Abortion

Question 1

What is the difference between the terms:

1 - Abortion?

2 - Termination of pregnancy?

3 - Miscarriage?

4 - Post-coital interception?

Answer 1

• Abortion is an active measure taken to end pregnancy.
• Termination of pregnancy is a more politically acceptable term for abortion.
• Miscarriage is where pregnancy ends without active efforts to do so.
• Post-coital interception is where emergency contraception is taken to stop pregnancy from occurring post-fertilisation.

Question 2

When was all abortion last illegal in the UK?

Answer 2

1967.

Question 3

What is the Offence Against the Person Act of 1861?

Answer 3

The act that deals with offences of violence committed against others with the objective of making the law easier to understand.

Question 4

Which act made abortion legal in the UK?

Answer 4

The Abortion Act of 1967.

Question 5

What is the law concerning purchasing medication online to facilitate abortion?

Answer 5

Buying medication online to facilitate abortion is illegal.

Question 6

Give an overview of the 2015 Natalie Towers case.

Answer 6

Natalie Towers was sentenced to 2.5 years imprisonment for using abortion medication at 32-34 weeks of pregnancy.

Question 7

Which section of which act amended the Abortion Act of 1967?

Answer 7

Section 37 of the Human Fertilisation and Embryology Act of 1990.

Question 8

What are the legal obligations of the doctor that takes responsibility for an abortion procedure?

Answer 8

1 - Notify the chief medical officer within 14 days of the termination.

2 - Send a completed HSA4 form.

Question 9

List the criteria according to section 1 of the Abortion Act of 1967 that determine whether an abortion can be carried out.

Answer 9

2 doctors must agree that one of the following apply:

1a: Under 24 weeks, the risk of injury to the physical or mental health of the mother or her existing children with continuation is greater than the risk of abortion.
1b: Abortion is necessary to avoid grave permanent injury regarding the physical or mental health of the mother.
1c: The risk to the mother’s life with continuation is greater than the risk of abortion.
1d: There is substantial risk that the child would suffer from abnormalities as to be severely handicapped.

Question 10

What proportion of pregnancies result in miscarriage?

Answer 10

1 in 4.

Question 11

How many abortions happen in the UK per year?

At which stage of gestation do most of these abortions occur?

Answer 11

• ~200,000.

- Most occur >12 weeks of gestation.

Question 12

What is the law concerning abortion in Ireland?

Answer 12

Abortion is illegal in the republic of Ireland but legal in Northern Ireland.

Question 13

List the two categories of abortions.

Answer 13

1 - Medical.

2 - Surgical.

Question 14

Describe the process of medical abortion.

Answer 14

1 - Oral mifepristone is taken in clinic (basically lots of oestrogen) that blocks the hormonal cascade for continuation of pregnancy.

2 - Oral misoprostol is taken once a day for 3 days afterwards to promote the expulsion of the uterine contents.

Question 15

Describe the process of surgical abortion.

Answer 15

• If <12 weeks gestation, suction alone is sufficient.

- If >12 gestation, cervical dilation + suction is done.

Question 16

What proportion of people that have abortions already have children?

Answer 16

60%.

Question 17

List the procedures involved in conscientious objection in practice.

Answer 17

1 - Tell the patient that you do not provide the particular treatment or procedure, being careful not to cause distress or imply any judgement.

2 - Tell the patient that they have a right to discuss their condition and the options for treatment with another practitioner.

3 - Make sure that the patient has enough information to arrange to see another practitioner.

Question 18

What is the limit of conscientious objection?

Answer 18

In emergencies, you must not refuse to provide treatment necessary to save the life of, or prevent serious deterioration in the health of, a person because the treatment conflicts with your personal beliefs.

Question 19

List 2 factors that must balance autonomy of the healthcare professional and ability to conscientiously object.

Answer 19

1 - Resource management (e.g. if the abortion is handled by private healthcare, the NHS will have to pay for the services).

2 - Impact on colleagues (the responsibility will fall on other healthcare professionals to deal with the proceedings).

Question 20

What proportion of unintended pregnancies are aborted?

Answer 20

40%.