Abortion care in the UK is 'heading towards a crisis,' warns expert

December 22, 2016

Abortion care in the UK is "heading towards a crisis" and reform of the law is just one of the many obstacles that needs to be overcome, argues an expert in the Journal of Family Planning and Reproductive Health Care.

Among the challenges women seeking abortion face include inequitable access, a lack of trained staff, stigmatisation, and a culture of exceptionalism, explains Dr Sandy Goldbeck-Wood, editor in chief of the journal, and clinical lead for abortion services at Cambridge University Hospitals.

She argues that "problems of access and stigma, familiar worldwide, are compounded in the UK by an abortion law that is now widely seen as not fit for purpose" which is considered to be "out of step with technical advances in safe medical abortion and current UK social values."

Most women believe they have a right to make their own decision about abortion, but British law still requires the identification of serious physical or mental health risk by two doctors not necessarily qualified, and who may not know the woman personally.

The law is, therefore, widely seen by clinicians as "hypocritical andanachronistic," explains Dr Goldbeck-Wood.

Another problem is that abortion care has become artificially separated from the rest of reproductive health care, she adds. In the UK, a high proportion of abortion care is provided in specialist organisations outside the NHS.

Trainees in obstetrics and gynaecology - among them the potential service providers of the future - have too little opportunity to benefit from the learning environment that abortion care offers.

"As well as reinforcing stigma, this deprives trainees of valuable learning opportunities," she says

Organisations calling for the law to be reformed include the British Pregnancy Advisory Service, the Royal College of Nursing, the Royal College of Midwives and other women's health organisations.

And if the law is to be reformed, says Dr Goldbeck-Wood, there will be a strong need for debate which is respectful and acknowledges the ethical complexity in this sensitive area of .

"Abortion care remains a high-volume, under-researched and under-integrated area of women's healthcare," she writes. "2017 is an excellent time for practitioners to be challenging hypocrisy and exceptionalism in UK abortion care, and leading respectful debate centred on women's needs, with complexity acknowledged."

A study led by Dr Louise Keogh, from the University of Melbourne, assessed the decriminalisation of abortion in the Victoria state of Australia in 2008.

It found that a change in the law has empowered women, and increased clarity and safety for clinicians, but has failed to address stigma, access to services and workforce sustainability.

Commenting on the study, Sally Sheldon, professor of law at Kent University, says that the abortion law reform in Victoria has vital lessons for the UK.

She says that removal of specific criminal prohibitions against abortion "should not be seen as a panacea", even though it is important to remove criminal law prohibitions and to establish abortion care as a health issue.

Much more work is needed to remove stigma, encourage doctors to provide terminations, and improve "equitable access to excellent, modern abortion services," she concludes.

Explore further: Women denied abortion initially report more negative psychological outcomes

More information: Editorial: Reforming abortion services in the UK: less hypocrisy, more acknowledgment of complexity jfprhc.bmj.com/content/early/2 … 0/jfprhc-2016-101696

Commentary: Abortion law reform in Victoria: lessons for the UK jfprhc.bmj.com/content/early/2 … 1/jfprhc-2016-101676

Research: Intended and unintended consequences of abortion law reform: perspectives of abortion experts in Victoria, Australia jfprhc.bmj.com/content/early/2 … rhc-2016-101541.full

Related Stories

Women denied abortion initially report more negative psychological outcomes

December 14, 2016
Women who were denied an abortion initially reported less psychological well-being compared with women who received the wanted procedure, findings that researchers suggest do not support policies restricting women's access ...

Indiana sued over ultrasound 18 hours before abortion rule

July 7, 2016
The American Civil Liberties Union of Indiana is challenging a new state requirement that women get an ultrasound at least 18 hours before they have an abortion.

International team explores the stigma surrounding abortion

June 28, 2011
An international team of researchers says abortion stigma is under-researched, under theorized and over emphasized in one category: women who've had abortions. As a result, they're launching a new direction into research ...

Women in developed world still face many barriers to early abortion

June 25, 2015
Women in developed countries still find it very difficult to get an abortion in early pregnancy, despite facing fewer legal constraints than in other parts of the world, concludes an analysis of the available evidence, published ...

Oklahoma's first new abortion clinic in 40 years opens doors

September 16, 2016
Despite facing some of the nation's strictest anti-abortion laws, a Kansas-based foundation opened a new facility in Oklahoma City—the first new abortion provider in the state in 40 years.

Abortion covered in most health plans for Congress

December 5, 2013
A lawmaker says abortion is covered in 90 percent of the insurance plans being offered to members of Congress and their staff under President Barack Obama's health care law.

Recommended for you

New insights into controversial diagnosis of adolescent chronic fatigue

October 23, 2017
Crucial new research could provide some clarity around the controversy surrounding the diagnosis and treatment of chronic fatigue syndrome (CFS) in adolescents. The research by the Murdoch Children's Research Institute published ...

New prevention exercise programme to reduce rugby injuries

October 23, 2017
A new dynamic 20-minute exercise programme, performed by rugby players before training and pre-match, could dramatically reduce injuries in the sport according to a benchmark study published today (Sunday 22 October).

Our laws don't do enough to protect our health data

October 23, 2017
Have you ever wondered why your computer often shows you ads that seem tailor-made for your interests? The answer is big data. By combing through extremely large datasets, analysts can reveal patterns in your behavior.

Do boys really have a testosterone spurt at age four?

October 23, 2017
The idea that four-year-old boys have a spurt of testosterone is often used to explain challenging behaviour at this age.

Expert: Be concerned about how apps collect, share health data

October 20, 2017
As of 2016 there were more than 165,000 health and wellness apps available though the Apple App Store alone. According to Rice University medical media expert Kirsten Ostherr, the Food and Drug Administration (FDA) regulates ...

Three million Americans carry loaded handguns daily, study finds

October 19, 2017
An estimated 3 million adult American handgun owners carry a firearm loaded and on their person on a daily basis, and 9 million do so on a monthly basis, new research indicates. The vast majority cited protection as their ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.