6 Our patients BPAS has seen a 31% increase in patients over the last five years for abortion care. The method of abortion has changed, with a decrease in surgical and an increase in Early Medical Abortion (EMA). This aligns to national trends and is due to several factors, including post covid legislation enabling permanent provision of Pills by Post. The Sacha Study also highlighted the reasons some women choose this option as opposed to surgical abortion: • Convenience around work and childcare • Efficiency and reduced travel time • The comfort and privacy of being in their own space. • Perception that at-home treatment reduced stigma. • Greater autonomy and choice The shift towards Early Medical Abortion (EMA) in England and Wales over the past decade has no doubt been revolutionary for patients, however this has been driven in part by constraints on patient choice and particularly by barriers relating to skills gaps, infrastructure requirements, service structure, cost, reliance on the non-profit sector, and commissioning practices involving under-funding and competition. BPAS currently offers contraception to all patients accessing abortion care. Uptake varies and over a five-year period has decreased by 4.4%, however uptake of LARC (Long Acting Reversible Contraception) has decreased by almost half at 8.9%. In 2023 127,000 women a year in England had an IUCD IUS fitted in a community medical setting. BPAS fitted 2.8% of these. Despite data that shows demand for LARC continues to increase, provision of LARC within Sexual Reproductive Health services and GP practices is struggling to meet demand. Reduction in funding and fragmented commissioning has resulted in services struggling to meet demand with provision not yet returning even to pre-pandemic levels. “I felt very safe and understood talking to the nurse. I was understood and she was very kind and supportive. It was all dealt with very quickly. I had my package the next day (Saturday). Couldn’t fault the service at all.”
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