Centre for Reproductive Research and Communication, British Pregnancy Advisory Service, Stratford-upon-Avon, UK
Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
BMJ Sex Reprod Health. 2022 Oct;48(4):288-294. doi: 10.1136/bmjsrh-2022-201502. Epub 2022 Apr 22.
During the COVID-19 pandemic, the British governments issued temporary approvals enabling the use of both medical abortion pills, mifepristone and misoprostol, at home. This permitted the introduction of a fully telemedical model of abortion care with consultations taking place via telephone or video call and medications delivered to women's homes. The decision was taken by the governments in England and Wales to continue this model of care beyond the original end date of April 2022, while at time of writing the approval in Scotland remains under consultation.
We interviewed 30 women who had undergone an abortion in England, Scotland or Wales between August and December 2021. We explored their views on the changes in abortion service configuration during the pandemic and whether abortion via telemedicine and use of abortion medications at home should continue.
Support for continuation of the permission to use mifepristone and misoprostol at home was overwhelmingly positive. Reasons cited included convenience, comfort, reduced stigma, privacy and respect for autonomy. A telemedical model was also highly regarded for similar reasons, but for some its necessity was linked to safety measures during the pandemic, and an option to have an in-person interaction with a health professional at some point in the care pathway was endorsed.
The approval to use abortion pills at home via telemedicine is supported by women having abortions in Britain. The voices of patients are essential to shaping acceptable and appropriate abortion service provision.
在 COVID-19 大流行期间,英国政府临时批准了米非司酮和米索前列醇这两种药物在家中使用,以进行医疗流产。这使得完全远程医疗流产护理模式得以引入,咨询可以通过电话或视频电话进行,药物可以送到妇女家中。英格兰和威尔士政府决定在 2022 年 4 月的原定截止日期之后继续采用这种护理模式,而在撰写本文时,苏格兰的批准仍在磋商中。
我们采访了 2021 年 8 月至 12 月期间在英格兰、苏格兰或威尔士进行流产的 30 名妇女。我们探讨了她们对流产服务配置在大流行期间变化的看法,以及远程医疗流产和在家中使用流产药物是否应该继续。
绝大多数受访者支持继续允许在家中使用米非司酮和米索前列醇。支持的理由包括方便、舒适、减少耻辱感、隐私和尊重自主权。远程医疗模式也因其类似的原因而受到高度评价,但对一些人来说,其必要性与大流行期间的安全措施有关,并且支持在护理过程中的某个时刻选择与医疗专业人员进行面对面的互动。
英国进行流产的女性支持通过远程医疗在家中使用流产药物的批准。患者的声音对于塑造可接受和适当的流产服务提供至关重要。