I am an interdisciplinary researcher and work primarily on abortion care. I draw on critical public health, epidemiology, sociology, and anthropology, amongst other disciplines and epistemologies. I am a Research Fellow in PHES, where I am working on my NIHR/Wellbeing of Women Doctoral Fellowship. During my fellowship I will be exploring how the introduction of telemedicine has impacted the accessibility and equity of abortion services in England and Wales. I have an MPH from Imperial College London and an undergraduate degree in anthropology from the University of Cambridge. In addition to my role at the School, I am also the Research & Engagement Lead at the British Pregnancy Advisory Service (BPAS)- the UK's largest abortion provider. I have been working there since 2018 on research with the aim of improving access to high-quality abortion services for all who need it.
I was recently a carer for one of my parents, Pip, who died of a brain tumour in 2022 and happened to be transgender. This time in my life was completely transformative, and has changed my relationship to my work and the wider world. Pip's experiences, and mine of looking after her, are captured in this report from Hospice UK: https://www.hospiceuk.org/publications-and-resources/i-just-want-be-me
I was recently a carer for one of my parents, Pip, who died of a brain tumour in 2022 and happened to be transgender. This time in my life was completely transformative, and has changed my relationship to my work and the wider world. Pip's experiences, and mine of looking after her, are captured in this report from Hospice UK: https://www.hospiceuk.org/publications-and-resources/i-just-want-be-me
Affiliations
Department of Public Health, Environments and Society
Faculty of Public Health and Policy
Teaching
I have supervised masters students at Imperial College London and LSHTM. I am a seminar lead for module 1804, Sexual Health.
Research
I am currently working on my NIHR doctoral fellowship, the abstract for which is below:
Background
In March 2020 the UK Government approved a 2-year regulatory change allowing home-use of mifepristone, the first pill used in medical abortion, up to gestations of 9 weeks and 6 days to curb the spread of COVID-19. This change was made permanent in March 2022. By removing the legal requirement for attendance at a clinic to take mifepristone, it became possible to implement full telemedical care pathways. Through telemedicine, eligible patients have their consultation with the abortion provider over the phone. Patients then receive the two sets of abortion pills through the post and use them at home where they complete the abortion. Telemedicine has removed logistical (e.g. travel) and service-level (e.g. waiting times) barriers which may have increased access for some. However, some patients may face barriers to accessing telemedicine including language/sociocultural issues, or digital exclusion. Telemedicine may increase privacy for some patients, whereas others, including those living in shared housing, may feel their privacy is compromised. It is likely barriers are experienced unequally and vary by socio-cultural/economic factors. Despite the rapidly growing evidence base on the safety, efficacy, and acceptability of telemedical abortion, there is currently no evidence on how accessible and equitable this new service is, or how its introduction has impacted accessibility and equity of abortion services as a whole.
Aims and objectives
This project aims to examine the impact of introducing telemedical abortion on accessibility and equity of abortion services in England and Wales.
Research questions
• How has telemedical abortion impacted on abortion accessibility and equity in England and Wales?
• What impact has the introduction of Mifepristone at Home (proxy for telemedicine) had on accessibility and equity of abortion care in England and Wales?
• What are the experiences and needs of socio-economic groups underserved by abortion services, including telemedicine?
Methods
Work Package 1 is a scoping review of literature pertaining to accessibility and equity of abortion services in England and Wales. Work Package 2 Using national abortion data for England and Wales, I will conduct an Interrupted Time Series Analysis to see whether telemedicine has reduced the average gestational age at abortion, and how this varies by socioeconomic characteristics. I will also assess whether groups who have historically accessed abortion later are still doing so, or whether the introduction of telemedicine is linked to any change in the timing of their abortions. This will allow me to identify groups of patients who are underserved by abortion services. Work Package 3 comprises qualitative research with abortion patients to identify the needs of individuals and communities who have difficulties accessing abortion care in general and/or who are underserved by telemedical abortion.
Background
In March 2020 the UK Government approved a 2-year regulatory change allowing home-use of mifepristone, the first pill used in medical abortion, up to gestations of 9 weeks and 6 days to curb the spread of COVID-19. This change was made permanent in March 2022. By removing the legal requirement for attendance at a clinic to take mifepristone, it became possible to implement full telemedical care pathways. Through telemedicine, eligible patients have their consultation with the abortion provider over the phone. Patients then receive the two sets of abortion pills through the post and use them at home where they complete the abortion. Telemedicine has removed logistical (e.g. travel) and service-level (e.g. waiting times) barriers which may have increased access for some. However, some patients may face barriers to accessing telemedicine including language/sociocultural issues, or digital exclusion. Telemedicine may increase privacy for some patients, whereas others, including those living in shared housing, may feel their privacy is compromised. It is likely barriers are experienced unequally and vary by socio-cultural/economic factors. Despite the rapidly growing evidence base on the safety, efficacy, and acceptability of telemedical abortion, there is currently no evidence on how accessible and equitable this new service is, or how its introduction has impacted accessibility and equity of abortion services as a whole.
Aims and objectives
This project aims to examine the impact of introducing telemedical abortion on accessibility and equity of abortion services in England and Wales.
Research questions
• How has telemedical abortion impacted on abortion accessibility and equity in England and Wales?
• What impact has the introduction of Mifepristone at Home (proxy for telemedicine) had on accessibility and equity of abortion care in England and Wales?
• What are the experiences and needs of socio-economic groups underserved by abortion services, including telemedicine?
Methods
Work Package 1 is a scoping review of literature pertaining to accessibility and equity of abortion services in England and Wales. Work Package 2 Using national abortion data for England and Wales, I will conduct an Interrupted Time Series Analysis to see whether telemedicine has reduced the average gestational age at abortion, and how this varies by socioeconomic characteristics. I will also assess whether groups who have historically accessed abortion later are still doing so, or whether the introduction of telemedicine is linked to any change in the timing of their abortions. This will allow me to identify groups of patients who are underserved by abortion services. Work Package 3 comprises qualitative research with abortion patients to identify the needs of individuals and communities who have difficulties accessing abortion care in general and/or who are underserved by telemedical abortion.
Selected Publications
Patient and public involvement in abortion research: reflections from the Shaping Abortion for Change (SACHA) Study.
2024
BMJ sexual & reproductive health
Patient experiences of undergoing abortion with and without an ultrasound scan in Britain.
2024
BMJ sexual & reproductive health
Travel for later abortion in the USA: lived experiences, structural contributors and abortion fund support.
2023
Culture, health & sexuality
Patient and Public Involvement (PPI) in abortion research: an exploratory survey.
2022
BMJ sexual & reproductive health
Client perspectives on choice of abortion method in England and Wales.
2021
BMJ sexual & reproductive health
Risk messages relating to fertility and pregnancy: a media content analysis.
2021
Wellcome open research
