As is the case in so many countries, debate about second trimester abortion continues in the UK often uninformed by the actual situations that women face when considering this procedure. However, a new study of women in England and Wales seeking second trimester abortion provides important insight which many hope will inform debate and practice.
The study indicates that:
- There is no single reason why women have abortions in the second trimester
- Much of the delay occurs prior to women requesting an abortion
- Women's concerns about what is involved in having the abortion contribute to that delay
- Various aspects of relationships with partners and or parents plays a role in a delayed decision about abortion
- After requesting an abortion, delays are partly service-related (waiting for appointments etc.) and or relating to individual women (missing or cancelling appointments etc.)
Specific (and multiple) reasons reported for delays in decisions about abortion included:
I was not sure about having the abortion, and it took me a while to make up my mind up and ask for one (41%)
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I didn't realise I was pregnant earlier because my periods are irregular (38%)
I thought the pregnancy was much less advanced than it was when I asked for the abortion (36%)
I didn't realise I was pregnant earlier because I was using contraception (31%)
I was worried about how my parent(s) would react (26%)
I was worried about what was involved in having an abortion so it took me a while to ask for one (22%)
Report co-author Dr. Ellie Lee says she hopes that this research "will generate more discussion about some very practical concerns and issues that affect women seeking second trimester abortion. Ethical debate has its place, but policy makers and service providers need to be looking at how and why women find themselves seeking second-trimester abortion."
At the launch of the study in London on 19 April, most agreed that the study shows there is a clear need for better education for women of all ages concerning abortion, and also that, while second trimester abortion remains a less requested procedure than earlier abortion, there is a clear need for access to that service to be maintained and improved. There was also discussion about where young people are getting information about abortion, and concerns were voiced about the outreach work that anti-choice organisations are doing in schools and colleges around the UK.
I spoke to Ann Furedi who runs British Pregnancy Advisory Service (BPAS), the largest provider of abortion in the UK:
"This study confirms that a significant number of women—for a variety of reasons—do take time to decide what to do about an unwanted pregnancy. So we need a balance for women to be given time to make their decision, and also access to appropriate support and services as soon as possible if they decide to terminate the pregnancy," says Furedi.
On educating young people, Furedi argues that "abortion is usually dealt with as a moral issue in schools, an environment that creates polarity and discussions about whether abortion is ‘right' or ‘wrong'. What young people are not getting enough information about is actual access to services, and support networks, should they find themselves with an unwanted pregnancy."
The study, says Furedi, is also a reminder that women do not make decisions about abortion lightly. She describes how many women who come to BPAS are genuinely surprised and or upset that they have an unwanted pregnancy. "But this has a lot to do with the continued stigmatisation of abortion. We need more public education about the real situation that women face, rather than about the ethical rights and wrongs of what remains a legal and needed service."
Somewhere, not a million miles away from the UK, I have been reading about legal decisions on provision of abortion. Some of the language used in the discussion about abortion in the United States resonated with a really vulgar disinterest in women and their health and their well-being.
This study on second trimester abortion is an important reminder that women's voices and concerns and expectations must be used to inform and improve service provision, public education, and also ultimately policy and legislation about abortion. While abortion may be a political issue in some people's minds, for others, the politicisation of abortion just takes the decision-making process further and further away from women, and further and further away from practical and realistic responses to women's needs when faced with unplanned and unwanted pregnancy.
(The research study was conducted by The Centre for Sexual Health Research at the University of Southampton and the School of Social Policy, Sociology and Social Research at the University of Kent. Download the study as a PDF.)