Your report of Dr. Persaud’s assurances of preparation for public hospitals to offer services for elective abortions is very encouraging (2 June, 2014).
Several of us have been waiting for this since 1995.
In fact, I recall a former CMO, Dr. Rudy Cummings, making a similar effort to open services at West Demerara Hospital. That was in 1996. Never happened.
I totally agree with Dr. Persaud in respect of the sensitive and controversial nature of providing these services.
In my view, the real constraint is neither skill nor resources but stigma, prejudice, bias and hypocrisy.
But let’s assume it is indeed skill. I have a simple suggestion that could make the CMO’s task a lot easier: follow the very conservative WHO’s guidance and permit mid-level health personnel to provide medication abortion for treatment in the first few weeks of pregnancy.
That would remove the burden on doctors, avoid any strain on hospitals, significantly reduce cost and substantially improve access. A winner on all fronts.
And yes, our law makes clear provision for this.
Further, with all due respect, Dr. Persaud is incorrect when he states that a license to practice medicine does not permit a practitioner to do abortions.
Our law permits any duly registered medical practitioner to provide abortions up to 8 weeks. It is only for treatment after 8 weeks that special training is required.
Frankly, for all his admirable courage, Dr. Persaud is moving in precisely the wrong direction.
He is restricting to doctors and burdening hospitals with a procedure that has become increasingly simple and safe. In many countries, early non-surgical (medication) abortion is being provided readily by mid-level providers and outside of hospitals.
Our CMO is relegating nurses to counselling only. Counselling is very important, but nurses can do a great deal more.
Dr. Persaud is running against both the tide of technology and the tide of history. He should go with the flow.
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