(Dis)proportionate Abortion Care Regulation and the COVID-19 Pandemic in Great Britain

Questions of proportionality have long been raised in relation to the regulation of abortion. It has historically been considered a contentious matter of policy rather than one of individual healthcare, leading to extensive (and generally conservative) regulation. So controversial is it that even more liberal governments tend to avoid making changes, meaning abortion policy often does not move forward with medical developments and evidence. Consequently, abortion policy often lags behind clinical reality and social climate. Abortion is often subject to over-regulation, and Great Britain is no exception.During the COVID-19 pandemic, wider public health measures (i.e., lockdown) exacerbated existing barriers to accessing abortion care in Great Britain. Governments responded by temporarily permitting the use of telemedicine in abortion care pathways, something that had long been called for by providers and others. More than two years on, these changes have been made permanent, but with an increased focus on the finer details and the introduction of guidelines that disproportionately limit the clinical judgement of providers.In this chapter, we will take a chronological approach to examining the extent to which abortion regulation in Great Britain can be considered proportionate, though with a specific focus on the period of the COVID-19 pandemic. We ultimately argue that whilst while more recent developments may represent movement in the right direction, there is an underlying disproportionate regulation of abortion care in Great Britain which is rooted in abortion exceptionalism. As long as this view of abortion as distinct rather than routine healthcare continues, its regulation is likely to remain disproportionate.