Trigger warning: Abortion, sexual assault and miscarriage
Initially introduced as a temporary measure during the pandemic, telemedicine abortions (also known as a ‘pills-by-post’ abortion) were voted to become a permanent part of women's healthcare in 2022 providing easier access to the healthcare for thousands of women. The rules on securing pills for another person are quite clear: it's illegal. The pregnancy must also be less than 10 weeks along.
Sadly, however, one man named Stuart Worby, accompanied by a woman named Nueza Cepeda, recently took advantage of the system by procuring pills and spiking a pregnant woman with them, causing her to have a miscarriage.
Worby, according to reports, crushed one of the two pills needed to end a pregnancy into a glass of orange juice, then sexually assaulted the unnamed woman the following day and forced her to take the second pill to expel the pregnancy. The alleged assault took place in 2022.While this case is heartbreaking, it's one incredibly rare example of the pills-by-post system being abused, yet increasingly brazen anti-abortion groups, such as Right To Life UK, are jumping on the incident as an opportunity to call for the end of telemedicine abortions.
Since the rolling back of Roe v Wade in the US, anti-abortion groups in the UK (some of whom receiving funding from American churches) have been accused of stepping up their scare tactics. Right To Life UK is now calling on the government to stop telemedicine abortions, glossing over that the onus should be on those who abuse the system rather than the system itself.
Those seeking a remote abortion are still required to speak with a medical professional and be walked through their options before the necessary medication (two pills, the first to end the pregnancy and the second to dispel it) are signed off. They would then be sent in a discreet envelope through the post.
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The scheme wasn't simply enshrined in law overnight either. It was debated, voted on and data was used to come to a careful conclusion, with everyone from the Royal College of Obstetricians and Gynaecologists (RCOG) to MSI Reproductive Choices (who’ve provided abortion care since the 70s) agreeing that telemedicine abortions are a safe set-up. The World Health Organization has also recommended the method worldwide.
Still, a spokesperson for Right To Life UK recently told the BBC, "If at-home abortions had not been introduced, Stuart Worby would not have been able to obtain these pills from this abortion provider, and this tragic case would not have happened.
"The woman involved would not have been poisoned and her baby would not have had his or her life ended."
Thankfully, it sounds as though the government is holding firm on this, with a Home Office rep responding by advocating for freedom of choice for women: "Our deepest sympathies are with the victim in this horrific case. It is crucial that women who choose abortion are able to do so safely, and the department works closely with NHS England, the Care Quality Commission and providers to ensure that abortions are provided legally and with robust clinical oversight."
The British Pregnancy Advisory Service (BPAS) added that "women should not be punished for the actions of abusive men."
Heidi Stewart, the CEO of BPAS, said, "For anti-abortion groups to use this abuse, to call for the removal of confidential, accessible abortion care to thousands of women each year, is predictable and completely unsupported by evidence.
"Making abortion harder to access would give the defendant and men like [Worby] more power and control over the most vulnerable women."
Here's why we need to continue fighting back against anti-choice rhetoric...
AN ENVELOPE COULD SAVE YOUR LIFE
As someone who had to face protestors on my way into an abortion clinic, I can attest that it's vital we don't succumb to pressure from anti-choice groups on this matter – a telemedicine abortion is something I only wish I’d had the option of when I underwent a termination seven years ago.
Had a pills-by-post option existed, it would also have meant the in-person appointments I attended, which involved undergoing scans (plural) to detect how far down the line things were (not far enough, it turned out; I was initially sent away and told to return a week later when the embryo would be more ‘clearly visible’ on-screen), could have been replaced with telephone consultations. [In the majority of cases – and if you prefer to be seen in-person, you still can be.]
No travelling long distances or struggling to arrange childcare, no pushing through protestors waving placards, no unnecessary scans that can impact drastically on your mental health (typically an expectant mother isn’t usually offered a scan until 10 to 14 weeks of pregnancy, unless there’s a suspected risk or problem). These are just a few of the plus-points of allowing telemedicine abortions to remain in place.
