These Q&As relate to the Coronavirus (COVID-19) Infection and abortion care – information for healthcare professionals: Version 3.1 published 31 July 2020 published by the Royal College of Obstetricians and Gynaecologists, Royal College of Midwives, Faculty of Sexual and Reproductive Healthcare and British Society of Abortion Care Providers.

Q1. What impact will the COVID-19 infection have on my request for an abortion?

Abortion care is an essential part of healthcare, and services must be available even where non-urgent or planned services are suspended. Abortion care is time-sensitive, and services should be available to provide you with support and care as early as possible.

The extent of service disruption will vary across the UK, but abortion services are still open and all women should be able to access timely care. We would encourage you to contact your local abortion care provider as early as possible. We understand that some women will need an abortion later in their pregnancy. You will be able to discuss your needs with your health care professional so the right care for you can be provided.

Q2. What changes have been made to abortion care to reduce my risk of exposure to coronavirus (COVID-19)?

Abortion care providers have changed how they are working to support social distancing and limit the need for face-to-face appointments to keep you, staff and other women as safe as possible during the coronavirus pandemic. This means that you will be able to have your appointments with your healthcare professional over the telephone or by video. In England, Wales and Scotland, after speaking to a healthcare professional over video or telephone, you may be eligible for an early medical abortion and be able to receive a treatment package in the post, which eliminates any need to travel.

Q3. Do I have to have a GP appointment and be referred by my GP to receive abortion care?

No. You can request an abortion directly from your local abortion care provider. This means that you do not need to have an appointment with your GP first. This is known as self-referral and can be done over the telephone. Information about your local abortion care services will be available online or can be provided by national abortion care providers via their booking and information lines.

British Pregnancy Advisory Service (BPAS): +44 (0) 3457 30 40 30

Marie Stopes International UK (MSI): +44 (0) 345 300 8090

National Unplanned Pregnancy Advisory Service (NUPAS): +44 (0) 333 004 6666

Informing Choices Northern Ireland: +44 (0) 28 9031 6100

Q4. How do abortion care services make sure consent and safeguarding procedures are still in place for telephone appointments during the coronavirus pandemic?

You will be given information and the time you need to fully think things through so that you can give informed consent to receive abortion care, if that is what you choose. You will be able to ask questions and written information should be provided or available to you before your appointment. Your health care professional will ensure this is given to you in a way you can access.

Safeguarding is an essential part of abortion care. In some cases, your health care professional may recommend a face-to-face appointment. If this is the case your health care professional will discuss this with you and advise on what precautions you can take when travelling to and during the appointment.

Q5. Will I need to go into an abortion care clinic for my appointment or to receive my care during the coronavirus (COVID-19) pandemic?

There are two types of abortion care, medical abortion care and surgical abortion care. Medical abortion care means that you will take some medication to end the pregnancy. Surgical abortion care is an operation under local anaesthetic, sedation or general anaesthetic.

Medical abortion care should be provided with as little physical contact as possible to minimise any possible risk of transmission of COVID-19 to you, staff and other women. We recommend that your appointments with healthcare professionals be carried out over the telephone or via video link wherever possible. You may still need to attend a clinic in person for part, or all, of your care.

In England and Wales if your pregnancy is less than 10 weeks, you may not need to go into a clinic or have a face-to-face appointment with your healthcare professional. Instead, you may receive a treatment package in the post. In Scotland this may be available if your pregnancy is less than 12 weeks.

Q6. If I have early medical abortion care, will I have to go into an abortion care clinic to receive the medication I need during the coronavirus (COVID-19) pandemic?

Not necessarily. If you are in England and Wales, you can access early medical abortion care from home (via a treatment package sent you in the post) if your pregnancy is less than 10 weeks. In Scotland you may be able to access care from home (via a treatment package sent you in the post) if your pregnancy is less than 12 weeks.

The treatment package sent to your home address will include your medication, written advice and information, and a plan for a follow-up assessment, which may be over the telephone or by video. It may also contain pain relief and/or contraception but this will be discussed with you during your appointment. A telephone number will also be provided in case you have any questions. You may prefer to pick up the treatment package from the abortion care provider, in which case this should be done with minimal contact to prevent the spread of coronavirus (COVID-19).

Q7. What happens after a medical abortion?

Before you receive your abortion care medication you should receive information on what to expect before and after your abortion care. This will be discussed with you during your appointment with your healthcare professional and through written information and advice shared with you via e-mail or via post.

After all types of abortion care, it is likely you will experience period-like stomach cramps and vaginal bleeding that may last a week or two but usually gets better each day. Please see our information about abortion care for patients and the public for more information on what to expect.

Q8. If I cannot have an early medical abortion because I am over 10 weeks (or 12 weeks in Scotland), will I be able to still get an abortion, and will I have to go into hospital / abortion care service during the coronavirus (COVID-19) pandemic?

Access to abortion care is an essential part of healthcare. Surgical and medical treatment is available up to 24 weeks’ gestation based on preference, medical need, and how many weeks along the pregnancy is.

