Delays in abortion referrals limit women抯 choices, says report
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《英国医生杂志》
Women in some parts of England have to wait up to two months from first seeking advice about an abortion to having the procedure, says a survey. The delays in referral mean that many women are presenting to services later than nine weeks pregnant and cannot be considered for early medical termination using the abortion pill, mifepristone, despite this being a popular option among women.
The survey, from the All-Party Parliamentary Pro-Choice and Sexual Health Group, shows that only 52% of the primary care trusts (PCTs) that have set a maximum waiting time of three weeks, in accordance with national guidelines, meet this target consistently. Just over one in 10 of the trusts surveyed reported waits of five to eight weeks.
The survey, which was conducted by Voice for Choice—an alliance of national pro-choice organisations including British Pregnancy Advisory Service, Marie Stopes International, and the Family Planning Association—reviewed the abortion services of 243 primary care trusts. Sluggish referral times, inadequate provision, and restrictive policies in some trusts are blamed for the variation in waiting times.
In particular, late referrals are restricting access to medication termination, shows the survey. Many women say they prefer this option because it makes them feel more in control. Because the method requires no anaesthesia or surgery, complications are reduced.
Just 51% of NHS abortions were carried out within the first 10 weeks of pregnancy, well below the government target of 60%. Newham PCT, in east London, performed particularly badly, carrying out just 9% of abortions within 10 weeks of pregnancy.
Baroness Gould, chair of the all-party group said, "Current wide variations amongst PCTs in the percentage of abortions carried out before 10 weeks have a critical effect on the choice of abortion methods. Medical as well as surgical abortion is now offered in 90% of PCTs, but if a woman has to wait beyond the timeframe suitable for this procedure, her ability to chose this method is denied."
However, despite delays in accessing abortion services, the survey states that in general abortion services have been improving.
It recommends that primary care trusts should aim to commission abortion services to cover the demand among the local population. Fast track referral guidelines should also be put in place for GPs and family planning services, and attempts should be made to treat women having abortions separately from other gynaecological patients. Written protocols on good practice should be provided by trusts to cover all aspects of abortion services, it adds.(London Debashis Singh)
The survey, from the All-Party Parliamentary Pro-Choice and Sexual Health Group, shows that only 52% of the primary care trusts (PCTs) that have set a maximum waiting time of three weeks, in accordance with national guidelines, meet this target consistently. Just over one in 10 of the trusts surveyed reported waits of five to eight weeks.
The survey, which was conducted by Voice for Choice—an alliance of national pro-choice organisations including British Pregnancy Advisory Service, Marie Stopes International, and the Family Planning Association—reviewed the abortion services of 243 primary care trusts. Sluggish referral times, inadequate provision, and restrictive policies in some trusts are blamed for the variation in waiting times.
In particular, late referrals are restricting access to medication termination, shows the survey. Many women say they prefer this option because it makes them feel more in control. Because the method requires no anaesthesia or surgery, complications are reduced.
Just 51% of NHS abortions were carried out within the first 10 weeks of pregnancy, well below the government target of 60%. Newham PCT, in east London, performed particularly badly, carrying out just 9% of abortions within 10 weeks of pregnancy.
Baroness Gould, chair of the all-party group said, "Current wide variations amongst PCTs in the percentage of abortions carried out before 10 weeks have a critical effect on the choice of abortion methods. Medical as well as surgical abortion is now offered in 90% of PCTs, but if a woman has to wait beyond the timeframe suitable for this procedure, her ability to chose this method is denied."
However, despite delays in accessing abortion services, the survey states that in general abortion services have been improving.
It recommends that primary care trusts should aim to commission abortion services to cover the demand among the local population. Fast track referral guidelines should also be put in place for GPs and family planning services, and attempts should be made to treat women having abortions separately from other gynaecological patients. Written protocols on good practice should be provided by trusts to cover all aspects of abortion services, it adds.(London Debashis Singh)