Learning Objectives:-

Under the Abortion Act 1967 :-

Justification for medical termination of pregnancy include:

• The pregnancy does not surpass 24 weeks, and that continuation of the pregnancy would entail greater risk (to the mental/physical health of the pregnant lady or any existing children of her family) than if the pregnancy were terminated.
• Severe permanent injury to the physical or mental health of the pregnancy lady would be prevented by termination of the pregnancy.
• The risk to the life of the pregnancy lady would be greater by continuation of pregnancy than if it were terminated.
• if the child were born, there is considerable risk that it will suffer from physical or mental abnormalities, as to be significantly handicapped.

In this case point 3 and 4 would justify termination of pregnancy.

Under the HFEA 1990 Act, it amends the Abortion Act 1967 to allow abortions where there is a serious risk of foetal handicap upto birth.

• The rights of the mother and the interests of the foetus to life.
• The rights of that father and his wishes.
• At which point does the foetus attains human rights?
• Which is more important, the life of the mother or the life of the unborn foetus? How do you decide? In reality, the obstetrician is more concerned about the life of the mother. However the mother has been trying for so long to get pregnant, this baby is very special to her, and therefore she is less willing to terminate the pregnancy.
• Psychological trauma to the mother and her husband need to be considered as they have to choose between the life of the mother and the life of a baby. Also if she terminates the pregnancy, she may not be successful in getting pregnancy again.

• Incidence of preeclampsia is 5% (range 5 - 10%) of all pregnancies. Maternal complications of preeclampsia include:-

• HELLP (10-20%)
• Pulmonary oedema (2-5%)
• Acute renal failure (1-5%)
• Placental abruption (1-4%)
• Eclampsia (<1%)

• These risks increase in those < 33wk gestation.
• The importance of recognising early stages of pre-eclampsia.
• A recent study in the UK amongst medical student showed that 62% were pro-choice and 33% pro-life and 7% was undecided. This was comparably a lower pro-life percentage than a similar survey of GPs, the authors were unsure whether this was a societal change to abortion, or because doctors become more pro-choice as they develop.

• Abortion Act 1967
• HFEA 1990 Act
• Medical students' attitudes towards abortion: a UK study J Med Ethics 2008;34:783-787

Dom says...

This really hits the spot between clinical and ethical needs of patients. Its rather harrowing

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