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Previous Abortions: Does Midwife Need to Know?

By: Kathryn Senior PhD - Updated: 8 Jun 2010 | comments*Discuss
 
Pregnancy Abortion Medical History

Q.

I've had two abortions before becoming pregnant with this baby - one with the two tablets and one via the medical procedure.

I haven't told my midwife about these as my husband does not know about them. How important is it for the hospital to know this information?

(K.B, 7 April 2009)

A.

On a personal level, you have every right to keep the information about your past abortions private. If you do not want to, there is no need to tell friends, family or your partner. That is your decision.

However, making the decision to withhold information that may affect your medical care during your pregnancy is going to be a difficult one. You won’t want to do anything that could impact on your own health, or on the health of your baby. Everything may go well, and no-one may ever find out. But, if something were to happen, you have to think through how you would feel and weigh up your need to keep this completely private with any possible risks.

If you chose to tell your doctors and midwife, they have a duty to respect your confidentiality as their patient and would not disclose the information to anyone else, not even your partner. You would need to explain the situation privately and you should find a midwife understanding and sympathetic. The details of this part of your medical history would not be put into notes that could be read by your partner or family but it would give the people looking after you in pregnancy this extra information, which they should know if anything were to go wrong.

To give you one example, if a woman has a rhesus negative blood group and her baby is rhesus positive, the first pregnancy, even one that is terminated, must be followed by an anti-D injection to stop the woman making antibodies to the baby’s blood. In subsequent pregnancies, this could cause anaemia in the baby. If such a woman had a termination, but was not given an anti-D injection she could produce harmful antibodies during her first full pregnancy. Doctors and midwives, working on the assumption that it was her first pregnancy, would not be looking for this problem. It might not be diagnosed until things had become really serious.

Giving your doctor and midwife the full information gives them the chance to provide the best medical care for you that they can. They will protect your right to privacy and they are unlikely to be judgemental about your previous decisions.

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