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Abortion services in the UK need less hypocrisy and more acknowledgment of complexity

As 2017 gets under way, the USA swears in a new president with anti-abortion views, the UK marks 50 years since the 1967 Abortion Act, abortion remains a hot topic. Patchy access to services, inadequate training, a dwindling workforce and an unhelpful culture of exceptionalism blight UK abortion services, as highlighted by a collection of articles in this journal issue. While UK practitioners rally in new organisations and campaigns, an editorial calls for reform of its hypocritical and antiquated abortion law, but also for respectful debate which acknowledges the subject's complexity. See page 3

Iran's pronatalist policy risks disadvantaging the poorest, most

The political changes Iran has seen in recent decades make it a kind of natural experiment in family planning. An editorial by the journal’s International Advisory Editor, formerly resident in Iran, summarises the country’s family planning (FP) history in the light of an article in this issue (see page 37). Initially introduced as a maternal and child health measure, FP in Iran has always been subject to both liberal and conservative social and political influences. But a major swing to a pronatalist policy now promises to restrict access to contraception severely. The author argues that while it is government’s prerogative to legislate, it has no place in the bedrooms of the nation. See page 5

Abortion care lags behind other areas of healthcare in defining quality

How do we know what ‘good’ looks like in abortion care? This systematic review sets out to define quality in abortion care. The authors found more than 75 quality indicators proposed in the peer-reviewed and grey literature, spanning areas as diverse as policy, trained-provider availability, support for women's decision-making, and clinical safety. The diversity of indicators reflects the complexity of abortion care, but the lack of agreement and consistency between publications demonstrates the lack of a universal, translatable model. Abortion providers must drive this agenda, define what good looks like, and …

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