Dr Benjamin Black is a Trainee in Obstetrics and Gynaecology and a member of the Global Health Trainee Committee.
Why is the availability of abortion care important for women?
Abortions will happen with or without safe access. There seems no logical reason to deny women the availability of safe care or to make it unnecessarily complicated.
What drew you to working in abortion care?
As a medical student, I spent time volunteering in a clinic for refugees and illegal immigrants crossing from Myanmar into Thailand. Many women and girls presented after having performed or acquired an unsafe abortion. Witnessing the result of these procedures had a lasting impact on me and my interest in the social, economic and political determinants to accessing safe abortion care. I also reflected on the privilege we have in the UK, and other countries, where safe abortion is an available and legal choice and how easy it can be to take this for granted.
These views were only further solidified as I worked in other locations with limited frameworks for safe abortion care. In particular, whilst based in Central African Republic; high sexual violence, abuse of minors and lack of access to healthcare within a complex emergency setting resulted in many women and girls attending either following or in need of an abortion. On my first day in the country I watched an 18-year-old die from septicaemic shock following a back-street abortion. Working with these women and my local colleagues I gained a deeper appreciation for the desperate choices our patients faced.
I chose to incorporate abortion care into my practice as I believe that without doing so I would not be meeting the needs of women’s healthcare more generally.
As an abortion care provider/advocate have you experienced stigma within the healthcare system? If so, what steps do you think would address this?
I think we need to talk more openly about abortion and integrate it into our profession. Aside from cases of fetal abnormality, much of abortion care is side-lined or dealt with outside of NHS or general gynaecology. This has reduced exposure to doctors of the women and their care.
What do you think are the key priorities to ensure abortion services are sustainable today and into the future?
In addition, I would like to see provision of abortion directly by the GP at first visit rather than referral. I think that this would be possible, particularly for home-based medical abortion.
What role is there for post abortion family planning in abortion care services?
Family planning/contraception should be a part of healthcare at all levels, including abortion services. Much like an HIV test is no longer considered a specialist investigation, but routine and opportunistic. Family planning should be part of our conversation with patients at any consultation specialist or general; whether that be GP, antenatal, postnatal, gynaecological or during abortion consultations.
This interview has been condensed and edited.