This audit established a recent picture of pregnancy services termination in Wales, the UK, using the Royal College of Obstetricians and Gynaecologists’ Guidelines as a baseline. The context of abortion is rapidly changing, and services need to adapt to meet women’s needs.

A questionnaire survey was sent to all NHS Trusts in Wales; 10 out of 13 responded.

In the nine Trusts performing abortions in Wales, medical abortions accounted for 57% and surgical abortions for 43%. Doctors in training were involved in six Trusts. All but one Trust complied with referral times. Five Trusts provided a dedicated clinic. Written information provided before abortion varied in accessibility and quality. Choice of abortion within gestation bands was limited in some Trusts, with some only providing medical termination. Essential abortion aftercare was performed by Trusts, whereas follow-up and counseling were less comprehensive.

Trusts are willing to adapt to new methods of working with an increasing number of medical terminations. However, this advantage was offset by a lack of choice of abortion methods offered by some Trusts. Doctors in training should be provided exposure to abortion procedures in all Trusts as this has been shown elsewhere to improve attitudes. Providing dedicated abortion clinics, quality written information, and comprehensive abortion aftercare should enhance compliance with the guidelines.

Overall, in Wales, there is compliance with national guidelines, although, for a number of the guideline recommendations, there remains room for improvement.