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Are we prepared for change? The need for evidence on healthcare practitioner readiness for current and future trends in abortion provision in the UK
BMJ Sexual & Reproductive Health ( IF 3.3 ) Pub Date : 2022-04-01 , DOI: 10.1136/bmjsrh-2021-201243
Rebecca S French 1 , Jill Shawe 2 , Melissa J Palmer 3 , Jennifer Reiter 4 , Kaye Wellings 3 ,
Affiliation  

Significant changes are occurring in the landscape of abortion provision in the UK. More women are having medical abortions and self-managing these at home, resulting in an increase in the proportion of abortions performed before 10 weeks’ gestation.1 Since 2018, women in Britain have been able to take misoprostol, the second medication for medical abortion, at home provided they have attended a clinic to have it prescribed. The COVID-19 pandemic has accelerated the trend towards self-management. As an emergency and temporary measure due to concerns about reduced health service access for women with unwanted pregnancies during the pandemic, consultations about pregnancy options have occurred by telephone or video and, if women wish and are deemed clinically appropriate, a medical abortion pack of both mifepristone and misoprostol can be posted to their home (up to 9 weeks, 6 days’ gestation in England and Wales, and no restriction in Scotland, but clinical guidelines state up to 11 weeks, 6 days). Laws prohibiting abortion have been repealed in Northern Ireland, effectively decriminalising most abortions, and pressure for decriminalisation has been mounting in the rest of the UK. The changes are taking place alongside shifts in thinking about healthcare generally. Recognition of patient-centred approaches and supported self-management, alongside enhancement of activities that complement clinical care in sexual and reproductive health, has gained more prominence. The changes have significant implications for all methods of abortion …

中文翻译:

我们准备好迎接改变了吗?需要证据证明医疗保健从业者对英国堕胎提供的当前和未来趋势的准备情况

英国的堕胎条款正在发生重大变化。越来越多的女性在家里进行药物流产并自行管理,这导致在妊娠 10 周之前进行堕胎的比例增加。1 自 2018 年以来,英国的女性已经能够服用米索前列醇,这是用于药物流产的第二种药物,在家里,前提是他们已经到诊所开过处方。COVID-19 大流行加速了自我管理的趋势。由于担心在大流行期间意外怀孕的妇女获得医疗服务的机会减少,作为一项紧急和临时措施,已通过电话或视频就怀孕选择进行咨询,如果妇女愿意并被认为在临床上合适,可以将包含米非司酮和米索前列醇的药物流产包邮寄到他们的家中(英格兰和威尔士的妊娠期最长为 9 周 6 天,苏格兰没有限制,但临床指南规定最长为 11 周 6 天)。北爱尔兰废除了禁止堕胎的法律,有效地将大多数堕胎合法化,而英国其他地区的非刑事化压力也越来越大。这些变化伴随着人们对医疗保健的普遍看法的转变而发生。承认以患者为中心的方法和支持的自我管理,以及加强补充性健康和生殖健康临床护理的活动,已经获得了更多的关注。这些变化对所有堕胎方法都有重大影响…… 在苏格兰没有限制,但临床指南规定最多 11 周 6 天)。北爱尔兰废除了禁止堕胎的法律,有效地将大多数堕胎合法化,而英国其他地区的非刑事化压力也越来越大。这些变化伴随着人们对医疗保健的普遍看法的转变而发生。承认以患者为中心的方法和支持的自我管理,以及加强补充性健康和生殖健康临床护理的活动,已经获得了更多的关注。这些变化对所有堕胎方法都有重大影响…… 在苏格兰没有限制,但临床指南规定最多 11 周 6 天)。北爱尔兰废除了禁止堕胎的法律,有效地将大多数堕胎合法化,而英国其他地区的非刑事化压力也越来越大。这些变化伴随着人们对医疗保健的普遍看法的转变而发生。承认以患者为中心的方法和支持的自我管理,以及加强补充性健康和生殖健康临床护理的活动,已经获得了更多的关注。这些变化对所有堕胎方法都有重大影响…… 在英国其他地区,非刑事化的压力越来越大。这些变化伴随着人们对医疗保健的普遍看法的转变而发生。承认以患者为中心的方法和支持的自我管理,以及加强补充性健康和生殖健康临床护理的活动,已经获得了更多的关注。这些变化对所有堕胎方法都有重大影响…… 在英国其他地区,非刑事化的压力越来越大。这些变化伴随着人们对医疗保健的普遍看法的转变而发生。承认以患者为中心的方法和支持的自我管理,以及加强补充性健康和生殖健康临床护理的活动,已经获得了更多的关注。这些变化对所有堕胎方法都有重大影响……
更新日期:2022-04-01
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