Abortion at Home – Guidance

RCOG GuidanceThe Royal College of Obstetricians & Gynaecologists has issued updated information for healthcare professionals providing abortion care during the current COVID-19 crisis.

This update addresses the changes needed in order to ensure the safe delivery of remote abortion services, at home .

Some of the important aspects addressed include:

  • It is essential that women are provided with written information prior to remote consultation
  • Women must be given enough time during the consultation to get answers to any questions that they might have
  • Informed consent must be given, but does not need to be in written form, though it must be noted in the client record
  • It is not necessary to use ultrasound to confirm gestational age, nor is there a need for routine blood tests 
  • Providers are asked to carefully assess aspects related to safeguarding
  • Providers should offer to discuss contraception options

Sayana PressThere is a recommendation that the treatment package posted to the woman should include a second dose of misoprostol which can be taken, if needed to ensure completion of the abortion.

Post-abortion contraception is recommended, though it is noted that due to #StayHomeSaveLives the preferred long-acting reversible methods are not going to be an option. I wonder if this could be an opportunity to promote the use of Sayana Press?

 

I noted with interest the suggestions to maximise the involvement of nurses, rather than doctors, and to consider providing surgical procedures using conscious sedation to minimise on the use of theatre facilities and anaesthetic support. These are already part of well established models being used by Marie Stopes International overseas in resource-constrained settings, a label which I suppose, now also applies to us here in the UK.

MSI should be able to apply its best practice learnings from overseas programmes in which it has been enabling and supporting women to access the abortion pill from pharmacies and to self-administer at home.

 

About Kevin Duffy

Interim Management and Consulting - Healthcare Development. Kevin has thirteen years senior management experience in the development and delivery of healthcare services in Africa and South Asia.
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