Induced abortion: an audit of reported current practice among consultant gynaecologists in Scotland.

OBJECTIVE: To obtain an overview of current abortion practice in Scotland for comparison with agreed criteria for good quality care based on literature review.
DESIGN: Postal questionnaire survey.
SUBJECTS: All 132 consultant gynaecologists practising in the NHS in Scotland.
RESULTS: Response rate 92%. The survey revealed regional inequalities in the availability of services, particularly with regard to early medical abortion and second trimester procedures. It also revealed great individual variations in many areas of practice notably in screening for genital tract infection, the use of cervical predilatation, contraceptive provision, and follow up. Several aspects of practice compared poorly with the agreed criteria for good quality care.
CONCLUSIONS: The postal questionnaire approach achieved a good response rate and has provided an informative overview of current practice on a national basis. Variations in the provision of services and in clinical practice, both among regions and among individual consultants, have been identified. Elements of abortion care in which great variations exist and in which current practice compares poorly with the agreed criteria have been highlighted as appropriate areas for the development of national guidelines and for educational initiatives. Such a questionnaire approach to assessing current practice can complement, and possibly replace, some aspects of casenote review audit.