Dr Clare Lipetz is a Consultant Gynaecologist and has supported the RCOG’s Leading Safe Choices programme in South Africa and Tanzania.
Why is the availability of abortion care important for women?
Having choice and control over one's fertility and reproduction is essential for women and in my view a basic human right. Women use contraceptives that are not 100% effective (although often being told they are 99% effective which is plain wrong). Individual circumstances change and abortion will always be necessary and unavoidable. Unrestricted access to abortion care is life changing and can be life saving.
What drew you to working in abortion care (UK/Global)?
Abortion care is part of a gynaecologist's work and I take pride in providing an efficient, safe and empathic service. We still need to improve though! I have taught abortion skills in three sub Saharan countries and have seen the benefits of safe abortion care to women. It is humbling to work with health care professionals who are committed to developing and delivering high standards of care, often in very difficult circumstances in under resourced facilities.
Since you became an O&G how has the landscape around abortion changed?
There is still stigma attached to having an abortion for patients and those who work in abortion care. Having criminal law dictate how abortion is provided seems antiquated and paternalistic.
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 that abortion is seen by some doctors as a dirty secret and of little technical interest. There are many staff who do not want to be involved due to their personal convictions and this must be respected. However, we must show respect to all colleagues and patients.
What do you think are the key priorities to ensure abortion services are sustainable today and into the future?
Easy access to services (self referral); regional services for complex patients; abortion care networks and national standards; change in the law regarding abortion
What impact do you think the decriminalisation of abortion would have on abortion care services?
It would remove some of the stigma around abortion; allow easier and quicker access to services; contribute to increasing nurse led provision of care.
What role is there for post abortion family planning in abortion care services?
Women should be provided with contraception at the time of abortion with proper education about the efficacy of methods and full choice of all methods. Women should understand that contraception will be offered at the end of any pregnancy and we should make it our business to do so: whether after a full term pregnancy, abortion or miscarriage. It is not coercion but choice that we are offering.
This interview has been condensed and edited.