Ladies in waiting: the timeliness of first trimester services in New Zealand

Data were collected from all patients attending nine TOP clinics around the country between February and May 2009 (N = 2950). Patient records were audited to determine the timeline between the first point of entry to the health system to the date of termination. In addition, women were invited to fill out a questionnaire to identify personal level factors affecting access to services (N = 1086, response rate = 36.8%).Women waited an average of almost 25 days between the date of the first visit with the referring doctor and the date of their termination procedure. There was a delay of 10 days between the first visit with the referring doctor and the date that the appointment for the procedure was booked, and a further 10 days delay between the date the appointment was booked and the first appointment date. Over half of the women in this study had their pregnancy terminated at ten weeks or above.Women in New Zealand are subject to a lengthy delay while seeking TOP services. Efforts should be made by TOP clinics as well as referring doctors to reduce the waiting times for this service.Termination of pregnancy (TOP) services are a core service in New Zealand, accessed by a large proportion of the female population. National statistics indicate that approximately one quarter of all pregnancies in the country end with a TOP, and one in every four women undergoes a TOP in her lifetime [1]. With an induced pregnancy termination rate of 19.7 per thousand women of reproductive age, New Zealand joins the United States and the United Kingdom among the countries with high induced pregnancy termination rates [1,2].Although TOP is a safe procedure when conducted under hygienic conditions by a trained provider, the risk for clinical complications increases with gestational age [3-6]. Studies in the USA and Denmark found that abortion-related mortality increases exponentially with additional weeks of gestation, and women who have an induced abortion in their second trimester are sig