Lucy Caird


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    Most women choosing termination of pregnancy
    are certain of their decision and do not need more
    Caird, L1; Cameron, S2; Glasier, A3; Hough, T1
    1 Raigmore Hospital, NHS Highland, UK; 2 Chalmers Sexual and
    Reproductive Health Centre, UK; 3 Department of Reproductive and
    Developmental Sciences, UK
    A self-administered questionnaire using a validated measure of
    pregnancy intention (London Measure of Unintended Pregnancy)
    was introduced as part of routine assessment for women
    requesting a termination of pregnancy (TOP) at a NHS hospital
    clinic in Inverness, Scotland, UK aimed at identifying those who
    may need more discussion on their decision to proceed with a
    TOP. We wished to determine the proportion of women for
    whom the pregnancy was clearly unintended, the proportion who
    were not certain of their decision and who would like more
    detailed discussion, and the proportion who subsequently
    proceeded with a termination of pregnancy.
    Methods: A retrospective review was conducted of the outcome
    of the pregnancies amongst women attending the service between
    January and July 2011.

    Results: One hundred and eighty-five women with a viable
    pregnancy completed a questionnaire. The pregnancy was clearly
    unintended in 166 (90%) cases. One hundred and sixty-seven
    women (90%) stated that they were certain of the decision to
    have a TOP and 150 women (81%) did not want further
    discussion about this decision. One hundred and sixty-three
    women (88%) proceeded with a termination of pregnancy.
    Conclusion: Most women referred to a clinic requesting an
    induced TOP have a clearly unintended pregnancy, are certain of
    their decision and do not wish further counselling. Subjecting
    women to compulsory counselling about their decision to have a
    TOP is in conflict with their wishes and would waste resources.

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    Telemedicine for abortion care: the Highlands experience

    Lucy Caird1, Sharon Cameron2, Tracy Hough1 1Raigmore Hospital, Inverness, UK, 23 Department of Reproductive and Developmental Sciences, University of Edinburgh,, Edinburgh, UK -

    In NHS Highland we provide an abortion service in a geographically challenging environment especially in terms of providing care within the context of the UK Abortion Act. Travel time to and from our service will be a consistent barrier to providing early medical discharge with those excluded consistently at around 35%. Our aim was to improve care by streamlining care with fewer visits and thus remove some inequity in providing abortion care in our remote and rural area. To reduce visits we offer a telephone consultation option with information sharing that affords women the chance to reflect on their choices and for us to 'one stop' their visit especially where flights or ferries are involved. Women from further away have to choose either day case medical or surgical abortion in hospital and this has resource implications for the gynaecology service. Manual vacuum aspiration can offer women the advantages of same-day treatment and as with all surgical abortion the easy insertion of intrauterine contraception chosen by 55% of the women having MVA. In this paper we discuss how we have developed new ways to deliver this service remotely and have aimed to make it as streamlined as possible for women.