Caring For The Women Having Abortions During A Pandemic

Photo Courtesy of Alex Nommay.
I’m an abortion care nurse at a Marie Stopes clinic in Manchester. I always feel incredibly passionate about my job but the coronavirus crisis has really brought that home. 
I’ll never forget one woman I cared for shortly after lockdown was announced. She was so scared about the virus that she asked me to scan her with my arm outstretched fully so that I wouldn’t be too close to her. She was wearing gloves and a mask. She was completely petrified. 
We had staff shortages that day because some of our nurses needed to isolate. There was pressure in the air and in reality, on the nurses working in my clinic and on the women who came to see us because they urgently needed our services.   
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One in three of us will need to access abortion services before the age of 45 and last year, across the UK, over 200,000 women made the journey to an abortion clinic. Women from all over the country, of all ages, backgrounds and occupations, travelled to a clinic like mine. 

One woman I cared for shortly after lockdown was announced was so scared about the virus that she asked me to scan her with my arm outstretched fully so that I wouldn't be too close to her. She was wearing gloves and a mask. She was petrified. 

There are as many individual stories, circumstances and reasons why women make this journey as there are women who make it. The need for sexual and reproductive health services has only increased as we face the global pandemic of COVID-19 and large numbers of women struggle to access contraception during lockdown. Sadly, in some cases this has been made even more difficult for women who are forced to isolate with their abusers
In abortion care, and especially during COVID-19, nurses are on the front line. Because abortion has not been decriminalised in England, two doctors must sign off every procedure. However, it's us – nurses – who comfort the women when they come into a clinic, who talk clients through their options, safeguard them if we think they may be vulnerable and generally provide them with all the care they need as they progress through their abortion. 
Every woman’s experience is different but what’s often the same is the choice they have. If under nine weeks and six days' gestation, every client could choose between a medical and a surgical procedure; unfortunately, the pandemic has forced clinics to temporarily limit this choice. Most women – 71% last year in England and Wales – choose a medical abortion and visit the clinic to take two pills, mifepristone and misoprostol. 
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As the COVID-19 pandemic worsened in the UK, hundreds of women continued to make the journey to an abortion clinic to take these pills. I met women who had broken quarantine, having left their house, where they were isolating with family members, without telling anyone. This shouldn’t have happened. 

Women would arrive so scared that they were shaking, asking me whether they were safe. As nurses we have to be adaptable but it really impressed upon me the importance of the work that we do to support women.

Women would arrive so scared that they were shaking, asking me questions about whether they were safe. As nurses we have to be flexible and adaptable, especially as we work under new conditions that we never envisaged but it really impressed upon me the importance of the work that we – abortion nurses – do to support women at what can be a very difficult time, even without a pandemic.
On 31st March, the UK government allowed women to take early medical abortion pills at home during the COVID-19 crisis. Experts like us at Marie Stopes have been calling for this for some time but, in the midst of this public health crisis, it was vital that such action was taken. 
This decision changed my role in many ways. I have undertaken training to allow me to provide telemedicine appointments, so that women can have full nurse-led consultations over the phone before having their abortion pills sent to their home address, allowing many women to access abortion care without having to leave their homes.
Since the changes, I’ve had women tell me about the relief they feel that it’s no longer necessary to travel to the clinic and not just for fear of flouting the government guidance on self-isolation, either. 
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One woman told me she feared the anti-abortion protestors who plague too many of the UK’s abortion clinics, standing outside and harassing women as they come in and out. She was grateful that she wasn’t having to come in person and face them. Having comforted women who have come into my clinic distressed and in tears, with bags and coats over their heads, I completely understand why. 
Of course, some procedures do still require women to come to the clinic. My colleagues and I are working hard with my team to ensure their safety as we adhere to social distancing rules, which can be difficult, particularly when all you want to do is give someone a much-needed hug. 
For nurses all around the world, this is an extraordinarily difficult time to work. But as we settle into this new normal that is nursing during coronavirus, the wellbeing of the women who Marie Stopes International serves is well and truly at the centre of everything we do. Our job is to protect them, even when it means putting our own health at risk. 
But when this crisis is over, we really need to think about how we can make abortion care as accessible as possible for those who need it. Can telemedicine for early medical abortions continue for some women? Will buffer zones finally be put in place to ban anti-abortion protestors? I’ve worked in abortion care for five years; I know that barriers and challenges don’t stop – and will never stop – women from needing and seeking abortions, but there should be as few in their way as possible.
Please sign our petition and help us change the law to fix abortion provision once and for all.
Marie Stopes International is a global organisation providing contraception and safe abortion services to women and girls in 37 countries. If you need to access contraception or abortion services from the UK, visit mariestopes.org.uk for information and advice.

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