Scotland’s approach to later-term abortion access has come under scrutiny following revelations that the Task and Finish group convened to address this issue excluded the nation’s only two fully qualified surgeons capable of performing procedures up to the legal limit of 24 weeks. Documents obtained by The Herald revealed that despite eagerness from these experts to participate, their absence raises significant concerns about the efficacy of the discussions aimed at expanding access to abortion services during critical gestations.

The Scottish women’s health minister, Jenni Minto, informed The Herald that NHS chief executives had selected “local representatives from relevant services” for membership in this group. However, many have questioned whether these representatives possess the necessary expertise to address the nuances of later-stage abortion care. One of the excluded surgeons expressed to The Herald a hope that their presence could significantly inform the group’s decisions, highlighting a collective confusion surrounding their exclusion. Ed Dorman, a seasoned abortion provider with over four decades of experience in England, emphasised that the two Scottish surgeons were the most qualified individuals to develop a new service model for later-stage abortions, terming their absence “mystifying.”

Currently, the situation is stark: Scottish women require travel to England to access later-term abortion care, with the latest figures indicating some are forced to make the journey every four days to receive such services. Health boards in Scotland only offer procedures post-20 weeks under stringent conditions, such as severe foetal abnormalities or threats to the woman’s health. The consequence of excluding qualified personnel from policy-making discussions could lead to a reluctance to expand surgical abortion services, with concerns rooted in a significant drop in surgical procedures from 22% in 2014 to just 1.9% in 2024.

Dorman pointed out that the rise of telemedical abortion options during the COVID-19 pandemic may have led to fewer surgical abortions being performed, but this shift has inadvertently limited options for women needing care at later gestations. He voiced a prevailing worry that the absence of surgical expertise in the Task and Finish group could prompt a preference for medical over surgical abortions, which many women find traumatic. He highlighted that, especially for individuals with previous uterine surgeries, surgical abortions may be the safer option.

The Scottish Government’s Women’s Health Plan, established in 2021, promised an accessible framework for women to make informed choices about their abortion care. Despite commitments from the Scottish National Party to make abortion services available up to the 24-week legal gestation limit, glaring gaps in service provision persist. Recently, Minto signalled her intent to evoke change by urging the Task and Finish group to report back within six months while also providing funding for clinician training in later-stage abortion provision.

Notably, the British Pregnancy Advisory Service (BPAS) reported alarming increases in the number of women travelling from Scotland to England for abortion services, noting that 65 women made the journey in 2022, with indications that the figure could rise to 85 by the end of 2023. Campaigners have voiced strong condemnation of the Scottish Government’s inability to establish adequate services domestically, stressing the distress experienced by women forced into long journeys for care, often exacerbated by factors such as domestic violence or socio-economic challenges.

As discussions evolve within the Task and Finish group, the Scottish Government’s commitment to addressing this pressing issue remains critical. The potential establishment of comprehensive and equitable abortion services within Scotland must be a priority to ensure that all women, irrespective of their circumstances, receive the care they need close to home and without undue suffering.

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Source: Noah Wire Services