I’ve just been denied medical management of a failed abortion

[Tinyteatime]

I had a medical termination last Saturday, 7 weeks pregnant after my coil failed. Thought it had passed relatively easily so came away on a short holiday with my family luckily only 1.5 hours away from home. Started heavy bleeding and bad cramps yesterday, came to a&e as as advised by the BPAS clinic as I was flooding a pad and blood leaking through my trousers. Passed some very large clots. Internal scan reveals what they think is a foetal heart beat still in there. I’ve been in hospital one night and they said they would do the surgery on me this morning. I’ve just been told that all the doctors available won’t perform the procedure due to religion. This in the U.K. in 2019, in a hospital that offers abortion services. They’ve said I can stay another night and have it tomorrow, I have a breastfed baby that I’ve already been away from for one night, I’m in pain, bleeding and I’ve already had sepsis last year from a womb infection whilst giving birth so I’ve raised infection risk as a concern. I feel so angry about this. Would they deny women treatment for miscarriage? Or is it because there may still be a foetal heartbeat present? Is it simply because I’ve chosen to end the pregnancy myself? How in an nhs hospital can women be denied healthcare like this?

Fucking hell OP I hope you’re going ok. What a total shit show and i’m Glad you’re getting some insight from a number of posters here (Quince for a start).

I don’t have any advice to offer but you have my support as I was once told I needed to wait +2 weeks for ERPC surgery after a miscarriage due to staff holidays.

Sending lots of support and hope the extensive notes you have will give you an opportunity to challenge your experience.

I was googling "doctors in UK who oppose abortion" but didn't find anything useful re stats.

I did find this very factual, non - emotional , subjective article in The Sun from earlier this year.

www.google.co.uk/amp/s/www.thesun.co.uk/fabulous/3782462/uk-abortion-laws-nhs-termination-alabma-illegal/amp/

The subjectivity slipped a little here by the use of the word "unfortunately" but I'm happy for The Sun to highlight this.

Doctors in the UK have the right to refuse to sign off on your abortion if they have a moral objection to it, this can, unfortunately, mean needing to see more than two doctors to get the two signatures

Why the hell would a doctor specialise in gynaecology if they had religious misgivings about performing terminations??

You're in the wrong damn job, surely??
How dare they treat you so disrespectfully??

Jesus, i'm so angry for you, Tiny. 😠

@ ameanstreakamilewide I think because 98% of obs and gynae is not terminations

Given that one in three women has an abortion at some point in her fertile years, I'd guess that, though of course it's not the biggest part of practising gynaecology, it's still a pretty substantial fraction of the overall workload. A lot will be done in specialist clinics, but even so, it's hardly an unusual procedure, so one would expect mainstream obs and gynae to know about it, and to know how to handle it.

It's fascinating how attitudes change. One of the major pressure groups pressing for legalised abortion back in the day were doctors and midwives - because they had to deal with the aftermath of botched backstreet abortions, they were the ones who saw women dying from haemorrhages and infections.

Now (thanks to safe, legal abortion) it is mercifully rare to see a woman with serious complications from abortion, so I think a minority of medics now feel they have the right to be "holier than thou" about it.

Which has no place in obs and gynae. Can't deal with all aspects of women's health, don't go into women's health as a specialisation. Do genito-urinary surgery, or heart surgery, or opthalmology, or... There's thousands of specialisations to choose from. Don't do the only one which involves you routinely refusing to carry out perfectly reasonable and legal medical treatment on one in three of your patients.

Excellent post fermats.

Why the hell would a doctor specialise in gynaecology if they had religious misgivings about performing terminations??

Oh come on most of it does not involve abortion.

Given that one in three women has an abortion at some point in her fertile years

Where does that statistic come from ?

Where does that statistic come from ?

www.law.ox.ac.uk/news/2017-10-12-1-3-women-uk-will-have-abortion-so-why-it-so-secret

www.mariestopes.org.uk/abortion-services/

One in three women in the UK will have an abortion by the time they are 45.

The last gov.uk stats from 2018 show that abortion is on the rise.

www.gov.uk/government/collections/abortion-statistics-for-england-and-wales

Lass

I looked at the official statistics. They also contain these facts. I'm sure I've seen criticism of that 1 in 3 women statistic being skewed by the fact some women have more than 1 abortion.

38% of women who had an abortion had one or more previous abortions

The percentage of women having an abortion in 2017 who had had one or more previous abortions varies by ethnic group. 33% of Asian women having abortions in 2017 had previously had an abortion, compared with 46% of Black women (Figure 2c). 38% of White women having an abortion in 2017 had previously had an abortion

Oh come on most of it does not involve abortion.

www.independent.co.uk/life-style/health-and-families/features/1-in-3-women-have-an-abortion-and-95-dont-regret-it-so-why-arent-we-talking-about-it-10392750.html

Read this link Lass. Abortion is part and parcel of a woman's reproductive life cycle now. Thankfully in the UK it is safe and no longer dangerous because it is a medical procedure and not done in unsafe conditions, unless of course you happen upon those within a medical care setting, like the OP, who obviously have faith objections to it.

www.independent.co.uk/life-style/health-and-families/illegal-abortion-1960s-sixties-uk-pro-choice-activist-diane-munday-bpas-a7657726.html

Stats for the US run at 23%:
www.guttmacher.org/news-release/2017/abortion-common-experience-us-women-despite-dramatic-declines-rates

The NHS's own information gives the one in three statistic
www.nhs.uk/conditions/abortion/
albeit without references.

