Abstract

PIP: British law is based on the principle that the informed consent of the woman is necessary for any investigation or treatment of the fetus at any point in pregnancy. The pregnant woman, not the fetus, is regarded as the patient. Conflicts have arisen, however, between women and their obstetricians in cases where abortion of a fetus with a serious congenital abnormality is requested, especially at gestational ages of 25 weeks or more. The proportion of abortions in England and Wales performed at 20-24 and 25 or more weeks are only 1.2% and 0.05%, respectively. Anecdotal evidence suggests that UK physicians believe the grounds for abortion for fetal abnormality should be more limited in the third trimester. However, there is no legal barrier to abortion after 24 weeks to prevent the birth of a child with a serious mental or physical handicap. The Royal College of Obstetricians and Gynecologists has recommended that measures be taken to ensure the death of the fetus in utero whenever a termination is performed after 21 weeks. Although abortion after 24 weeks should be necessary only on the rare occasions when a fetal abnormality has not been discovered earlier in pregnancy, it should be regarded as ethical regardless of its timing.