Will easy, early abortions become another casualty of the Tories’ culture war?

Doctors say a return to pre-Covid rules, where women had to get a clinic appointment, will leave thousands waiting too long

How long ago the Abortion Act of 1967 seems now, and yet the struggle for a woman’s right to control her own body never ends. Time and again this basic principle comes under attack from rightwing and religious lobbies forever seeking to limit and reverse it.

Now they are at it yet again. As the prime minister dashes to roll back all coronavirus legislation a month early to mollify his rebels, the health secretary, Sajid Javid, and his junior minister, Maggie Throup, will decide whether to maintain the abortion laws that were introduced as part of emergency Covid laws, allowing women to request earlier and easier terminations at home. If Javid and Throup instead return to the old abortion laws that were in place before Covid, where women had to have an in-person clinic visit in order to get an abortion, thousands of women will have to chase scarce clinical appointments, forcing many to wait beyond the time limit for medical abortions.

Amid the horror of Covid, some good has come out of the experience of coping with the pandemic. The NHS found imaginative ways to reach more patients despite its desperately overstretched resources. One of the great successes was ensuring that women locked down at home had easy access to abortion. Part of the 2020 Coronavirus Act suspended the old 1967 abortion rules and allowed women within their first 10 weeks of pregnancy to telephone a clinician to request the two pills for a medical abortion to take at home. Women using this service were asked if they were sure of their dates, certain of their decision and had no other medical problems. To obey the law, the usual two signatures from doctors were later added to the form. The pills were sent to most women by post, but women seeking an abortion could still opt to visit a clinic to talk to someone in person.

Professor Lesley Regan, former head of the Royal College of Obstetricians and Gynaecologists and chair of its abortion taskforce, says the at-home system has been “hugely successful, with shorter waiting times, when every week of pregnancy brings a greater risk.” She talks of how it helps deprived women at home with little access to transport, those living in isolated rural areas and those without childcare. The British Pregnancy Advisory Service (BPAS) says telemedicine helps women on zero-hours contracts who risk losing work if forced to visit a clinic. Home abortion also protects “women threatened with domestic violence who fear attending treatment will alert their abuser to their pregnancy”.

Around 100,000 women a year in England and Wales are now using this quicker route to an early abortion. If the law reverts in just two weeks time, Prof Regan, BPAS and all the abortion providers are horrified that thousands will suddenly need non-existent clinic appointments. “We couldn’t do it. It’s impossible,” Regan says. The main abortion providers, writing to warn the health minister, say the delays caused will mean “a significant increase in the numbers of women needing surgical procedures at later gestations”, with an impossible strain on NHS theatre capacity. These concerns are backed by the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, the BMA and the Faculty of Sexual and Reproductive Healthcare. They warn it will cost millions to reopen clinics pointlessly – and there are no extra staff available.

Telemedicine has exposed the absurdity of the 1967 rule that requires two doctors to sign a form. BPAS says, “We have doctors, who are in short supply, sitting in rooms all day just signing forms for women they haven’t seen, instead of treating patients in need.” If waiting times for abortion rise, Nice, the NHS value-for-money arbiter, finds every day of delay in providing abortions costs another £1.6m.

But the impact on women matters most. Abortions rose slightly during 2020, the first year of the pandemic, most among those suffering financially, according to official figures. Most women seeking abortions already have children: teen pregnancies have been falling this century. Women who lost income in the pandemic often seek an abortion because of a lack of money. The BPAS says many are avoiding this government’s draconian two-child benefit limit from harming their existing family. Jacob Rees-Mogg and Nadine Dorries are among the anti-abortion MPs who eagerly voted for those anti-natalist benefit cuts that ironically pushed more women into choosing abortions.

Sad research findings across the developed western world show growing numbers of women having fewer children than they hoped to have: those countries with the best maternity leave and easiest childcare have the smallest gap between the number of children born and the number women wanted. This country, with among the highest childcare costs in the world and among the lowest benefits, doesn’t welcome babies.

Neither Javid nor Throup have ever voted in favour of abortion rights, the BPAS notes. Javid voted against an amendment brought by Stella Creasy on the lack of progress on abortion rights in Northern Ireland, in favour of an anti-abortion amendment that would have criminalised women seeking abortions on the grounds of foetal sex, and in favour of Dorries’ amendment to stop abortion providers providing counselling to women. Meanwhile, Throup has voted against regulations introducing abortion to Northern Ireland. Women deserve better.

Now Javid has just two weeks to decide whether to put extra pressure on the NHS by returning to the bad old abortion law, or free women to go on choosing earlier and easier terminations at home. A public consultation on the matter closed in the summer, but its findings remain secret. Ask the Department of Health and all they say, even at this 11th hour, is “We will keep the future of these provisions under review.” What of the vanished consultation? “It will be published in due course.” The fear is that abortion will become yet another victim of the prime minister’s culture war. The idea of a government headed by a philanderer presiding over abortion rights is beyond obscene.

• Polly Toynbee is a Guardian columnist