Termination of pregnancy

This is a practical review of termination of pregnancy, but in the introduction the authors have traced the origins of induced abortion (termination of pregnancy; TOP) and the development of societal and legal thinking on the subject in the United Kingdom, which led to the Abortion Act in 1967. This legalization of abortion has had a major effect upon morbidity and mortality arising from TOP. Since that time attempts have been made to alter the terms of the Act, with variable success. The terms of the Act are discussed, followed by a description of modern methodology of TOP. Best practice is detailed, as is the mode of action of abortifacients and issues regarding surgical technique. Whatever the gestation, the woman requesting TOP should be offered a choice of method, but the earlier the abortion is undertaken, the lower the rate of complication, and certain techniques may be more suitable in different circumstances. There are recommendations with respect to available facilities in a termination service – these are explained. Finally, some problematic issues are discussed.