To receive abortion care after 10 weeks (or 12 weeks in Scotland), your initial appointment with your healthcare professional may be provided over the telephone or via video link if possible in order to limit face-to-face contact and how many times you visit your local abortion care service in person. However, you will still have to attend your local abortion care service in person to receive your care and treatment.

Q9. What can I do to reduce my risk of catching coronavirus (COVID-19)?

The most important thing to do is to wash your hands regularly, and as soon as you come from public places to your home or workplace. There is useful advice on the NHS UK Coronavirus (COVID-19) web pages on the best way to reduce any infection risk, not just for coronavirus (COVID-19), but for other things like colds and flu.

The Government has also advised all citizens to reduce social contact as much as possible through social distancing measures. This means that you should work from home if possible and avoid public and crowed places as much as possible.

Q10. What should I do if I think I may have coronavirus (COVID-19) or have been exposed and require abortion care?

If you:

Have a high temperature

Have a new, continuous cough

Experience a loss of or change in your sense of taste and smell

Are living in a household with someone who shows these symptoms

You should stay at home for 10 days. Do not go to a GP surgery, pharmacy or hospital. You should use the NHS 111 coronavirus (COVID-19) service who will discuss with you your symptoms and advise if you need a test. You can access information about this service here.

In addition, you should also contact your abortion care provider to inform them that you have symptoms of coronavirus (COVID-19), particularly if you have any appointments booked in the next 10 days. They will discuss with you the best approach to your abortion care and whether it will have to be delayed until after your period of self-isolation.

You should use the NHS 111 online coronavirus (COVID-19) service, or call NHS 111 if:

you feel you cannot cope with your symptoms at home

your condition gets worse

your symptoms do not get better after 10 days

Q11. Are pregnant women at greater risk of contracting coronavirus (COVID-19) or developing severe symptoms?

There is no evidence that pregnant women are at any greater risk of contracting coronavirus (COVID-19) or developing severe symptoms if they are infected.

If your symptoms require treatment or you are admitted to hospital as a result of contracting coronavirus (COVID-19), you should tell your healthcare provider that you are pregnant – even if you are planning abortion care treatment.

Q12. Will being in self-isolation or shielding delay my abortion care?

You should contact your abortion care provider if you have any routine appointments booked in the next 10 days and are currently in self-isolation. If you are shielding, you should inform your abortion care provider of this so they can plan appropriately.

If you are in self-isolation or shielding, you may be able to access an early medical abortion remotely, with a treatment package posted to your home after a video or telephone call with a healthcare professional.

If you suspect you have coronavirus (COVID-19), or have tested positive, and are experiencing only mild symptoms, and your pregnancy has not yet reached 10 weeks (in England and Wales) or 12 weeks (in Scotland), you may be able to receive an early medical abortion care treatment package which will be posted to you at home.

If it is not possible for you to be offered early medical abortion care, your abortion care provider should either ask you to come into the clinic when infection control procedures are in place or refer you to another provider who can treat coronavirus (COVID-19) patients safely.

Q13. If I have coronavirus (COVID-19) or think I may have it, will this delay my abortion care?

You should contact your abortion care provider to inform them that you have symptoms of coronavirus (COVID-19), particularly if you have any appointments booked in the next 10 days and are currently in self-isolation.

If you are eligible for an early medical abortion and have no symptoms, or mild symptoms, you should be able to have your consultation over video or by telephone and receive a treatment package in the post.

If you are not eligible for an early medical abortion, your abortion care provider should either ask you to come into the clinic when infection control procedures are in place to protect you, the staff and other women or refer you to another provider who can treat COVID-19 patients safely.

If your pregnancy is likely to be below 20 weeks’ gestation, your care should be booked as a priority 10 days after your symptoms of coronavirus (COVID-19) started (unless you remain unwell). If you continue to be unwell, you should contact your abortion care provider who can advise you on next steps.

If your abortion care cannot be safely delayed, your healthcare professional should discuss with you how best to proceed with your treatment and care depending on local availability. This may mean admission to a different service who can treat coronavirus (COVID-19) patients for either medical or surgical abortion care.

Q14. If I don’t have a scan, how do I know I haven’t got an ectopic pregnancy?

You will be asked some questions to make sure it is safe to proceed without needing a scan. If your healthcare professional recommends a scan, procedures will be in place to limit the risk of coronavirus (COVID-19) infection. This will be discussed with you.

Evidence shows that it is safe to receive abortion care without a scan, and that the risk of having an ectopic pregnancy in women having abortion care is low (less than one in a thousand). Having medical abortion care would not affect this but it is important that it is picked up.

In the unlikely event you do develop worsening pain after your abortion care, especially if this is under your ribs or shoots up into your shoulder, then you should seek medical help immediately. This advice is the same for anybody in early pregnancy, whether they have received abortion care or are continuing their pregnancy.

If you need to seek help, it is important that you inform your healthcare provider that you have had early medical abortion care without an ultrasound – this information will not be available to anybody outside the abortion care service.

You can find more information about ectopic pregnancy in our patient information here.