The experience of travelling to Britain for an abortion need not be atraumatic one, according to the British Pregnancy Advice Service. CarolCoulter visited one of its clinics
The Blackdown Clinic, which has provided abortions for the British Pregnancy Advisory Service for 28 years, is situated in an 18th-century country house in Warwickshire, about 20 miles from Birmingham Airport. It also provides contraceptive advice, vasectomies and sterilisations.
The BPAS is a charity, and 70 per cent of its operational costs are met by the British National Health Service. Its charges to private clients are based on costs, plus a little extra for administration, and it allows reductions for hardship cases, according to its director, Mr Ian Jones.
On Saturdays, unlike most BPAS clinics, the Blackdown clinic is not open for clients, but last Saturday it was opened to show a group of journalists around and explain the procedures. The Irish Family Planning Association invited Irish journalists to view the facility, but The Irish Times paid its own costs.
Clinic manager Ms Chris Nicholls said 97 per cent of the clients attend on a daycare basis. The procedures vary depending on the length of gestation.
Up to 63 days a chemical abortion is possible. A woman attends for a consultation and takes one tablet orally. Two days later she returns, and three tablets are inserted into her vagina. She then goes home and aborts there in anything from one hour to a day.
However, this procedure does not suit most Irish women as it requires the woman to be in the vicinity of the clinic for three days. They usually opt for a surgical abortion, involving a general anaesthetic, although it is possible to have an early abortion with a local anaesthetic.
More than half the Irish women attending BPAS clinics do so on the basis of self-referral. Most of the rest are referred by the Irish Family Planning Association.
The woman is admitted and then taken to be examined by a nurse, where she is checked for problems such as ectopic pregnancy. If a complication like this is found, she is immediately checked into the nearest NHS hospital. If everything is normal she is put on a trolley and prepared with a drip for the anaesthetic, and for ECG monitoring during the operation.
The operation takes only two to three minutes where the pregnancy is up to 12 weeks' gestation, but it can take up to 12 minutes if the pregnancy is up to 19 or 20 weeks. That is the upper limit on abortions done by the Blackdown clinic.
"The cervix is dilated and the products are suctioned out of the uterus," Ms Nicholls explained. Asked what happened to the "products", she said: "Every woman is allowed look at them. She can take them home for burial if she wishes. Every operation is separately packaged, and she can come back the next day for them if she wishes. Otherwise we have a contract with a company which arranges cremation."
The director of counselling with the IFPA, Ms Cherie de Burgh, said there were a number of late terminations among Irish women because of severe foetal abnormalities in a planned pregnancy.
"There is a huge amount of loss," she said. "In one case the clinic arranged- for a local undertaker. The couple was able to hold the baby, name her and have a funeral. There was a cremation, and the mother was able to take the ashes home."
Following the operation the woman stays on the trolley for recovery in the eight-bed recovery room. After a minimum of half-an-hour, up to any period she wishes, she can go to a "recliner" room with reclining armchairs for tea and a biscuit. After a further rest there she gets dressed and goes downstairs to the dining room for a light meal, is discharged and goes home, with a letter of referral for her GP or the IFPA and a supply of anti-biotics to ensure against infection.
Overnight facilities exist for those who have later abortions, or who feel unwell after the anaesthetic, although Ms Nicholls pointed out that improvements in anaesthetics over the past five years made this a much rarer occurrence.
Late abortions involve induced labour, and this is carried out with controlled sedation. There is a cottage in the clinic grounds for partners, and the woman stays overnight in a different small ward.
Asked about reported depression and suicidal tendencies among women who have had abortions, Mr Jones said: "Most women have a huge sense of relief. If it resulted in such depression, given the number of Irish women who have abortions, doctors' surgeries would be clogged with women suffering from post-abortion depression."