Abortion provision in Northern Ireland: the views of health professionals working in obstetrics and gynaecology units.

INTRODUCTION: Abortion became decriminalised in Northern Ireland in October 2019. Until that point there existed no evidence concerning the views of health professionals on decriminalisation or on their willingness to be involved in abortion care. The purpose of this study was to address this lack of evidence, including all categories of health professionals working in obstetrics and gynaecology units in Northern Ireland. METHODS: The online survey was targeted at medical, nursing and midwifery staff working in the obstetrics and gynaecology units in each Health and Social Care (HSC) Trust in Northern Ireland. The survey was issued via clinical directors in each Trust using the REDCap platform. RESULTS: The findings showed widespread support for decriminalisation of abortion up until 24 weeks' gestation (n=169, 54%). The majority of clinicians stated they were willing to provide abortions in certain circumstances (which were undefined) (n=188, 60% medical abortions; n=157, 50% surgical abortions). Despite regional variation, the results show that there are sufficient numbers of clinicians to provide a service within each HSC Trust. The results indicate that many clinicians who report a religious affiliation are also supportive of decriminalisation (n=46, 51% Catholic; n=53, 45% Protestant) and are willing to provide care, countering the assumption that those of faith would all raise conscientious objections to service provision. CONCLUSIONS: The findings of this study are very encouraging for the development, implementation and delivery of local abortion care within HSC Trusts in Northern Ireland and should be of value in informing commissioners and providers about the design of a service model and its underpinning training programmes.

Gynaecologists' attitude to abortion provision in 2015.

We aimed to ascertain the attitude of consultant gynaecologists towards the working of the 1967 Abortion Act, women's choice and decriminalisation of abortion, and whether they had requests on the grounds of foetal sex in the last five years. A postal questionnaire was sent to a 20% random sample of NHS gynaecologists, coded and analysed using SPSS. 286 doctors replied, 78%. 60% considered the abortion act was working satisfactorily. Ninety percent thought the woman should decide whether to continue the pregnancy in consultation with her doctor. However, 15% thought it too easy to obtain. Fifty-six percent of those with an opinion agreed that abortion should be decriminalised and treated like any other medical procedure. It is time to consider decriminalisation of abortion. About half performed abortions and 152 (97%) had never had a request for an abortion on the grounds of foetal sex. Sex selection is not a major problem in the UK.

Comparison of Marie Stopes scalpel and electrocautery no-scalpel vasectomy techniques.

OBJECTIVE: To compare the intra-operative experience and postoperative sequelae between the standard Marie Stopes scalpel vasectomy procedure and electrocautery non-scalpel vasectomy (ENSV) techniques. DESIGN: Randomised prospective comparative study. SETTING: Marie Stopes vasectomy centres in the UK. PARTICIPANTS: A total of 325 men undergoing vasectomy between January and June 1999. INTERVENTION: Random allocation to the two study arms plus questionnaires at 4 and 14 weeks postoperatively. MAIN OUTCOME MEASURES: Ease and speed of the procedure; pain levels during and after the procedure; early postoperative complications and time taken to return to work and sexual activity. RESULTS: The ENSV technique was marginally quicker to perform. Pain levels intra-operatively were comparable. Response rates to the questionnaire were 84.6% and 37% at 4 and 14 weeks, respectively. The ENSV group experienced less pain and bleeding from the wound postoperatively and were quicker to heal. For men who experienced postoperative problems, the time taken to return to work was marginally better in the ENSV group. The time taken to return to sexual activity was marginally faster in the ENSV group. CONCLUSION: The ENSV procedure appears to be suitable for mass application in locations where electricity is available.

The evolution of the Marie Stopes electrocautery no-scalpel vasectomy procedure.

OBJECTIVE: To review the evolution of the procedure, the reoperation rate and efficacy data for vasectomies performed in Marie Stopes centres during the periods 1990-1994 and 1995-1999. DESIGN: Retrospective review of re-operation rates and primary and secondary failures during the periods 1990-1994 and 1995-1999. SETTING: Marie Stopes vasectomy centres in the UK. PARTICIPANTS: A total of 41 123 men undergoing vasectomy. RESULTS: The re-operation rate for the period 1990-1994 was 0.7% and fell to 0.46% for 1995-1999. The reported pregnancy rate fell from 1 in 1429 procedures for the period 1990-1994 to 1 in 2804 for 1995-1999. CONCLUSION: The results show that vasectomy has had a low failure rate well below that of other methods of birth control. The outcome data continue to improve over time with the evolution of improved techniques and surgical expertise.