Abortion

Question 1

What are the 2 different options for abortion?

Answer 1

Medical and surgical abortion

Question 2

Describe the medical abortion procedure

Answer 2

A woman will take 2 tablets/pills.

Question 3

What are the 2 drugs taken for a medical abortion?

Answer 3

Mifepristone first and then Misoprostol

Question 4

Nowhere in Scotland currently offers late abortions above what number of weeks?

Answer 4

20 weeks

Question 5

What changes were made in 2018 regarding Medical abortion?

Answer 5

A woman has to take the Mifepristone in clinic but could now take the 2nd tablet (misoprostol) home and take it there instead.

This reduces the number of clinic visits required.

Question 6

Pros of at home medical abortion

Answer 6

Safe if under 10 weeks and some are done under 12 weeks.

Allows for more privacy, involvement of partner/friend, own food/entertainment

Question 7

Cons of at home medical abortion

Answer 7

Causes painful, heavy bleeding (need another adult to make sure you are okay)– like the worst period you can imagine

Risk that procedure is not complete (need to take pregnancy test after)

GI upset common.

Question 8

3 types of surgical abortion

Answer 8

Dilatation and evacuation – procedure done for those at higher gestation usually

Suction abortion (STOP) – uses vacuum as part of a machine

Manual vacuum aspiration (MVA) – done under local anaesthetic

Question 9

Follow up after having an abortion

Answer 9

Medical abortions at home – need to take a follow up pregnancy test in case procedure was incomplete.

With all abortion treatment, if a woman runs into problems, she needs 24 hour access to advice and emergency admission if required.

Question 10

1967 Abortion Act covers which countries?

Answer 10

Scotland
England
Wales

Question 11

What are the clauses of the 1967 Abortion Act?

Answer 11

A. Continuing with the pregnancy would involve risk to the life of the pregnant woman greater than if the pregnancy were terminated

B. The termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman

C. The pregnancy has NOT exceeded its 24th week and that the continuance of the pregnancy would involve risk, greater than if it were terminated, of injury to the physical or mental health of the pregnant woman

D. The pregnancy has NOT exceeded its 24th week and that the continuance of the pregnancy would involve risk, greater than if it were terminated, of injury to the physical or mental health of any existing child(ren) of the family of the pregnant woman

E. There is substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped.

Question 12

According to the 1967 Abortion act, how many doctors must agree that one of the 5 clauses apply to a woman requesting an abortion?

Answer 12

2

Question 13

In the UK what is the time limit for an abortion?

Answer 13

24 weeks

Question 14

In the UK, an abortion can be carried out in emergency if…

Answer 14

If it saves the life of the pregnant woman.

If it prevents grave permanent injury to the physical or mental health of the pregnant woman.

Question 15

What is the ‘conscientious clause’?

Answer 15

Any healthcare professional can refuse to participate in any treatment authorised by the Act if it conflicts with their religious or personal beliefs.

Question 16

What are the exceptions to the ‘conscientious clause’?

Answer 16

If a woman is undergoing abortion treatment and is admitted due to bleeding a doctor would have to assist her.

A doctor also has to treat a pregnant woman who requires care even if they are considering abortion.

A doctor must ensure that a woman is still able to access care ie they must refer them, give them unbiased information about how to get another doctor/other help.

Question 17

What is the law on abortion in Northern Ireland as of 2019?

Answer 17

Abortion is legal up to 28 weeks

Question 18

Ethical questions raised by abortion

Answer 18

Right to life of the foetus

Religious grounds - sanctity of life

Rights of the woman - autonomy, her body/health

Legal restrictions result in more unsafe abortions and maternal death

Question 19

Fraser Guidelines, Gillick Competence on contraception

Answer 19

Lord Fraser stated that a doctor could proceed to give contraceptive advice and treatment to a girl under 16, “provided he is satisfied on the following matters:

• That the girl (although under the age of 16 years of age) will understand his advice;
• That he cannot persuade her to inform her parents or to allow him to inform the parents that she is seeking contraceptive advice;
• That she is very likely to continue having sexual intercourse with or without contraceptive treatment;
• That unless she receives contraceptive advice or treatment her physical or mental health or both are likely to suffer;
• That her best interests require him to give her contraceptive advice, treatment or both without the parental consent.” (Gillick v West Norfolk, 1985)

Question 20

Contraception options

Answer 20

Most effective - implant, intrauterine device (IUD) or sterilisation

Injectable, pill, patch, ring, diaphragm

Condoms, pull out, sponge, spermicide, fertility awareness based methods