Second trimester abortion: women’s health and public policy

This issue of Reproductive Health Matters grew out of a conference on second trimester abortion convened in London in 2007 by the International Consortium on Medical Abortion and attended by 90 expert clinicians and advocates from all over the world.

In many countries, legislation prohibits or restricts the grounds for second trimester abortions. Instead of preventing women from having abortions, these laws often force them to risk their lives doing so. There will always be women who need abortions after 12 weeks of pregnancy, but the numbers diminish greatly by 20 weeks, and become rare after 24 weeks.

Abortion-related deaths have been declining globally in the past three decades because many more countries now have safe, legal abortion. Methods have become substantially safer and simpler, more providers have been trained, and women with complications are more likely to seek and to receive medical help, even where abortion is still legally restricted.

This issue calls for the need for second trimester abortion to be met in a safe, timely and sympathetic manner In-depth, country-based research is needed, to bring out the facts on second trimester abortion, as evidence of why it should be treated as a legitimate form of women’s health care and supported in public health policy. Papers in this supplement cover the law and safety of second trimester abortion; women’s and providers’ perspectives; policy, politics and values; moving from unsafe to safe service delivery; currently recommended methods; methods that should go out of use; and recommendations for advocacy and action from the ICMA conference.

Titles include:

•A critical appraisal of laws on second trimester abortion
•Reasons for second trimester abortions in England and Wales
•A week in the life of an abortion doctor, Western Cape Province, South Africa
•Decision-making after ultrasound diagnosis of fetal abnormality
•Fetal pain: do we know enough to do the right thing?
Among papers on the law and safety of second trimester abortion; women’s and providers’ perspectives; policy, politics and values; service delivery; and recommended methods and methods that should go out of use. Other articles focus on countries such as Cuba, India, Mongolia, Mozambique, Nepal, the Netherlands, USA and Vietnam.