Abortion

Question 1

Pre abortion act 1967

Answer 1

All abortion was a criminal act
Offences against the persons act 1861 section 58
Punishable by life imprisonment
Still applicable for abortion performed outside of legal provision
There were usually no doctors involved if they were they were working outside of the NHS

Question 2

Terminology - abortion

Answer 2

Used in law - abortion act

Question 3

Terminology- termination of pregnancy

Answer 3

Is used in the hospital scenario

Question 4

Terminology - miscarriage

Answer 4

Naturally occurring

Question 5

Terminology - post coital conception

Answer 5

Emergency contraception - not classed as an abortion as it is stopping a pregnancy from happening not aborting a pregnancy

Question 6

How many doctors must agree that abortion can take place

Answer 6

2

Question 7

What is section 1(1)a of the abortion act

Answer 7

Pregnancy has no exceeded 24 weeks and that the continuation of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman or any existing children of the family of the pregnant woman
Under 12 weeks always termination less risk
Not quantity of risk just risks - ding need to quantify
Can’t afford another child

Question 8

Section 1b criteria

Answer 8

The termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman
- woman has liver failure and if continues with the pregnancy she is likely need a transplant
Not transcient
No time limit

Question 9

Section 1c

Answer 9

The continuation of the pregnancy would involve risk to the life of the pregnant woman greater than if the pregnancy were terminated - death due to preeclampsia
Death is likely
No time limit

Question 10

Section 1d

Answer 10

There is substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped
No time limit

Question 11

Section 1d how is the seriousness of the handicap assessed

Answer 11

It is up to the opinion of the clinician and for the woman what is serious to her

Question 12

Which form needs to be filled out and within how many days dies it need to be sent to the chief medical officer

Answer 12

HSA4

14 days

Question 13

Form split up differently

Ground A on the form is what ground in the abortion act

Answer 13

1 c

Risk to life greater than if terminated

Question 14

Ground B permanent physical injury is what in the abortion act

Answer 14

1b

Question 15

Ground C on the abortion act

Not exceeded 24 weeks risk greater than is terminated

Answer 15

Section 1a

Question 16

Ground D - family existing children

Answer 16

1a

Question 17

Ground E on form risk to child

Answer 17

1 d.

Question 18

ground F and G on the form

Answer 18

Emergency treatment

Question 19

Selective termination

Answer 19

Multiple foetuses reduce the number

Question 20

Vast majority of termination happen when

Answer 20

Before 3 months

Question 21

Feticide

Answer 21

Termination not be a live baby
Kill fetus before before termination
KCl Either into skull or heart
Only 4% don’t have feticide after 22 weeks

Question 22

Down syndrome termination - challenge.

Answer 22

Huge spectrum of presentation - don’t know how handicapped they will be

Question 23

How many diagnoses of Down syndrome come to birth

Answer 23

8%

Question 24

Cleft palate - 30 termination

Answer 24

Can be fixed

Question 25

Feticide - live births

Answer 25

Born alive - minute and 4 and a half hours

Left to die

Question 26

Why chose have a termination - can be separated into trimesters

Answer 26

First trimester - panic, fear of someone finding out, contraceptive failure, inability to care for the child, pregnancy resulted from rapper or assault, social factors
Second trimester - prolonged consideration of choices, relationship changes, awaiting feral screening
Third trimester - fetal handicap, don’t need termination to sort blood pressure out you can have early delivery

Question 27

Conscientious objection - only legally allowed for abortion

Answer 27

Under section 4 no duty to participate in any treatment
Must refer to another doctor
Exceptions are 1b and 1c must participate to prevent grave permanent injury to the physical or mental health of the mother or prevent maternal death

Question 28

Who does conscientious objection apply to

Answer 28

Not midwives or nurses

On,h applies to someone carrying or ordering it not assisting

Question 29

Case janaway v Salford AHA 1988

Answer 29

Dismissed her to court lost the case essential cog but not entitled to claim conscientious objection

Question 30

Royal college of obs and gynae worried

Answer 30

Lack of speciality trainees because of the termination role, can conscientiously objecting so they don’t have enough staff willing to do it
GP don’t refer leaflet tells you to go to an abortion provider so many GPS conscientiously objecting
NHS funds
Dinner party tests - can’t tell them what you do - no one wants to admit they do the abortion