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
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
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
- 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’.
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
Medical Abortions and Terminations of Pregnancy: 2006/07
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.