Evidence base to inform health service configuration for abortion provision 

Abortion service provision in the United Kingdom

Key Aims/Outcomes

Our aim is to provide an evidence base to inform the optimal configuration of health services and systems in response to current and future changes in the legal and regulatory context of abortion provision in the UK. The objectives are to:

  • collate, synthesise and summarise recent evidence for innovative models of abortion care with the potential to enhance access, quality of experience and cost-effectiveness;
  • explore the potential for beneficial and harmful consequences of current trends in abortion provision and identify implementation strategies to harness positive outcomes of current developments and mitigate adverse outcomes;
  • assess the potential of GPs and non-clinician providers in abortion provision, their education and training needs and their views on innovations in care;
  • elicit women’s views on current experiences of abortion and on preferences for abortion techniques, models of care and sources of support;
  • consult decision-makers on the range of innovative abortion practices and procedures and on the potential feasibility, acceptability and sustainability of their adoption in UK health services and systems.

School Priorities

Disparities, disadvantage and effective health care

Project Summary

Ensuring that abortion is a safe, effective and positive experience is an important part of good reproductive health care. Roughly one in three women have an abortion in their lifetime. In the UK, the drive for abortion to be brought into line with modern health care practice is gathering pace. Many people have called for abortion to be decriminalised, so removing the need for medical permissions; advances in technology have produced safe and effective methods, including medical abortion; and in the last two years, government ministers in England, Wales and Scotland have allowed women to take the second medical abortion pill themselves at home. Considerable changes are likely to be seen in provision of abortion in the next five years. These could have real benefits, making earlier abortion more likely, giving women more control over their abortion, making abortion feel more normal and removing stigma, and saving NHS resources by allowing task shifting to nurses and midwives and removing obstacles in the care pathway. Yet the evidence is that, at present, health services and systems are not well enough prepared to achieve these impacts. Workforce capacity is uncertain; training is not in place to equip non-specialist health care providers for a greater role in abortion provision; women’s needs for support and care are not fully known; ways of judging quality of care are not agreed; and not enough advantage is being taken of new models of care, abortion techniques and sources of support being developed elsewhere. Our aim is to gather evidence, which will help health services and systems in the UK to harness the best of the recent innovations in abortion provision to improve care.

Funding Sources/Amount

National Institute for Health Research (UK)

$1,850,943

Project Time Frame

November 2020 to November 2021

Research Team Members

Prof Kaye Wellings - London School of Hygiene and Tropical Medicine

A/Prof Rebecca French - London School of Hygiene and Tropical Medicine

Jennifer Reiter - Lambert Council

Prof Sally Sheldon - University of Kent

Dr Patricia Lohr - British Pregnancy Advisory Service

Prof Louise Keogh - University of Melbourne

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More Information

Louise Keogh

l.keogh@unimelb.edu.au