Another positive to being able to access a 'pills in the post' abortion is that waiting times dropped from 10.7 days, to 6.5 days – no doubt lessening the anxiety that some of the 150,000 patients who’ve actually had a telemedicine abortion in the first two years of it being offered may have experienced during a potentially difficult time. Contrary to misleading claims, nobody has died from having an early at-home abortion either.
For Alice, who had an abortion five years ago, having the option to avoid an intrusive scan is a key reason she believes the option is a vital lifeline for women. After falling pregnant in her thirties, she says this was one of the toughest parts of her termination experience. “When I got a positive sign on a pregnancy test as a married woman in my 30s, it didn’t feel how I imagined it would for that kind of woman. Married women in their 30s are supposed to want to get pregnant, aren’t they?” she recalls. “All week, every time I went to the toilet, I hoped my period would appear. It didn’t. My husband and I were dazed, we weren’t ready to be parents.”
Like me, Alice’s first port of call was the internet, where the MSI Reproductive Choices (formerly Marie Stopes) website appeared – she made the call. “They asked me all the questions, like ‘how late is your period?’ and booked me in. The days leading up to the appointment, I felt like I was carrying a shameful secret. The clinic wasn’t what I expected, I had to sit in a waiting room full of women. You’re there, looking, silently measuring each other up. One woman had a really swollen belly and was crying. Then my name was called.”
Upon entering the starched white room, Alice was asked further questions and had a scan, something she and I were both told was needed in order to check how many weeks along the pregnancy was and to confirm it wasn’t ectopic. To that note, MSI now say, “As there is no test or screening done for ectopics in the normal population it seems inappropriate to do so in those needing an abortion, where the risk is five to ten times lower. A better approach is to inform patients of the warning signs and ensure they're aware of when to seek help.”
Alice was seven weeks pregnant. “Then the nurse asked me a question that made my whole world crash down. ‘Do you want to know if it’s a twin pregnancy?’,” she says. “I was floored but said ‘okay’. Then she simply replied, ‘it is’ and turned around the screen, showing me two tiny dots.”
If she’d have been able to take pills for her abortion via the mail, Alice would never have known she was carrying twins – something that to this day, she still wishes she had no knowledge of. “Now whenever I see twins, I wonder what if? I didn’t need to have that scan,” she reflects. “I wish I hadn’t had that scan. I wish I’d never been told that my body was pregnant with twins.”
When I, at the age of 25, discovered I was pregnant – I had the opposite issue. Nothing appeared on screen when jelly was smeared across my abdomen and an ultrasound device pushed against my skin. This meant the clinic (which I generally found to be welcoming and understanding) was unable to administer me the medication I was silently screaming for, so that I could stop living the surreal double-life I’d been plunged into. As soon as the ‘positive’ result appeared on the test, everything within me said ‘no’; this was not my time to become a parent. I wasn’t emotionally, mentally, or financially ready at all.
So, I left the clinic, with the equivalent of cartoon birds chirping around my head and tried to function, quite impossibly, like a 'normal' human for another week. I felt sick throughout my days in the office, jittery when out with friends, like I was walking through fog and counting down the minutes until I could get the pills signed off. Something that wouldn’t have happened if I’d have been able to access a telemedicine termination in the first instance.
I also could’ve avoided having my wrist grabbed by that woman with wiry grey hair and a bobble hat, holding up a sign up featuring an image of a bloody foetus, on my way in and out of the clinic. It was the middle of a blizzard, a snowy February, and still, the protestors were there. “Do you need money, dear? Do you need help?” she’d asked, piling guilt onto my already sloped shoulders. Imagine if, like getting the morning after pill delivered, I could’ve accessed that healthcare from home? There's no way we can let emboldened protestors, like that woman, try to take this option away from us.
WHEN YOU CAN'T LEAVE HOME
As difficult as our experiences were, Alice and I, in the grand scheme of things, were lucky. We both had supportive partners and were able to safely attend clinics, resulting in the terminations we needed – something that’s not always an option for those in more vulnerable situations, such as an abusive or controlling relationship. This is a major cause for concern for the likes of Women’s Aid, Refuge and MSI Reproductive Choices.
