This page provides answers to frequently asked questions by trainees about termination of pregnancy. It provides examples of some of the issues discussed in the advice for trainees on termination of pregnancy produced by the RCOG Trainees’ Committee.
I’m an ST2 doctor in O&G and have a conscientious objection to termination of pregnancy, but I’ve been asked by the ward manager to prepare women for an afternoon’s surgical termination list of women with pregnancies of less than 15 weeks. What should I do?
The Abortion Act 1967 specifies that you can use conscientious objection to opt out of performing or witnessing terminations only. You should prepare the women for theatre as you would for any other procedure, such as an evacuation of retained products of conception. You should be expected to take consent from these women, as the procedure is the same as the procedure would should be gaining competency in for women with a miscarriage.
I’m an ST5 doctor and have been asked to assist one of my unit’s associate specialist doctors in the weekly termination clinic. No procedures are carried out, but decisions are made about terminations and the relevant paperwork is completed. I have a conscientious objection to termination. What should I do?
Doctors in O&G should be able to counsel women about all of their options when they request a termination. If the woman would like to pursue the option of termination, you should have already taken the relevant history and performed the relevant examinations in order to provide appropriate counselling. You don’t have to authorise a termination (i.e. sign the blue form), but you could complete some paperwork, including consent. You shouldn’t have to prescribe any drugs used for termination, but you could prescribe analgesia and antiobiotic prophylaxis.
I’m an ST1 doctor and have been asked to prescribe and give women on a surgical termination list vaginal misoprostol. I have a conscientious objection to termination. What should I do?
Vaginal misoprostol helps prevent women undergoing instrumentation of the cervix from sustaining damage. While you should be able to give vaginal misoprostol as part of your training, in this circumstance prescription and administration contribute to performing a termination. As such, you wouldn’t be expected to perform this futy.
I’m an ST1 doctor and have been asked to prescribe mifepristone for women about to have a medical termination. Nurses will administer the drug, but I have a conscientious objection to termination. What should I do?
The Department of Health construes prescribing drugs as partaking in termination, and therefore you wouldn’t be expected to prescribe the drug.
I’m an ST3 doctor and have been called to A&E at 3am to see a woman who underwent a termination at the local charity unit at 6pm the previous day. The woman is in pain. On examination, the cervical os is closed and there’s no blood in the vagina. Her observations are normal. I know that the woman has had a termination, and I have a conscientious objection to termination. What should I do?
You should treat this woman as you would treat any other, regardless of her previous procedure. This woman needs analgesia and further assessment.
I’m an Educational Supervisor and my trainee has asked me to sign off their competency in the logbook about termination. I know from previous discussion that this trainee has a conscientious objection to termination, which I share. What should I do?
The trainee should demonstrate, e.g. by completion of a workplace-based assessment or a certificate of completion of the RCOG’s e-learning material, that they can perform at the level expected by a trainee as set out in the curriculum. You shouldn’t sign off the competency unless you’re sure that the trainee has these competencies. Your own objections don’t prevent you from signing a trainee off, provided you’re satisfied that the trainee is competent.