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Title: Gynaecologists' abortion practice.
Author: Francome C, Savage WD.
Journal: Br J Obstet Gynaecol; 1992 Feb; 99(2):153-7. PubMed ID: 1554669.
Abstract:
OBJECTIVE: To ascertain the relation between gynaecologists' opinions on the provision of abortion and the service provided by the Health Service in their district and to investigate the methods used for second trimester abortion. DESIGN AND SETTING: A postal questionnaire sent three times to a 50% random sample of gynaecologists practising in the National Health Service (NHS) in 1989 in Great Britain. SUBJECTS: 343 of 396 practising gynaecologists, 87% of those selected. MAIN OUTCOME MEASURES: Proportion of gynaecologists holding views or reporting practice. RESULTS: Although only 11% actually performed abortions beyond 20 weeks, 57% approved later operations in cases of rape and 85% for a threat to the woman's health; only 47% approved late abortion for schoolgirls under 16 years. Dilatation and evacuation was used by only 1% of NHS gynaecologists even though from 13 to 16 weeks it is a safe and efficient method. Although Government statistics report that vacuum aspiration is used in over one third of second trimester abortions, this is technically unlikely and was not confirmed by this study. Less than 50% of abortions in England and Wales are performed in the NHS yet fewer than 40% of gynaecologists reported problems in providing an abortion service. Overall 21% thought they were providing abortions for over 90% of the women resident in their districts, whereas only 2% of districts achieve this proportion in their home regional health authority. Overall 60% supported separating abortion work from general gynaecology, and 45% would like regional abortion units. Only 27% supported fertility control acquiring the status of a subspecialty. CONCLUSIONS: Accepting these suggestions would improve the service, reduce regional variations in provision, provide opportunities for research and could have an important effect in helping slow the world population increase. This study sought to ascertain the relation between gynecologists opinions on the provision of abortion and the service provided by the Health Service in their district and to investigate the methods utilized for 2nd trimester abortion. The subjects, 343 or 296 practicing gynecologists (87% of those selected) received a postal questionnaire sent 3 times to those practicing in the National Health Service (NHS) in 1989 in Great Britain. Although 11% actually performed abortions beyond 20 weeks, 57% approved later operations in cases of rape and in 85% for a threat to the woman's health. Only 47% approved late abortion for those girls under age 16. Dilatation and evacuation was used by only 1% of the NHS gynecologists, even though it is considered a safe and efficient method between 13-16 weeks. Although government statistics report that vacuum aspiration is used in over 1/3 of 2nd trimester abortions, this is technically unlikely and was not able to be confirmed by this study. Less than 50% of abortions in England and Wales are performed in the NHS; however, fewer than 40% of gynecologists reported problems in providing abortion service. Overall, 21% thought they were providing abortions for over 80% of the women who lived their in districts, whereas only 2% of districts achieve this proportion in their home regional health authority. Overall, 60% supported separating abortion work from general gynecology, and 45% would like regional abortion units. Only 27% supported fertility control acquiring the status of a subspecialty. It is concluded that by accepting these suggestions, service would improve, there would be a reduction in regional variations in provision, and there would be additional opportunities for research which would have significant impact in helping to slow the world population increase.

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