Telemedicine can be a useful adjunct to in-person care. The Royal College of Paediatrics and Child Health safeguarding guidance for under-18s accessing early medical abortions[1] requires that providers aim to see under-18s in-person ‘at some point in the EMA care pathway’. This guidance will be included in the new NHS Standard Contract from April 2023.

    Romanis and Parsons[2] don’t address the prevention of mid-term abortions (the central reason why under-18s should be seen in-person) focusing their analysis on abortion care providers’ views of access to abortion care.

    Abortion deliveries beyond 10 weeks are inevitable if not preceded by clinical examination and/or ultrasound scans,[3-5] and the psychological consequences of a mid- or late-trimester home delivery can be severe.[6,7] Under-18s lack brain maturity[8-10] and are more vulnerable to effects of trauma.[11,12] The law imposes particular responsibility to prevent foreseeable trauma in this age group.[13,14]

    Under-18s are also vulnerable to child sexual exploitation and abuse. Virtual consultations enable unseen and unheard coercive adults to overhear and intercept the patient's conversations.[15,16] Ensuring they are seen in-person enables rapport and guarantees privacy. Following no-test medical abortions, under-20s, compared to others are more likely to report wanting a face-to-face abortion in the future...

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    Conflict of Interest:
    None declared.