Evaluation of Current Termination of Pregnancy and Related Services at Grimsby(UK) and Recommendations for Service Improvement

作     者：Ka Yan Shirley SZE Ibrahim BOLAJI Ka Yan Shirley SZE;Ibrahim BOLAJI;Department of Obstetrics and Gynaecology,Hull York Medical School(HYMS),Diana,Princess of Wales Hospital,Scartho Road,NLAG NHS Foundation Trust,Grimsby DN33 2BA,England

作者机构：Department of Obstetrics and GynaecologyHull York Medical School(HYMS)DianaPrincess of Wales HospitalScartho RoadNLAG NHS Foundation TrustGrimsby DN33 2BAEngland 

出 版 物：《Journal of Reproduction and Contraception》 (生殖与避孕（英文版）)

年 卷 期：2013年第24卷第3期

页      面：181-193页

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1001[医学-基础医学(可授医学、理学学位)] 100404[医学-儿少卫生与妇幼保健学] 10[医学] 

主　　题：termination of pregnancy (TOP) contraception long acting reversible contraception (LARC) 

摘      要：Objective To develop local termination of pregnancy （TOP） dataset and to identify ＂hotspots＂ for highest activity and gaps in our fertility control services. Methods This was a retrospective analysis of 305 women who received TOP under section C of the Abortion Act 1967 over a period of 9 consecutive months from 1st March through to 31st October 2012. Results There were 275 （90.2%） British White （BW） and 30 non-BW women. Among 30 non-BW women, 10 （3.3%） were British Asian, 8 （2.6%） were Polish, 6 （2.0%） were British Black or Black, 5 （1.6%） were Chinese and i （0.3%） was White Latvian. The TOP rate was 8.9% in the under 18 years old and 27.9% in the over 30 years old. Totally 240 TOPs （78. 7%） occurred in 〈10 weeks and 276 TOPs （90.5%） occurred under 13 weeks of gestation. Eight-five women who received TOP-service have had one or more previous termination（s） in the last 3 years. The contraception use was low pre-TOP and none of the women were on long-acting reversible contraception （LARCs） pre- TOP, including those who had repeat terminations. Conclusion There are inequalities and gaps in the TOP and related services in Grimsby which must be addressed to reduce the rate of TOP. This is a major challenge involving multiple agencies. Provision of contraception across all age and ethnic groups, improving sex education, engaging with parents and women to improve their negotiation skills for safer sex, supporting vulnerable women, reducing risk factors e.g. alcohol and substance misuse and raising aspirations across the region will contribute to a reduction in termination rate.