Memorandum by Jane Thomas, Director, Royal
College of Obstetricians and Gynaecologists
1. Welcome the aims and principles of the
strategy. In particular the aim to reduce unintended pregnancy
rates.
2. Implementation of this strategy will
require more specific action to ensure commissioning of contraceptive
serves which improve access to contraceptive advice and services,
especially for vulnerable groups.
3. Clinical guidelines for the NHS on the
effective and appropriate use of long acting reversible contraception
will help to ensure a range of contraceptive services are provided
for those that need them.
4. The complexities of managing sexual behaviour
and the fallibility of contraception mean that some unwanted pregnancies
are inevitable. Access to safe abortion is recognised by the WHO
as a public health issue because safe abortion prevents unnecessary
death and harm to women. Induced abortion is one of the most commonly
performed gynaecological procedures around 180,000 are performed
annually in England and Wales. At least one-third of British women
will have had an abortion by the time they reach the age of 45
years.
5. Setting a standard to reduce waiting
times for an abortion to within three weeks of the initial consultation
is important. Performing an abortion earlier in pregnancy reduces
the risk of complications.
6. The strategy proposed to but does not
address the disparities that exist in the abortion services across
the country. It highlights the link between social deprivation
and abortion; the variation in NHS service provision which is
not related to variation but the action plan targets do not ensure
that the NHS will address this need.
7. The RCOG published guidelines on The
Care of Women Requesting Induced Abortion. Re-commissioning
these guidelines within the NICE work programme would help to
improve quality and consistency of abortion services.
July 2002
| 
