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Women's access to abortion after 20 weeks' gestation for fetal chromosomal abnormalities: Views and experiences of doctors in N ew S outh W ales and Q ueensland
Author(s) -
Black Kirsten I.,
Douglas Heather,
Costa Caroline
Publication year - 2015
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12305
Subject(s) - abortion , criminal code , context (archaeology) , medicine , gestation , family medicine , obstetrics , pregnancy , gynecology , law , political science , criminal law , genetics , biology , paleontology
Background Induced abortions after 20 weeks' gestation comprise around one per cent of all terminations in Australia and mostly occur following the diagnosis of a fetal anomaly. However, these abortions are overly represented in legal cases against doctors and challenging to organise in those states where abortion remains in the criminal code and health department directives impose regulations. This study explores barriers to abortion access after 20 weeks' gestation in the states of Queensland and New South Wales. Materials and Methods We approached and sought consent from 22 doctors involved in abortion provision (15 in Queensland and seven in NSW) , who responded in depth to a set of clinical scenarios. This study presents participants' responses to three clinical scenarios of women presenting with a fetal chromosomal abnormality after 20 weeks' gestation. Results Of the 22 medical practitioners in this study, 18 reported that access to late‐term abortion in their state was restricted. The two key factors perceived to affect the decision to terminate a pregnancy in this context were the legal status of abortion and Department of Health policies mandating that applications for abortion be presented to clinical ethics committees. Practitioners reported that committees were slow to convene and inconsistent in their decisions. Conclusions Ethics committee involvement for late‐term abortions is required by state health policy in NSW and Queensland, where abortion is still a criminal offence. This process is seen by abortion providers to hinder timely access to services and excludes women from the decision‐making process.