Select Committee on Health Minutes of Evidence

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

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