MSI tell me about Claire*, who called them in 2021 after discovering she was pregnant. She explained that she was absolutely sure she wanted a termination, and that her ex-partner and the father of her son had been abusive. Despite him being jailed in 2018, she still had major concerns about his friends and family, who lived nearby to her closest clinic – meaning, Claire didn’t feel safe collecting her medication or undergoing a consultation in person.
Thankfully, MSI conducted a safeguarding assessment over the phone, and supported Claire by sending her the pills she needed (alongside a method of contraception). “Claire felt more comfortable discussing distressing and intimate details over the phone than she would have done if she was forced to come into a clinic,” a spokesperson explained. “With Claire’s consent, MSI also connected her with a support worker.”
How many trapped in difficult situations would have to resort to illegal, underground methods to obtain a termination, without the convenience of telemedicine? We all know that making abortion harder to access doesn’t prevent it from happening, it only puts those seeking a termination at risk (even resulting in more than 22,000 deaths globally each year).
Yet, ethics do - of course - still come into play, with faith-based and pro-life groups, such as Christian Concern and Right To Life, forever putting pressure on MPs to revoke telemedicine abortions. Some MPs, such as Carla Lockhart, are regularly vocal in their attempts to call out those in favour of abortion and it seems any obstacle that can be put in place to make accessing this form of healthcare harder, is a win in their eyes.
There are also a very small number of reports of women taking the at-home pills whilst substantially over the ten-week-mark, the most high-profile case being that of Carla Foster, who was jailed as a result – something pro-lifers say proves pregnant people could unlawfully abuse the system and access the pills after the legal cut off point.
A judge presiding over Foster's case said it was "a case that calls for compassion, not punishment", when later reducing her sentence.
Concerns have also been raised by anti-choice groups that gestation may be inaccurately assessed (something leading medical experts have said there's no evidence to support and if a pregnant person shares those worries, they're still able to book an in-person appointment if preferred; it's really all about choice).
MSI also say, in response to worries that people could be more easily coerced or forced into an abortion, that in their experience, safeguarding is most effective when clinicians are able to offer a range of options, including both remote consultations and in-person care.
Speaking to Cosmopolitan UK at the time pills-by-post abortions were being debated in Parliament, Baroness Liz Sugg said, “The removal of telemedical abortion provisions would almost certainly lead to a resurgence in women seeking to access unregulated pills bought online.
“Without telemedicine, waiting times will rise and current staffing levels would be insufficient. There’s also a serious risk that some women would, as a result, be unable to access legal abortion care, either because the providers do not have the capacity or because increased waiting times push some over the legal limit.”
I've never regretted my decision to have an abortion, not for a single second, and mostly I just feel overwhelmingly grateful not to have been forced into becoming a mother due to a lack of available healthcare. If I had to, I would do it all again and push past a million protestors in order to reach the safe haven that was the clinic. Here's hoping that the government continues to dig its heels in, in the face of increasingly brazen anti-choice protestors.
Jennifer Savin is Cosmopolitan UK's multiple award-winning Features Editor, who was crowned Digital Journalist of the Year for her work tackling the issues most important to young women. She regularly covers breaking news, cultural trends, health, the royals and more, using her esteemed connections to access the best experts along the way. She's grilled everyone from high-profile politicians to A-list celebrities, and has sensitively interviewed hundreds of people about their real life stories. In addition to this, Jennifer is widely known for her own undercover investigations and campaign work, which includes successfully petitioning the government for change around topics like abortion rights and image-based sexual abuse. Jennifer is also a published author, documentary consultant (helping to create BBC’s Deepfake Porn: Could You Be Next?) and a patron for Y.E.S. (a youth services charity). Alongside Cosmopolitan, Jennifer has written for The Times, Women’s Health, ELLE and numerous other publications, appeared on podcasts, and spoken on (and hosted) panels for the Women of the World Festival, the University of Manchester and more. In her spare time, Jennifer is a big fan of lipstick, leopard print and over-ordering at dinner. Follow Jennifer on Instagram, X or LinkedIn.
