Secondary care services are struggling to manage demand for induced abortion. The study objective was to identify service-related delays and barriers faced by women seeking abortion care.

The study comprised a case note review and cross-sectional surveys conducted in South Durham. We surveyed and reviewed the case notes of women attending two fertility control clinics. We also surveyed GPs who referred women to these clinics. The outcomes were waiting times within the pathway to induced abortion, women’s rating of care, GPs’ attitudes, and self-reported practice.

Of 210 women surveyed, 132 responded. Of 107 referred by GPs, 16 had to make a second appointment with another GP willing to guide them, and 34 waited two or more days to receive a date for their hospital appointment. Women rated global satisfaction, providing information, and staff interaction more highly in secondary than primary care. Of 170 GPs surveyed, 140 responded; 33 considered themselves ‘broadly anti-abortion’.

Women face delays in accessing induced abortion care, both before and after a referral from primary care. While scope exists for improving quality of care and access within present service configurations, alternative approaches that bypass traditional gatekeepers to abortion care should be evaluated.