Women seek later abortion in Scotland for many different reasons
posted on: May 9, 2014
A study by researchers from the MRC/CSO Social and Public Health Sciences Unit (SPHSU) at the University of Glasgow indicates for the first time that women in Scotland seek late abortions for a variety of complex reasons.
Abortion is legal in England, Scotland and Wales up to the 24th week of pregnancy (If there is a substantial risk to the woman's life or if there are foetal abnormalities there is no time limit). While the majority of abortions in Scotland occur before nine weeks’ gestation, a low but consistent number are obtained at 18 or more weeks. Abortion for nonmedical reasons is not generally available after 20 weeks in Scotland and some women in this situation may travel to England to seek a termination.
The researchers found that those travelling to England for the procedure often faced financial, logistical and physical barriers – for example, having to go to England for a termination might mean incurring travel and accommodation charges. The study - Women's Experiences of Termination of Pregnancy (WELTOP) - was funded by the Scottish Government and conducted by the MRC/CSO SPHSU.
Lead author Dr Carrie Purcell conducted in-depth interviews with 23 women presenting for abortion services at 16 or more weeks gestation at participating National Health Service clinics in Scotland between January and July 2013. The study participants were asked about their reasons for seeking later abortion services and the consequences of doing so, as well as their experiences around the procedure.
Common reasons reported by the participants for seeking an abortion at a later stage included: women not recognizing they were pregnant; life circumstances having changed since they became pregnant; and conflicting emotions about whether to continue the pregnancy or seek abortion. For women with children, the key reason for seeking abortion was concern for the well-being of their family.
Dr Purcell commented:
“The women we spoke to came from a wide range of backgrounds and age groups, and none of them took lightly the decision to seek a later abortion. Even when having to travel a substantial distance to obtain an abortion, our participants felt termination was best for them and for the significant others in their lives, including children and partners. This indicates that later abortion continues to be an essential part of healthcare provision for women in Scotland.”
Women seeking later services reported that their perceptions of the resources required to travel to England were potential barriers to access. Those who did travel to England had to take time off from work and pay for travel and accommodation booked at short notice.
The researchers found that, for these women, the need to travel to England exacerbated an already stressful experience. The authors conclude that “reducing barriers to access and improving local provision of such abortions are a necessity.”
Principal Investigator on the study, Lisa McDaid, said:
“Most abortions in Scotland are carried out in the first trimester of pregnancy and little is known about the circumstances in which women might seek a termination at a more advanced stage of pregnancy.
“Although a relatively small study, this research has given Scottish women the opportunity to tell us about their experiences of later abortion for the first time. Most had not realised that they were pregnant and all found that they had to think through whether they could cope with the pregnancy and having a child. Although this was a difficult decision to make, all of the women we interviewed were clear that it was the right choice for them. Women who had to travel to England found this to be a particularly stressful and unpleasant experience and improving service provision could alleviate this.”
The paper, entitled ‘Experience of Later Abortion: Accounts from Women in Scotland’ is currently available online in Perspectives on Sexual and Reproductive Health.