Accessing abortion outside jurisdiction following legalisation of abortion in the Republic of Ireland.
abortion
health policy
reproductive health
reproductive rights
therapeutic
Journal
BMJ sexual & reproductive health
ISSN: 2515-2009
Titre abrégé: BMJ Sex Reprod Health
Pays: England
ID NLM: 101715577
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
27
08
2020
revised:
07
12
2020
accepted:
08
12
2020
pubmed:
29
12
2020
medline:
26
10
2021
entrez:
28
12
2020
Statut:
ppublish
Résumé
After having one of the most restrictive abortion laws worldwide, Ireland legalised abortion in January 2019. We examine how legalisation impacted on demand for online telemedicine outside the jurisdiction. We analysed anonymised data from 534 people from Ireland seeking online telemedicine abortion prior to legalisation (January-March and October-December 2018) and in the first 3 months following legalisation (January-March 2019). Numbers, characteristics and reasons for seeking the service before and after legalisation were compared. Content analysis of emails from people seeking the service following legalisation explored reasons for seeking care. Half as many people contacted Women on Web in the 3 months immediately after legalisation as compared with contacts 12 months prior (103 vs 221). Of these, the proportion receiving the service reduced, from 72% prior to legalisation to 26% after legalisation (p≤0.001). After legalisation, access related reasons for seeking online telemedicine featured less while reasons relating to privacy, stigma and avoiding protestors featured more. People continued to seek abortion through online telemedicine after legalisation, though the number of contacts reduced by half and the proportion receiving the service decreased considerably. To address access issues, policy measures should promote normalisation of abortion, legislate for safe zones around providers, and consider access in situations of coercive control or abuse including the role of telemedicine in the local model of care. Abortion provided through online telemedicine continues to be an important part of providing safe, accessible abortion even after legalisation.
Sections du résumé
BACKGROUND
After having one of the most restrictive abortion laws worldwide, Ireland legalised abortion in January 2019. We examine how legalisation impacted on demand for online telemedicine outside the jurisdiction.
METHODS
We analysed anonymised data from 534 people from Ireland seeking online telemedicine abortion prior to legalisation (January-March and October-December 2018) and in the first 3 months following legalisation (January-March 2019). Numbers, characteristics and reasons for seeking the service before and after legalisation were compared. Content analysis of emails from people seeking the service following legalisation explored reasons for seeking care.
RESULTS
Half as many people contacted Women on Web in the 3 months immediately after legalisation as compared with contacts 12 months prior (103 vs 221). Of these, the proportion receiving the service reduced, from 72% prior to legalisation to 26% after legalisation (p≤0.001). After legalisation, access related reasons for seeking online telemedicine featured less while reasons relating to privacy, stigma and avoiding protestors featured more.
CONCLUSIONS
People continued to seek abortion through online telemedicine after legalisation, though the number of contacts reduced by half and the proportion receiving the service decreased considerably. To address access issues, policy measures should promote normalisation of abortion, legislate for safe zones around providers, and consider access in situations of coercive control or abuse including the role of telemedicine in the local model of care. Abortion provided through online telemedicine continues to be an important part of providing safe, accessible abortion even after legalisation.
Identifiants
pubmed: 33361119
pii: bmjsrh-2020-200849
doi: 10.1136/bmjsrh-2020-200849
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
200-204Commentaires et corrections
Type : ErratumIn
Informations de copyright
© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.