Abortion Providers and Services
18 July 2016

French midwives third demonstration demanding to be recognised as medical, 2014

Le renforcement du rôle des sages-femmes réveille la bataille avec les gynécologues
(Strengthening of the role of midwives reawakens a conflict with gynaecologists) 

Following a government decree of 5 June 2016, midwives will soon be able to provide medical abortion pills up to seven weeks of amenorrhoea (nine weeks LMP) without the supervision of a gynaecologist. To promote knowledge of this new policy, the Department of Health launched a communications campaign on 22 June to raise public awareness of this expansion of midwives' roles.
On 28 June, six professional bodies for gynaecologists and obstetricians published a communiqué addressed to the government, objecting to the new policy. Their main concerns are that: 
  • There is no guarantee that existing gaps in medical care will be filled by midwives, yet the primary care of women and children would be devolved to them (Pap smear, vaccinations, ultrasound, reviews of the infant, deliveries, contraception, abortion, installing IUDs);
  • The government suggests that to consult a midwife is identical in terms of access to health care as to consult a doctor, while the level of training and competence are far from being the same;
  • The level of responsibility, particularly in the national insurance plan, between doctor and midwife is not the same. This means that if a mistake is committed by a midwife in the course of proposed care, it will be up to a physician to correct, repair and where appropriate to take responsibility for what happened, even though the situation was not of their doing.
This is a conflict that affects everyone in these two professions, not just in France... FULL STORY

Women's accounts of the experience of an ultrasound scan prior to abortion

Summarised and excerpted from:
Re-visioning ultrasound through women’s accounts of pre-abortion care in England,
by Siân M Beynon-Jones,
Gender and Society 2015;29(5):694–715.
The introduction to this study examines how the anti-abortion movement "has used developments in ultrasound imaging to claim that the fetus is visibly 'a person' and often draw on the accounts of women with wanted pregnancies who describe ultrasound as a pivotal moment of emotional bonding during which the “personhood” of an eagerly anticipated fetus is confirmed. They have therefore argued that "if women requesting abortion were shown ultrasound images of their pregnancies, they would inevitably share this emotional response and be dissuaded from the procedure". Over time, this construction of ultrasound has become entrenched through antenatal care practices, and prevented the multiplicity of pregnant women’s encounters with ultrasound from being voiced and acknowledged. 

This study took place in England where an ultrasound scan is a routine part of pre-abortion care in order to confirm the number of weeks of pregnancy. The practice became entrenched because medical abortion provision was initially restricted to 63 days of pregnancy LMP. Participants describe ultrasound as "... one of a series of medical assessments to which their own bodies needed to be subjected to enable their abortion, and as evidence that the embryo/fetus within their bodies was developmentally and morally insignificant. All such depictions represent a radical departure from the characterization of ultrasound as an experience of “maternal-fetal bonding."...

Tabbot Foundation's telemedicine abortion service is one reason why surgical abortion clinics are closing, but not the only one

Gynaecologist Paul Hyland, medical director of the Tabbot Foundation, readily admits he is helping to put his own separate abortion clinic out of business. Since the launch of the Tabbot Foundation in September 2105, a telemedicine service providing medical abortions, he has been forced to closed his Launceston abortion clinic. But there are other reasons too.
Dr Hyland says that changed laws around the licensing of day surgeries combined with additional costs of insurance, accreditation and compliance have pushed the cost of a surgical abortion to AUS $500 – double what the fee was just three years ago. Thus, he says, establishing the telemedicine service was a matter of necessity. The Foundation’s website averages 120 hits a day, sometimes generates up to 90 calls a day and consults with between 30 and 40 patients each week...

Attitudes towards abortion in graduate and non-graduate entrants to medical school in Ireland

Kevin O'Grady, Kieran Doran, Colm M P O'Tuathaigh,
Journal of Family Planning & Reproductive Health Care 2016;42:201-207
Background Recent legislation has sought to clarify abortion law in Ireland, allowing abortion where pregnancy endangers a woman's life, including through risk of suicide. Previous studies have shown that medical students’ attitudes towards abortion can predict their likelihood to provide abortion care services in the future.
Aim To survey graduate-entry (GEM) and undergraduate-entry (i.e. school-leaver; DEM) medical students in Ireland on their attitudes to abortion, in light of recent changes in legislation.
Methods Irish medical students completed an 18-item anonymous questionnaire, measuring knowledge and attitudes regarding abortion, and current Irish abortion law.
Results Of 525 respondents (response rate 52.9%), 92% indicated that abortion was justified in specific circumstances. Over 80% stated that abortion was justified in cases of risk to the life of the woman (including risk of suicide) or where the fetus would not survive until term...
Editor: Marge Berer

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