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Late termination of pregnancy: law, policy and decision making in four English fetal medicine units
Author(s) -
Statham H,
Solomou W,
Green J
Publication year - 2006
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.2006.01144.x
Subject(s) - abortion , legislation , thematic analysis , medicine , qualitative research , family medicine , law , psychology , pregnancy , obstetrics , political science , sociology , social science , genetics , biology
Objective UK abortion law allows terminations for fetal abnormality without gestational limit. This study aimed to understand the decision‐making experiences of fetal medicine professionals working within this legal framework. Design Qualitative study using semistructured interviews. Setting Four English fetal medicine units. Sample Fifteen doctors and midwives working in fetal medicine units and the Director of a related voluntary sector group. Methods Thematic analysis of transcribed interviews. Main outcome measures Attitudes to abortion legislation; how decisions are made about the offer of late abortion and feticide. Results Fetal medicine specialists acknowledged the difficulties of ensuring that they worked within the law and within their own ethical frameworks when making decisions about offering terminations after viability. Practice regarding which abnormalities meet the legal criteria appeared to be governed largely by consensus between colleagues within their own and other units and in discussion with other specialists. Study participants reported individual differences about abnormalities where they personally would not wish to be involved in a termination, and also noted a shift in general attitudes over time as to conditions that meet the legal criteria. A proscribed list was believed to be both unworkable, given the variability in diagnoses and unhelpful, leading to reduced patient care. Conclusions Research is needed to monitor attitudes to, and interpretation of, UK abortion legislation, which permits termination after a late diagnosis of fetal abnormality without gestational limit. If attitudes are changing, it is important to understand why, and what the consequences will be for parents and for health professionals.