Written Statement to the Assembly by Health Minister Edwin Poots – Wednesday 22 August 2012 – Abortion Statistics in Northern Ireland: Results of Audit on 2008/09, 2009/10 and 2010/11 Data
I wish to make a statement to the Assembly following receipt from the HSC Board of a report on the audit of abortion information collected by HSC Trusts.
Earlier this year I asked officials to develop options for introducing a new data collection and reporting system on termination of pregnancies. As a result of their investigations, concerns were raised around the reliability of previously published data on abortions in Northern Ireland.
On 24th May 2012 the Department instructed the HSC Board to undertake an audit of the clinical coding related to abortions in Northern Ireland to assess the accuracy of the data produced.
The audit has clarified the structure of the terminology within the UK National Clinical Coding Standards ICD-10 4th Edition Reference Book, in relation to coding practice for code ‘O04 – medical abortion’. The structure of the terminology used within the UK National Clinical Coding Standards ICD-10 4th Edition Reference Book is as follows:
- Abortion: The term abortion means the expulsion or extraction of all (complete) or any part (incomplete) of the placenta or membranes (products of conception) without an identifiable foetus or without a liveborn infant, or stillborn, before the 24th completed week of gestation. This covers a range of codes within the ICD 10 structure and includes ‘missed miscarriages1 (the retention of a dead foetus before 24 completed weeks of gestation, with no signs of abortion), spontaneous abortions (known miscarriages) and terminations of pregnancy.
- Medical Abortion: The term medical abortion within the confines of the use of the ICD-10 code ‘O04 – Medical Abortion’ equates to (i) the interruption of a live pregnancy for legally acceptable, medically approved conditions, (ii) re-admissions with retained products of conception following a previous termination of pregnancy, missed miscarriage or a spontaneous abortion that had been treated in the first admission with an evacuation of the products of conception and (iii) a patient who had a termination of pregnancy and had retained products of conception in the same episode that required surgical treatment.
- Termination of Pregnancy: For the purposes of the audit and any future issuing of statistical information, ‘termination of pregnancy’ will define any patient who has a live pregnancy terminated for Northern Ireland legally acceptable, medically approved conditions. This is a subset of the term ‘medical abortion’.
In previously released responses to assembly questions on abortion statistics, the Department had used the code ‘O04 – medical abortion’ to produce the statistics required. However, given the clarification contained within the above definitions, and following careful discussion with medical colleagues, the Department has accepted that those people requesting statistical information on the number of abortions in Northern Ireland, should in future be provided with the subset of data for ‘termination of pregnancy’.
As a result of this clarification, I am advised that it is more appropriate to provide statistics on ‘termination of pregnancy’ rather than previously published data on ‘medical abortion’. As a result, the revised figures on termination of pregnancy in Northern Ireland are as follows;
Medical Abortions and Terminations of Pregnancy: 2006/07 to 2011/12
Termination of Pregnancy
Source: HSC Board
The Department is, of course, content to provide figures on both ‘medical abortion’ and ‘termination of pregnancy’ in the future, in accordance with the definitions, as appropriate.
The HSC Board continues to audit 2006/07 and 2007/08 data and any amendments to previously published data will be published on the Department’s website at:http://www.dhsspsni.gov.uk/index/stats_research/hospital-stats/inpatients.htm
1CKS Clinical Knowledge Summaries http://www.cks.nhs.uk/miscarriage/background_information/definition