Government stats (ONS) on abortion.

assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/763174/2017-abortion-statistics-for-england-and-wales-revised.pdf

Currently 17 per 1000 women each year. So taken over a 30 year period (stats are for women aged 15 to 44) that's 510 per 1000.

Lower limit (highly implausible) - each woman choosing to have abortion has one a year for 30 years : 1.7% f women have abortions.

Upper limit (also highly implausible) - each woman choosing to have an abortion does so exactly once, so over entire 30 year period of a woman's reproductive life 51% have abortions.

The true number is somewhere between the two. I concede one in three may be on the high side, but one in four seems highly plausible.

Whether it's one in three or one in four, it's an incredibly common procedure, one which is legal, one which any medic with an ounce of compassion, empathy or professionalism should be prepared to deal with the aftermath of in a professional, non-judgemental way.

Whether it's one in three or one in four, it's an incredibly common procedure, one which is legal, one which any medic with an ounce of compassion, empathy or professionalism should be prepared to deal with the aftermath of in a professional, non-judgemental way.

^

This is a clear and well defined article on unsafe abortions worldwide.

www.ncbi.nlm.nih.gov/pmc/articles/PMC2709326/

It makes for very grim reading.

Lower limit (highly implausible) - each woman choosing to have abortion has one a year for 30 years : 1.7% of women have abortions

Upper limit (also highly implausible) - each woman choosing to have an abortion does so exactly once, so over entire 30 year period of a woman's reproductive life 51% have abortions

These ignore the number of women who never have an abortion and the 38% average over all ethnic groups who have at least 2.

If you (generic you) have trouble with stats, I find it's always helpful to turn them into frequencies. The 17 per 1000 is an average, over all age groups and averages over all women - the ones who have abortions, the ones who don't, all racial groups, all social groups.

Ignoring (to make the maths easier) variations in abortion rates with age (because in calculating the average that doesn't matter), we can follow a group of 1000 women from age 15 to age 44, i.e. 30 years.

Age 15 - 17 abortions.
Age 16 - 17 abortions
...
Age 44 - 17 abortions

Total number of abortions in this group of 1000 women, tracked longitudinally from age 15 to age 44
17* 44 = 510

Thus 510 abortions in a group of 1000 women.

Some women will have had one, some two, some multiple numbers. The upper and lower limits on the number of women having abortions (not the number of abortions in total) remain 1.7% and 51%, with a plausible number being somewhere between 1 in 4 and 1 in 3.

Yes, it's a back-of-the-envelope calculation. But it's a pretty good estimate. And tallies with the Guttmacher Institute's stats, and official NHS guidelines.

What is your argument Lass?

Scoring points?

it's an incredibly common procedure, one which is legal, one which any medic with an ounce of compassion, empathy or professionalism should be prepared to deal with the aftermath of in a professional, non-judgemental way

Of course and as this was aftermath issues the conscientious objection should not apply.

I'm just sceptical at the "1 in 3" figure particularly as both sides of the abortion debate use it to justify their position.

Also, the Guttmacher's web page is well worth a look. The lowest abortion rates in the world are typically in countries with free, legal abortion, and free, readily available contraception. Rates are actually higher in countries where abortion is illegal, because draconian attitudes to abortion typically go hand-in-hand with misogynistic attitudes to providing contraception.

What is your argumentLass?

Scoring points?

No, querying a very broad brush figure which seems implausible and which anti- abolitionists also use to justify their stance.

Is that all right with you? What was your point? Scoring points or shutting me up?

Sorry anti- abortionists

Lass, we've provided you with sources (ONS, Guttmacher Institute, NHS). We've talked you through the maths. We've agreed that there may be some uncertainty, but that ball-park the figure varies somewhere between one in four and one in three.

Not sure we can really do anything else if you still remain "sceptical". At this point it becomes a bit like arguing with a climate change denialist.

Nor is it relevant to the main point which is that abortion is a legal, common healthcare procedure which many, many women need, so it's bloody weird to choose to go into women's healthcare when you know you're not prepared to perform this legal, common healthcare procedure.

This is a thread about so called 'conscientious objectors' within a healthcare setting that in being so, could have led to the OP having further medical complications given her previous medical history.

Abortion is frequent within the reproductive life of a woman, that much is clear. Safe abortion is better for a woman of reproductive age. That much is clear.

Ergo, if you (generic you) wish to specialise within Ob/Gyn services, then you are highly likely to be treating women who are in their reproductive years with abortion. This is not a speciality to have 'conscientious objections'.

I'm a bit confused op. So you had a medical termination then came back into hospital with retained products and the doctor didn't want to operate?

Yes, that's exactly it, cushion. Furthermore, the doctor made clear that the reason they weren't operating was personal religious belief. It so happened that OP had stopped haemorrhaging by that point, but that wasn't the reason given for postponing treatment, the reason given was religious objections based on a dubious scan.

So the doctor that objected spoke to his/her colleagues and they found another doctor who doesn't object? And the op got the treatment she needed?