How can we navigate the minefield of evidence around the effects of abortion? This is challenging enough for the medical student, let alone the teenager with an unexpected pregnancy or the counsellor with limited medical background trying to help her work this through.
This book aims to draw together the evidence in a way that is accessible to all these groups, as well as partners of pregnant women. The content is divided into three sections. The first deals with the process of making a decision about an unplanned pregnancy and the next deals with the three fundamental options in this situation (parenting, adoption, or abortion). The final section tackles some of the more complex and controversial areas, which include the effect of abortion on mental health, future fertility, premature birth, breast cancer, and mortality. Appendices give a brief overview of the positions of major religions on abortion and link to a host of mainly web-based resources offering help.
The authors all bring considerable experience to this field. Mark Houghton brings long experience as a GP in Sheffield as well as extensive writing experience; Esther Luthy also has a background in general practice in Switzerland and Christine Fidler is an experienced pregnancy counsellor.
This experience is evident particularly in the first section of the book; the tools and exercises suggested would be very helpful either to a patient thinking through a decision independently or to a healthcare professional supporting them in that process. I can see this being helpful in my own work as a GP, although consultations where someone is genuinely weighing up a decision about an unwanted pregnancy are increasingly rare.
A great deal of references are offered. This is particularly helpful for the more sceptical reader who may want to check the source of figures on more controversial topics, such as links between abortion and breast cancer. Some studies quoted are older than I might have hoped for, but this reflects a paucity of research on some of these questions rather than any omission by the authors.
Although the book starts from a perspective of wanting to equip people to make decisions, and admirably avoids telling people what to do, the authors' underlying views about abortion are obvious enough on reading through the material. However, it is refreshing that they avoid the angry rhetoric or condemnatory language that can be so unhelpful when discussing this sensitive subject. There was a real sense that the pregnant woman and her unborn child were at the centre of the writers' thinking, rather than a particular campaign position.
The layout is straightforward and clear, and the language largely accessible to the educated layperson. For the healthcare student, this book is a helpful reference for sources of evidence that might challenge the common assumption that abortion is the least harmful option for a woman with an unexpected pregnancy. It is also likely to help if we have to deal in a personal capacity with someone close to us facing the challenge of an unplanned pregnancy.
