Key messages
In the UK there is inadequate provision of hospital-based abortion services, causing delays, difficulties, and denial of care for women with medical problems seeking to access a termination of pregnancy.
Surgical abortion by dilatation and evacuation is frequently the optimal method of abortion for women in the second trimester with complex medical problems, but availability of this procedure is especially limited.
We demonstrate the feasibility of expanding a hospital-based abortion services to accept referrals from across the UK. Other units, with the support of commissioners and the relevant national bodies, should consider doing the same, to ensure women are able to access care and are not forced to continue unwanted pregnancies that endanger their health.
Abortion services in the UK are increasingly commissioned within the independent sector. This has improved accessibility and lowered costs for the care of women who have no significant medical problems, but creates access problems for…