Access to abortion has been a prominent topic in the media over the past several months. Additionally, it is a key platform item for the Progressive Labour Party, and a priority outlined in the Throne Speech. These factors contribute to why I believe now is an appropriate and timely moment to engage in this important conversation. A few months ago, I faced a decision that changed my life. I was pregnant and unprepared ― emotionally, financially and mentally ― to carry the pregnancy to term.

Like many women, I didn’t make this decision lightly. I was scared, overwhelmed and desperate for support. What I encountered instead was a healthcare system full of delays, judgment and red tape.

It took weeks to even begin the process of seeking care, and by the time I was approved for a surgical abortion, I was nearly past the legal window. I had to attend multiple appointments, explain myself to multiple professionals, and carry the burden of secrecy through it all. I was fortunate enough to eventually receive care, but I still carry the emotional weight ― not from the decision I made, but from how difficult it was to access help.

As a woman, a mother, and someone who deeply values both reproductive rights and mental health, I believe it is time for Bermuda to modernise its approach to reproductive healthcare by making mifepristone accessible to women seeking non-surgical abortion care.

Mifepristone is a medication that blocks the hormone progesterone, which is essential to maintaining a pregnancy. When used in combination with misoprostol, it safely and effectively terminates early pregnancies — typically within the first ten to 11 weeks. This method has been endorsed by the World Health Organisation, the American College of Obstetricians and Gynaecologists, and countless other medical authorities worldwide¹².

Approved first in France and China in 1988, and later by the US Food and Drug Administration in 2000, mifepristone is used in more than 90 countries³. Its safety profile is well established: studies show it is over 95 per cent effective with a complication rate of less than 1 per cent when used appropriately⁴.

This is not an over-the-counter medication. It must be prescribed by a licensed healthcare provider and is typically administered in a structured medical process involving follow-up care. This offers a medically sound and emotionally manageable path for many women ― especially those unable to navigate Bermuda’s complex and often inaccessible surgical abortion process.

Outdated abortion framework

The legal window for obtaining an abortion in Bermuda is 12 weeks, yet it can take up to two months to secure an appointment owing to procedural delays. This means that women may be denied care simply because of bureaucratic hold-ups. These delays do not just inconvenience patients ― they violate their rights to timely medical care and increase the risk of complications the longer the pregnancy continues.

Moreover, the financial cost of surgical abortion ― often exceeding $500 ― places it out of reach for many, especially those without insurance. Mifepristone, while similarly priced, has the potential to be subsidised or supported through public health initiatives and non-profit partnerships, reducing inequity and improving access.

Emotional toll cannot be overlooked

Women navigating Bermuda’s abortion system may be required to see a general practitioner, obtain an ultrasound, meet with a gynaecologist and even undergo psychiatric evaluation ― all before being granted approval. These steps, while framed as safeguards, often serve to delay care and add emotional strain during what is already an incredibly vulnerable time.

In contrast, the medical abortion process with mifepristone typically involves two to three appointments and allows the patient to proceed with greater autonomy and privacy. For many women, this makes a meaningful difference in preserving their dignity, mental health, and sense of control.

Reproductive autonomy is healthcare

The mental and emotional consequences of denying abortion care are serious. Studies show that women denied abortions are more likely to experience anxiety, depression and even suicidal ideation⁵. Reproductive autonomy ― being able to decide when and whether to carry a pregnancy ― is a cornerstone of mental wellbeing. Furthermore, the World Health Organisation recognises access to safe abortion as a fundamental human right⁶.

Bringing mifepristone to Bermuda would demonstrate that we trust women to make informed decisions about their bodies and futures. It would also align Bermuda with international health standards and reflect our shared values of compassion, privacy and equity.

The time is now

This is not a radical proposal; it is a responsible, evidence-based and humane step towards improving healthcare in Bermuda. Medical abortion is a standard part of reproductive health in much of the developed world. Bermuda should be no exception.

Let us not fall behind in providing safe, affordable and dignified options for women. Mifepristone is more than a pill ― it represents progress, choice and respect. It’s time we bring this option home.

Sources:

1. World Health Organisation. (2022). Abortion care guideline. https://www.who.int/publications/i/item/9789240039483

2. American College of Obstetricians and Gynecologists. (2020). Medication Abortion Up to 70 Days of Gestation. https://www.acog.org

3. Guttmacher Institute. (2023). Medication Abortion Worldwide. https://www.guttmacher.org/fact-sheet/medication-abortion-worldwide

4. Raymond, E.G. et al. (2013). First-trimester medical abortion with mifepristone 200 mg and misoprostol: a systematic review. Contraception, 87(1), 26-37.

5. Foster, D.G. et al. (2018). A comparison of depression and anxiety symptom trajectories between women who had an abortion and women denied one. JAMA Psychiatry, 75(3), 207-217.

6. United Nations Human Rights Council. (2016). Report of the Working Group on the issue of discrimination against women in law and in practice. https://documents-dds-ny.un.org/doc/UNDOC/GEN/G16/123/32/PDF/G1612332.pdf

• Aysia Stovell is a human resources student, mother and advocate for women’s mental health and reproductive rights