Abortion at Home is Compliant with WHO

The WHO provides guidelines for women self-managing their abortion. Link here.

WHO Women Self-managing

The WHO says:

Given the nature of the medical abortion (MA) process, it is possible for women to play a role in managing some of the components by themselves outside of a health-care facility. Such self-assessment and self-management approaches can be empowering for women and help to triage care, leading to a more optimal use of health resources.

I think that the recent changes to abortion legislation in GB is aligned with the above statement – #AbortionAtHome is being permitted at this time to enable compliance with the #StayHomeSaveLives instruction, and also helps to optimise the NHS resources at this critical time. Link here to these new regulations.

icon-recommend-rigorous

The WHO states that it is not making a recommendation for the full independent management of medical abortion, by the woman alone. These guidelines state that women should only be self-assessing their eligibility for medical abortion within the context of rigorous research. This is covered in the new legislation through the provision of remote consultation and assessment by a registered medical practitioner.

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With regard to the second step above, the self-administration of the abortion pills, the WHO states that this is only recommended in circumstances where women have a source of accurate information and access to a health-care provider should they need or want it at any stage of the process. This is clearly the case in which the woman is in direct contact with an approved abortion service provider in GB, eg BPAS or Marie Stopes.

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The WHO states that women can self-assess the completeness of their abortion in circumstances where both mifepristone and misoprostol are being used and where women have a source of accurate information and access to a health-care provider should they need or want it at any stage of the process. Again, this is well covered in the new legislation and the proposed services provision.

The above WHO guidelines can be reviewed online using the interactive version here.

It is worth noting this additional remark by the WHO:

Self-management approaches reflect an active extension of health systems and health care. These recommendations are NOT an endorsement of clandestine self-use by women without access to information or a trained health-care provider/health-care facility as backup.

Activists are calling on the government officials responsible for healthcare in Northern Ireland, to immediately implement the same #AbortionAtHome regulations which now apply in all other parts of the UK. As noted above, and in this post, such an approach would be compliant with WHO guidelines and it would be legal.

Activists have an alternative contingency plan, though this is not their preferred way forward. In the absence of official service implementation, they plan to support women to procure the abortion pills online and to self-administer these at home. Whilst comprehensive information and guidance are easily accessible online, especially from those organisations which offer to ship the pills, such as Women Help Women, relying solely on such will not be as satisfactory as the remote consultations now being implemented by eg BPAS and Marie Stopes UK.

Assuming that a woman has correctly self-assessed her eligibility, or has been helped online to do so, the self-administration of abortion pills is relatively safe, though about 5% of these women will need some further intervention in order to complete the abortion, and a small number might need to receive care in a clinic or hospital. Given that these women are living in NI, if there is a need for emergency or follow-up care, they will be able to quickly access this from within the official health service.

As I noted in another post, it is legal for a woman in Northern Ireland to procure the abortion pills online and to self-administer at home, though it remains an offense for others to help her do so. I suppose being in another country offers legal protection to the organisations selling these pills, though activists in NI should bear this in mind.

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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