Termination of pregnancy

Question 1

when is the target time to perform a termination

Answer 1

under 9 weeks as less complications

Question 2

what are the different types of terminations available

Answer 2

medical - ie tablet medications

surgical

Question 3

legally, when can an abortion be induced

Answer 3

pregnancy has not exceeded 24 weeks
continuation of the pregnancy would cause greater harm to the physical or mental health of the women and/or her existing children than if the pregnancy were terminated

Question 4

what are some reasons for abortions

Answer 4

social factors

medical - fetal anomaly, maternal health

Question 5

what is discussed/done in clinic when a pregnant woman comes in for consultation about a termination

Answer 5

methods of termination
risk of prolonged bleeding after TOP
counselling available after TOP
contraception - agree and advise

FBC/group and screen/rubella/scan/self obtained swab for chlamydia and gonorrhoea and STI bloods offered

certificate A signed

Question 6

what drugs are used in the medical termination of a pregnancy and how do they work

Answer 6

1. mifepristone - switches off pregnancy hormone, keeps uterus from contracting and allowing pregnancy to grow
2. misoprostol - given 48hrs later, initiates uterine contraception which opens cervix and expels pregnancy

Question 7

what does “home abortion” mean

Answer 7

when undertaking a medical termination in scotland, england or wales, it is not legal to take the second misoprostol tablet at home instead of having to come into the clinic

Question 8

what are some complications of terminations of pregnancy

Answer 8

haemorrhage
uterine perforation (surgical)
carvical trauma
failed termination 
infection
RPOC
psychological problems

Question 9

how is future fertility affected by a TOP

Answer 9

unaffected with uncomplicated procedures
BUT
can be affected by severe infection, cervical trauma or uterine cavity damage (ashermans)

Question 10

when are medical vs surgical terminations carried out

Answer 10

medical usually before 9 weeks but can be up to 24 weeks

surgical usually after 9 weeks up to 24 weeks

Question 11

how are terminations carried out in in grampian

Answer 11

> 80% medical

up to 20 weeks - then referred to england

Question 12

what is conscientious objection

Answer 12

the right of medical staff to refuse participation in an abortion because the have a conscientious objection to the procedure (1967 Abortion Act)

Question 13

what is the stipulation to conscientious objection though

Answer 13

there is an obligation to ensure that the women seeking treatment still has access to abortion care

they have a right to refuse care as long as it does not affect any duty to participate in treatment necessary to save the life to prevent grave permanent injury to the mental or physical health of the pregnant woman