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  • Title: Abortion denied.
    Author: Barron SL.
    Journal: IPPF Med Bull; 1986 Apr; 20(2):3-4. PubMed ID: 12340686.
    Abstract:
    Throughout the world, legal abortion is now widely available, but nowhere is it available unconditionally. Most abortion laws seek to ensure that abortion is performed as safely as possible and only after careful thought. Restrictions may be minimal, but more usually 2 or more doctors have to be involved in certification with more stringent rules for abortion after 12 weeks' gestation. It follows that women who are denied abortion will include those who cannot negotiate the legal system (especially the very young and socially disadvantaged) or those who are ambivalent about the abortion. In Britain, the provisions of the Abortion Act call for 2 doctors to sign a certificate before the abortion. The limit of gestation is governed by the Infant Life Preservation Act, which protects the fetus beyond the limit of "viability," defined as 28 weeks. There is no legal restriction on 2nd trimester abortion, but there recently has been voluntary agreement to limit abortion to less than 24 weeks. There is considerable variation in the availability of abortion in the National Health Service (NHS), and delays may occur between the primary referral and the hospital consultation and again before admission to hospital. In Britain, the private clinics offer an alternative for women denied abortion in the NHS, especially for those in the 2nd trimester. In some regions, a large proportion of abortions are performed outside the NHS, often in private clinics run on a charitable basis. When more than 1 doctor is involved in the decision, as in Britain, Canada, and some parts of the US, the woman may be dissuaded, at the 1st consultation, from proceeding further. The woman denied a legal abortion is faced with 4 options: to seek a legal abortion elsewhere; to seek illegal abortion; to continue the pregnancy and accept motherhood; and to continue the pregnancy but arrange for the baby to be fostered or adopted. The Lane Committee, which reviewed the working of the Abortion Act in Britain, estimated that about 30% of those first refused eventually obtained an abortion. Reliable information about the use of illegal abortion is hard to find. Certainly deaths attributed to abortion in Britain and the US have declined since the liberalization of abortion laws. In many cases where abortion has been denied, it is because the request is made too late, owing either to ambivalence or to ignorance. More could be done to improve the early diagnosis of pregnancy and to improve the cumbersone delays in the referral system in many countries.
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