In the UK, abortion care is 'heading towards a crisis' and reformation of the law is needed to remove stigma, encourage doctors to provide terminations and improve equitable access to excellent, modern abortion services, says a new study.
The study was published 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," said a researcher Dr Sandy Goldbeck-Wood from Cambridge University Hospitals. The law is, therefore, widely seen by clinicians as "hypocritical and anachronistic," explains Dr Goldbeck-Wood.
‘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.’
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 health care.
Another problem is that abortion care has become artificially separated from the rest of reproductive health care, she adds. 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. The lead study author Dr Louise Keogh from the University of Melbourne assessed the decriminalisation of abortion in the Victoria state of Australia in 2008. v
The findings indicated 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. "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," said another researcher Sally Sheldon from Kent University in the London.
Much more work is needed to remove stigma, encourage doctors to provide terminations and improve "equitable access to excellent, modern abortion services," she concludes.