Few good things have come out of the Covid-19 pandemic, but improved access to pregnancy termination services has been a silver lining. While the change in regulations came into place in March 2020, the pandemic-led shift to telemedicine abortion did not come out of the blue. The clinical benefits of a telemedicine service for early medical abortion (EMA) have been known since before the pandemic, and were recommended by the National Institute for Health and Care Excellence in September 2019.

Early medical abortions involve two pills that are usually taken one or two days apart following an appointment with a clinician. Prior to the pandemic, government policy in England was that only the second pill for early medical abortion could be taken at home and that women should attend an abortion service to take the first pill. The temporary approval that was put in place in response to the pandemic enables women to take both pills (mifepristone and misoprostol) for EMA up to ten weeks into their pregnancy, in their own homes. This would follow a consultation with a clinician, but without the need to first attend a hospital or clinic.

There is overwhelming evidence that allowing women to access early medical abortion at home, where clinically appropriate, has created a safer and more effective service. During the pandemic, the largest-ever study of UK abortion care found that introducing a telemedicine service for abortion shortened waiting times for abortion treatment and increased the safety of abortion services by allowing women to receive care much earlier in their pregnancy. There is currently a real danger this learning could be lost as the rules which allow at-home care are due to expire in six months’ time.

Women do not deserve to have their choices removed on an issue which affects their health. There is no medical reason why telemedicine for early medical abortion should not remain a permanent option available to women alongside in-person appointments. Over 100,000 women in England and Wales have received a telemedicine abortion during the pandemic and data show that complications related to abortion have decreased4 since this service was introduced.

It’s not just medical bodies who see the benefits of this service; women do too. Recent research by the British Medical Journal found that 83 per cent of women who have used a remote consultation for an early medical abortion found it “very acceptable” and 89 per cent would opt to have treatment at home again if they needed another abortion.

Maintaining access to at-home care is important because we know it is often a lifeline for women in vulnerable situations who may struggle to attend a clinic in person due to a range of logistical, social and economic reasons. The impact of revoking the change will affect some women disproportionately – including those with caring responsibilities, victim-survivors of sexual violence and domestic abuse, women in remote or rural areas, and those on low incomes or in insecure work. It could lead to a rise in unregulated pills being bought online. It would also make the service less efficient and waste NHS resources.

Face-to-face care must still be provided for all women who request an appointment because of specific clinical or social factors; however, telemedicine must be maintained for women who also choose to access healthcare at home, as the evidence shows that it has improved access to abortion services across a wide range of patient groups, as well as improving safety.

The UK led the way in introducing telemedicine abortion care at home at the start of the pandemic, and many countries – including the US and France – have followed suit. We should be proud of what we have been able to provide for women.

With Baroness Sugg tabling an amendment to the Health and Care Bill to make the provision for telemedicine for early medical abortion permanent and this set to be debated on Wednesday, it would be deeply regrettable if politics were allowed to come before clinical best practice and above what really matters – women’s health.

Professor Helen Stokes-Lampard is Chair of the Academy of Medical Royal Colleges, Dr Latifa Patel is BMA Interim Representative Body Chair and Dr Edward Morris is President of the Royal College of Obstetricians and Gynaecologists