*Sensitive* How confidential is an abortion, really?

[BrewingMyCuppa]

Most websites I'm reading state it's confidential and most of the time nobody needs know, even if you're under 16. Knowledge about the abortion isn't even passed onto your GP without your consent.

However, there is a section that goes on to say your information may have to be shared if your safety or the safety of someone else is at risk.

I cannot think of any situations where it would be appropriate to share information with anyone else about a woman's abortion. Especially not medical ones. So why is it even stated?

If you started bleeding dangerously, or had an allergic reaction to the pill, they'd have to get emergency care and tell them why

Safeguarding. A woman may disclose something that would necessitate a safeguarding referral.

It's to cover the needed safeguarding actions if you're clearly being beaten, or on drugs, or appear to have been trafficked, that sort of thing.

Or if you need to be rushed to another medical centre for emergency or followup, they'll share records at that point because you can't be safely referred without knowing the medical history.

It would be extremely relevant medically if you have a subsequent pregnancy. Especially if you are a rhesus negative blood group.

I see there are quite a few obvious reasons I didn't even think of!

What if a woman phoned to cancel her follow up to complete the abortion, and says she's gone into labour after leaving the clinic, after having feticide? I wonder if they'd disclose her information to make sure she's safe?

They send you home and you return another day after the injection, from what BPAS say.

I'm just thinking of situations where confidentiality may become blurred. I've worked in a similar setting and it was fairly rare, but sometimes the lines of when to break confidentiality are tricky

It would be extremely relevant medically if you have a subsequent pregnancy. Especially if you are a rhesus negative blood group.

I agree but surely those two reasons are 100% the woman's choice to disclose? And she doesn't have to if she does not wish?

If someone under 18 was pregnant to someone older than 18 that would probably have to be reported

Stars You can legally consent to any aged man having sexual intercourse with you if you're 16+ and they're not in a position of trust (teacher, doctor etc)

I had an abortion before I had my DC's. It was carried out at the local hospital, on both my DC's birth notes it states pregnancies, so on dds it says 2 and on ds's it says 3. Whilst it doesn't state that pregnancy 1 ended by an abortion they have clearly recorded it as a pregnancy. I was a little surprised at seeing it the first time around.

Mama I think that's because it was carried out at a hospital, presumably NHS?

Places like BPAS are suppose to keep it a secret in those circumstances

I agree but surely those two reasons are 100% the woman's choice to disclose? And she doesn't have to if she does not wish?

Yes I suppose so. The trouble is there is a high risk that the rh -ve woman would not realise the medical importance of disclosing the abortion when she has her next pregnancy. I was in this position- luckily I did disclose my previous abortion, midwife explained the rh -ve issue and there were then checks to ensure I’d had anti d injections at the time.

I had an abortion between my second and third children. When I was at the booking in appointment for a subsequent pregnancy the booking in midwife could see the record of it but she put it on my printed notes as miscarriage for privacy. I'm rhesus negative though so it was important that there was a record.
Is there a particular type of disclosure/person who might find out that you're concerned about?

I have just had a conversation about this with a GP friend. She says

"If I see the woman initially I will only ever write 'pregnancy, unwanted' and 'referred for ToP' (if applicable) on her notes. This is normal practice among all GP surgeries. Lots of women don't end up having the termination. Organisations like BPAS only send GPs a notice of termination if patient had consented, and the vast majority do consent to that sharing of info. It can be really important for the GP to know because of the many many issues which can arise as a result, sometimes years later (mental health problems in particular) - it's better that the GP can see from the notes about the termination rather than rely on a distressed patient disclosing it"

Also she pointed out how few people actually have access to a patients notes - and it's a sackable offence to look at them if you don't have a valid reason, even if you're a doctor, hospital staff, etc. Your name is registered on the notes every time you open them and there is a robust auditing process in all NHS trusts.