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Early telemedical abortion, safeguarding, and under 18s: a qualitative study with care providers in England and Wales
BACKGROUND: Telemedical early medical abortion (TEMA) was introduced in England and Wales as a temporary measure in 2020 and was made permanent in 2022. While there are considerable data showing the safety, efficacy, and acceptability of TEMA for patients, there have been objections raised to TEMA b...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10579482/ https://www.ncbi.nlm.nih.gov/pubmed/36707235 http://dx.doi.org/10.1136/bmjsrh-2022-201762 |
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author | Romanis, Elizabeth Chloe Parsons, Jordan A |
author_facet | Romanis, Elizabeth Chloe Parsons, Jordan A |
author_sort | Romanis, Elizabeth Chloe |
collection | PubMed |
description | BACKGROUND: Telemedical early medical abortion (TEMA) was introduced in England and Wales as a temporary measure in 2020 and was made permanent in 2022. While there are considerable data showing the safety, efficacy, and acceptability of TEMA for patients, there have been objections raised to TEMA based on safeguarding—particularly for people under 18 years of age. Little is known about abortion care providers’ views and experiences of carrying out their safeguarding duties with people aged under 18 in the shift to TEMA. METHODS: This is a qualitative study involving online semi-structured interviews and reflexive thematic analysis. Audio-recorded, semi-structured interviews with abortion providers in England and Wales (n=20) generated data about their views and experiences of safeguarding in telemedical abortion care. Recordings were transcribed verbatim and then subject to reflexive thematic analysis to construct themes. RESULTS: While the study was designed with adult safeguarding in mind, the safeguarding of under 18s became a key area of discussion. Three major themes were constructed in relation to under 18s: (1) age as a risk factor in safeguarding; (2) telemedicine as improving access to care; and (3) telemedicine as enhancing communication. CONCLUSION: Care providers believe TEMA has benefitted the under 18s. There was a strong feeling both that TEMA had improved access (which, in turn, improved safeguarding) and that under 18s were comfortable communicating using remote means. Providers believe safeguarding proformas must account for the different nature of risks where service users are under 18, but that it is disproportionate to assume that TEMA is unsuitable for all under 18s or groups of under 18s. |
format | Online Article Text |
id | pubmed-10579482 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-105794822023-10-18 Early telemedical abortion, safeguarding, and under 18s: a qualitative study with care providers in England and Wales Romanis, Elizabeth Chloe Parsons, Jordan A BMJ Sex Reprod Health Original Research BACKGROUND: Telemedical early medical abortion (TEMA) was introduced in England and Wales as a temporary measure in 2020 and was made permanent in 2022. While there are considerable data showing the safety, efficacy, and acceptability of TEMA for patients, there have been objections raised to TEMA based on safeguarding—particularly for people under 18 years of age. Little is known about abortion care providers’ views and experiences of carrying out their safeguarding duties with people aged under 18 in the shift to TEMA. METHODS: This is a qualitative study involving online semi-structured interviews and reflexive thematic analysis. Audio-recorded, semi-structured interviews with abortion providers in England and Wales (n=20) generated data about their views and experiences of safeguarding in telemedical abortion care. Recordings were transcribed verbatim and then subject to reflexive thematic analysis to construct themes. RESULTS: While the study was designed with adult safeguarding in mind, the safeguarding of under 18s became a key area of discussion. Three major themes were constructed in relation to under 18s: (1) age as a risk factor in safeguarding; (2) telemedicine as improving access to care; and (3) telemedicine as enhancing communication. CONCLUSION: Care providers believe TEMA has benefitted the under 18s. There was a strong feeling both that TEMA had improved access (which, in turn, improved safeguarding) and that under 18s were comfortable communicating using remote means. Providers believe safeguarding proformas must account for the different nature of risks where service users are under 18, but that it is disproportionate to assume that TEMA is unsuitable for all under 18s or groups of under 18s. BMJ Publishing Group 2023-10 2023-01-27 /pmc/articles/PMC10579482/ /pubmed/36707235 http://dx.doi.org/10.1136/bmjsrh-2022-201762 Text en © Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ. This article is made freely available for personal use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained. |
spellingShingle | Original Research Romanis, Elizabeth Chloe Parsons, Jordan A Early telemedical abortion, safeguarding, and under 18s: a qualitative study with care providers in England and Wales |
title | Early telemedical abortion, safeguarding, and under 18s: a qualitative study with care providers in England and Wales |
title_full | Early telemedical abortion, safeguarding, and under 18s: a qualitative study with care providers in England and Wales |
title_fullStr | Early telemedical abortion, safeguarding, and under 18s: a qualitative study with care providers in England and Wales |
title_full_unstemmed | Early telemedical abortion, safeguarding, and under 18s: a qualitative study with care providers in England and Wales |
title_short | Early telemedical abortion, safeguarding, and under 18s: a qualitative study with care providers in England and Wales |
title_sort | early telemedical abortion, safeguarding, and under 18s: a qualitative study with care providers in england and wales |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10579482/ https://www.ncbi.nlm.nih.gov/pubmed/36707235 http://dx.doi.org/10.1136/bmjsrh-2022-201762 |
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