The Wessex abortion studies: I. Interdistrict variation in provision of abortion services

An analysis of fertility and the provision of abortion and abortion-related services in the health districts of Wessex showed considerable variation between districts in the provision of formal family-planning services. The patterns of fertility varied between the districts and there appeared to be some relationship between family-planning provision and the rates for illegitimate and "legitimated" births and induced abortion. Although the region as a whole was meeting the demand of 42% of its abortion patients within the National Health Service, there was a considerable variation from district to district which could be explained only in part by variations in the provision of resources. The main differences could be accounted for by the attitudes of the women and of their general practitioners and consultants. Of Wessex women obtaining induced abortions privately at the British Pregnancy Advisory Service (B.P.A.S.) clinic at Brighton, 85% said they would have been willing to have an N.H.S. operation locally if one had been available but that no choice had been offered. It is concluded that the differences in provision between the health districts are more likely to be explained by the attitudes of doctors to providing this service than by the wishes of women to use private medical treatment.