Preventing unwanted pregnancies.

Abstract

This editorial comments on the recent report of the Royal College of Obstetricians and Gynecologists on unplanned pregnancy. This report followed up an earlier report which recommended that the NHS make freely available contraceptive services. Even though this came to fruition, abortion rates continued to rise. In 1990, 174,000 legal abortions were performed in England and Wales, of which 33% were women 20 years. The current report reviewed education and contraceptive services with particular emphasis on teenagers. Unwanted teenage pregnancy was attributed to the lack of education on family planning and related issues in schools. The proposal is for a flexible sex education curriculum with specially trained teachers. Curriculum would be established in national guidelines. A suggested improvement was the addition of seminars for parents and school governors on sex education, even though this means competing with GCSE's. The media should take responsibility for focusing on contraception as a benefit if it continues to promote the delights of sexual intercourse. It is pointed out the emergency contraceptive knowledge is poor. A Family Planning Association (FPA) survey reports that only 1 out of 2 pharmacists receives requests about emergency contraception. Another FPA unpublished study shows that 500 out of 1000 women receiving legal abortions did not use any form of contraception before conception. The need for emergency contraception an appropriate clinic facilities is emphasized. The report also strongly disagrees with the closing of clinics which has been ongoing since the 1974 transfer of FPA clinics to the NHS. The district health authorities must function on a restricted budget while general practitioners in FP are paid from unrestricted funds. Community family planning clinics and general practitioners in the NHS differ considerably in the services offered. Practitioners offer oral contraceptives generally, while clinics provide a wide range of methods. NHS family planning services for contraception, sterilization, and abortion must be reoriented. The recommendation is that senior specialists oversee the community clinics and general practices and coordinate the provision for legal abortion. This specialist might serve as a focus of skill and professionalism for coping with changing social values and medical techniques.