Journal scan

Barriers to an early abortion remain in developed countries

Women in developed countries continue to face significant barriers to securing an abortion in early pregnancy, a review of the evidence suggests.

Researchers reviewed 38 studies of access to first trimester abortions in developed countries between 1993 and 2014.

From the providers’ perspective, the main barriers included moral opposition to abortion, lack of training, too few physicians, harassment of staff by opponents of abortion and insufficient resources.

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From the women’s perspective, the barriers were lack of local services (particularly for women in rural areas, on low incomes or from minority groups), clinicians’ negative attitudes to abortion, and cost.

Opposition to abortion ranged from more than one in three doctors in rural Idaho in the United States to around one in five GPs in the UK.

The World Health Organization (WHO) recommends a combination of mifespristone and misoprostol for early medical abortion, yet access to the drugs varies widely.

The researchers say access could be improved by increasing options, including telemedicine, and by ensuring correct referral processes when staff oppose abortion.

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