Key points

1. ✓ Services for termination of pregnancy should be offered as part of comprehensive reproductive health care.

2. ✓ All termination of pregnancy care facilities should offer contraception services or referral to such services.

3. ✓ Protocols on post-procedure contraception should be developed and a supply of contraceptives should be available at facilities for termination of pregnancy.

4. ✓ Counselling and support services should be commissioned as part of the package of care.

Introduction

Termination of pregnancy is one of the most commonly performed gynaecological procedures in Great Britain. At least one-third of British women will have had an abortion by the time they reach the age of 45 years. In 2007, for women resident in England and Wales:

1. • the total number of terminations was 198,500, compared with 193,700 in 2006, a rise of 2.5%

2. • the rate among girls under 16 years of age was 4.4/1000 and that in the under-18 age group, 19.8/1000, both rates higher than in 2006

3. • 90% of terminations were carried out before 13 weeks of gestation; 70% at under 10 weeks

4. • medical terminations accounted for 35% of the total, compared with 30% in 2006.

The RCOG, in 2004, published national evidence-based guidelines on The Care of Women Requesting Abortion, which set quality standards for abortion services.

The aim of a termination of pregnancy service is to provide highquality, efficient, effective, and legal and comprehensive care, which respects the dignity, individuality and rights of women to exercise personal choice over their treatment. Ideally, this service should be an integral component of a broader service for reproductive and sexual health, encompassing contraception and management of sexually transmitted infections. The objective should be to offer impartial support and advice to all women with an unintended pregnancy, who request a termination, regardless of age, ethnicity, language, disability, religious or personal circumstances.