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Safeguards needed for children seeking home abortions

Pregnant women and girls must see a qualified health professional in person

Artillery Row

Politicians of all parties and viewpoints are united by one belief: that the protection and safeguarding of children is paramount. The Government rightly acknowledges that “nothing is more important than children’s welfare”.

In unintended ways, however, this commitment to children’s welfare has been jeopardised over recent years. One such weakening came in the spring of 2020 when, as the pandemic forced us all to lockdown, virtual doctors’ appointments -also known as telemedicine- became much more commonplace.

I have tabled an amendment to the Health and Care Bill

This included the Government introducing emergency regulations to allow women to have medical abortions at home for the first ten weeks of their pregnancy following a telephone or video call consultation. The removal of an in-person consultation was no small detail. Virtual consultations can enable unseen and unheard coercive adults to influence the patient. They also allow pills to be obtained under false pretences. Without face-to-face consultations, requests for abortion pills can be entirely fraudulent, posing particular risks in terms of female exploitation. 

Whatever one’s views on abortion, few would argue that what can be a traumatic event, both physically and emotionally, should be undertaken in one’s home without having been seen in person by a medical practitioner at any point. And we are not just talking about women — those deemed old enough to make informed decisions. The pills by post policy also applies to girls under the age of 18, who are less likely to understand the risks involved and who are more vulnerable to the effects of trauma.

There have been documented cases of abortion providers putting women at significant risk by not carrying out basic checks, including women having abortions beyond the legal limit. Indeed the BBC recently highlighted the case of a sixteen-year-old, Savannah, who took abortion pills at home after a telephone consultation. The clinic she had spoken to calculated she was less than eight weeks pregnant, but they neither examined nor scanned her, and after taking the pills she was taken to hospital suffering “really badpain.

She was actually between 20 and 21 weeks pregnant, and she gave birth to a baby with a heartbeat indeed she said her “boyfriend could see feet.” Savannah said she had been left traumatised. If they scanned me and I knew that I was that far gone, then I would have had him,she said. It is hard to comprehend the trauma of an experience like this for such a young woman.

Disturbingly, the BBC reported that Savannah’s case is one of dozens of similar cases recorded by the body which comprises all senior NHS doctors and nurses who fulfil statutory child safeguarding functions on the NHS.

As Caroline Johnson, an MP who is also a consultant paediatrician, pointed out in Parliament recently, few MPs would have supported such a policy if they “think that a 14-year-old girl should be ringing up and receiving abortion medicines over the telephone”. This is, however, precisely what the legislation allows.

That’s why I have tabled an amendment to the Health and Care Bill in the House of Lords (due to be debated today, Tuesday 5th April) which is designed to ensure that pregnant women aged under 18 are guaranteed a face-to-face consultation with a registered medical practitioner, nurse or midwife before accessing an abortion. Children under 18 are recognised as being vulnerable in law, and the need for them to be seen face-to-face is essential in order to detect and prevent sexual exploitation or coercion.

This is not a debate about abortion or a woman’s right to choose

It is a stance backed by the NHS body made up of doctors and nurses who are the leading experts in the field of children’s safeguarding, the National Network of Designated Healthcare Professionals for Children (NNDHP). The NNDHP, who support safe access to abortion for young people, has released a statement saying: “all children and young people (those under 18 or those in care under 25) must be seen face to face, and the age of other applicants must be confirmed. The purpose of this position is to clinically assess the mid-trimester risk and prevent coercion and exploitation.” They expressed particular concern that phone and video consultations “enable unseen and unheard coercive adults to influence the patient” and “enable pills to be obtained under false pretences”.

In addition to risks from virtual consultations, the NNDHP has also raised concerns about the effects of trauma and neglected birth. They point to evidence of the home use of abortion pills resulting in traumatic incidents for which children do not have the emotional resources and the brain maturity needed to access support in these cases. Most distressingly, they are aware the policy has “led to live births of very premature but potentially viable infants”.

They are not alone in raising concerns; the Royal College of Paediatrics and Child Health recently raised concerns, saying that the “change in the legislation through the Health and Care Bill leaves a glaring gap — children and young people.” Highlighting concerns about the “particular challenges” of telemedicine for children and young people, the RCPCH noted “it is especially important to consider their safeguarding and holistic wellbeing, as well as their physical health needs.”

We should listen to the experts when it comes to children and the risks arising from continued remote consultations prior to the use of abortion pills at home. This is not a debate about abortion or a woman’s right to choose. It is about children’s welfare, and enshrining in law the essential protections for girls under the age of 18, whether that be from avoidable medical harm or from individuals who would cruelly seek to exploit or coerce them.

Successive Governments have rightly prioritised children’s welfare, and all of us in Parliament who make laws should keep this in mind. I hope that my fellow peers can support this amendment and do the right thing by young and vulnerable girls. 

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