The definition of termination of pregnancy is the voluntary ending of a pregnancy by removal of the products of conception. Terminations can be carried out using medical or surgical methods.
In England and Wales there are around 195,000 terminations performed annually, and at least one-third of British women will have had a termination before they reach the age of 45. Most women visit their GP as the first step in the referral procedure. Patients requesting your help are often unsure of what they want, are emotionally fragile and are uncertain how the doctor will react to their situation. It is vital therefore that the GP acts sensitively and empathically and provides accurate information, is aware of the legal requirements and provides non-judgemental support and counselling for a women who is facing an often difficult decision that she will have to live with for the rest of her life.
Box 24.1 The Law
Terminations in England, Scotland and Wales are regulated under the Abortion Act 1967 and the Human Fertilisation and Embryology Act 1990.
Terminations can be carried out under 24 weeks if there is:
(a) risk to the physical or mental health of the woman
(b) risk to the physical or mental health of her children or family.
There is no upper limit to the time at which a termination can be performed if there is:
(a) risk to the woman’s life
(b) risk of grave permanent damage to the woman’s physical or mental health or
(c) risk of physical or mental disability if the baby was born.
Terminations are still illegal in Northern Ireland apart from exceptional circumstances where there is immediate risk to the life of the mother or long-term or permanent risk to her physical or mental health.
Under the Acts, two doctors must sign a legal document (HSA1 form) to indicate under which grounds the termination can be performed.
Females under the age of 16 can have a termination without parental consent if the two medically responsible professionals deem that she is ‘Gillick’ competent and the Fraser guidelines are followed.
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