Reducing late abortions.

Abstract

The report of a meeting organized by the Birth Control Trust and focusing on reducing late abortion indicates that referral and assessment for abortion takes longer within the National Health Services (NHS) than in the private and charitable sectors. The NHS performs only 21% of all its abortions prior to the 9th week in comparison with 44% in the private sector. The NHS emerges as reluctant to perform 2nd-trimester abortion when the indications are social factors threatening mental health. The report covers many specific issues including the need for better provision of early pregnancy testing in general practice and in community clinics, the early detection of fetal abnormality, and the great regional variations in the provision of abortion within the NHS. It describes how NHS can provide good abortion facilities and includes examples from several centers in England. There is considerable difference between abortion performed early in pregnancy and when a delay has occurred. The woman's feelings change. Initially, she knows only that her period is late, realizing subsequently she is pregnant and only later coming to feel that she is going to have a baby. This is why, until modern times, abortion was not viewed as a crime up until the time when the woman felt quickening. Regarding the actual procedures, abortion using suction is a simple and safe procedure best performed on an outpatient basis within the first 12 weeks of pregnancy. Early abortion uses fewer health resources, involves less time off work or away from the family, and is far more acceptable to the woman. When considering the basic causes of delay, the attitude and behavior of the woman herself is important, but much responsibility for delay lies with the medical profession. That the medical profession is failing to cope is shown by the fact that the NHS performs fewer than half of all those abortions performed in women who are UK residents. Politicians who genuinely want to minimize late abortion should consider altering the Abortion Act to remove the current restrictions upon early abortion and the bureaucratic overtones which cause delays while retaining the present regulations for later procedures.