Access to and experience of later abortion: accounts from women in Scotland.
BACKGROUND
Except in the presence of significant medical indications, the legal limit for abortion in Great Britain is 24 weeks' gestation. Nevertheless, abortion for nonmedical reasons is not usually provided in Scotland after 18-20 weeks, meaning women have to travel to England for the procedure.


METHODS
In-depth interviews were conducted with 23 women presenting for "later" abortions (i.e., at 16 or more weeks' gestation) in Scotland. Participants were women who sought an abortion at a participating National Health Service clinic between January and July 2013. Interviews addressed reasons for and consequences of later presentation, as well as women's experiences of abortion. Thematic analysis attended to emerging issues and employed the conceptual tool of candidacy.


RESULTS
Delayed recognition of pregnancy, changed life circumstances and conflicting candidacies for motherhood and having an abortion were common reasons for women's presentation for later abortion. Women perceived that the resources required to travel to England for a later abortion were potential barriers to access, and felt that such travel was distressing and stigmatizing. Participants who continued their pregnancy did so after learning they were at a later gestational age than expected or after receiving assurances of support from partners, friends or family.


CONCLUSIONS
Reasons for seeking later abortion are complex and varied among women in Scotland, and suggest that reducing barriers to access and improving local provision of such abortions are a necessity. The candidacy framework allows for a fuller understanding of the difficulties involved in obtaining abortions.
Centre for Population Health Sciences, Medical School, University of Edinburgh, Edinburgh, United Kingdom. Carrie.Purcell@ed.ac.uk.
Carrie
C
Purcell
Sharon
S
Cameron
Lucy
L
Caird
Gillian
G
Flett
George
G
Laird
Catriona
C
Melville
Lisa M
LM
McDaid
D000023:Abortion Applicants / Q000523:psychology; D000029:Abortion, Legal / Q000331:legislation & jurisprudence*; D000293:Adolescent; D000328:Adult; D003657:Decision Making; D057210:Delayed Diagnosis; D004739:England; D005260:Female; D005865:Gestational Age; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D062526:Patient Navigation; D011247:Pregnancy; D012606:Scotland; D012944:Social Support; D013997:Time Factors; D055815:Young Adult