The Organization and Results of a Pregnancy Termination Service in a National Health Service Hospital

Summary A pregnancy termination service has been set up for patients living in the catchment area of a National Health Service hospital, without expansion of staff or facilities except by one extra, lay counsellor. The use of beds has been minimized by employing outpatient techniques in the majority of suction abortions. The organization is described in detail and the role of the counsellors is stressed. In the first year of the service, 488 of 529 patients who attended the weekly clinics had their pregnancy terminated; 433 had a suction abortion, 75 per cent of which were done under local anaesthesia, the proportion increasing to 93 per cent with greater experience. The use of local anaesthesia for suction abortion, compared with general anaesthesia, was not associated with any increase in the incidence of incomplete evacuation of the uterus (5.9 per cent) or possible sepsis (5.1 per cent) amongst women followed up, but there was a much smaller operative blood loss up to 10 weeks' gestation. Intrauterine contraceptive devices (IUCD) were fitted at the end of 44 per cent of suction abortions and this procedure was not associated with any increased incidence of postoperative pain or sepsis. The results in patients whose pregnancy was terminated by other methods are also reported. Following abortion, 84 per cent of patients attended a special follow‐up and contraception clinic. Of all patients who underwent abortion, at least 82 per cent were using a reliable contraceptive method (oral, IUCD, or sterilization), and, in addition, a quarter of those not followed up had been fitted with an IUCD after suction abortion.