Advancing Sexual and Reproductive Health and Rights
 
Perspectives on Sexual and Reproductive Health
Volume 46, Number 2, June 2014

Access to and Experience of Later Abortion: Accounts from Women in Scotland

By Carrie Purcell, Sharon Cameron, Lucy Caird, Gillian Flett, George Laird, Catriona Melville and Lisa M. McDaid

CONTEXT: Except in the presence of significant medical indications, the legal limit for abortion in Great Britain is 24 weeks’ gestation. Nevertheless, abortion for nonmedical reasons is not usually provided in Scotland after 18–20 weeks, meaning women have to travel to England for the procedure.

METHODS: In-depth interviews were conducted with 23 women presenting for “later” abortions (i.e., at 16 or more weeks’ gestation) in Scotland. Participants were women who sought an abortion at a participating National Health Service clinic between January and July 2013. Interviews addressed reasons for and consequences of later presentation, as well as women's experiences of abortion. Thematic analysis attended to emerging issues and employed the conceptual tool of candidacy.

RESULTS: Delayed recognition of pregnancy, changed life circumstances and conflicting candidacies for motherhood and having an abortion were common reasons for women's presentation for later abortion. Women perceived that the resources required to travel to England for a later abortion were potential barriers to access, and felt that such travel was distressing and stigmatizing. Participants who continued their pregnancy did so after learning they were at a later gestational age than expected or after receiving assurances of support from partners, friends or family.

CONCLUSIONS: Reasons for seeking later abortion are complex and varied among women in Scotland, and suggest that reducing barriers to access and improving local provision of such abortions are a necessity. The candidacy framework allows for a fuller understanding of the difficulties involved in obtaining abortions.

Perspectives on Sexual and Reproductive Health, 2014, 46(2):xx-xx, doi: 10.1363/46e1214

DOI:10.1363/46e1214







 

AUTHOR AFFILIATIONS

Carrie Purcell is research fellow, Centre for Population Health Sciences, Medical School, University of Edinburgh, Edinburgh, United Kingdom. Sharon Cameron is consultant gynecologist, NHS (National Health Service) Lothian, Edinburgh. Lucy Caird is consultant obstetrician and gynecologist, NHS Highland, Inverness. Gillian Flett is consultant in sexual and reproductive health care, NHS Grampian, Aberdeen. George Laird is network manager, NHS West of Scotland Sexual Health Managed Clinical Network, Glasgow. Catriona Melville is consultant in sexual and reproductive health care, NHS Ayrshire and Arran, Kilmarnock. Lisa M. McDaid is program leader in sexual health, MRC/ CSO (Medical Research Council/Chief Scientist Offi ce) Social and Public Health Sciences Unit, University of Glasgow.