In her Editorial, Mary Pillai refers to the article by Koh et al. (page 252) comparing three prostaglandin regimens for medical induction of mid-trimester abortion. While late abortion forms only a small proportion of the total number, its risks and complexity are greater than with early abortion. But the risks are dependent on the method used and there is evidence that the surgical approach to mid-trimester abortion using dilatation and evacuation (D&E) carries significantly fewer risks than the medical approach. She draws attention to the decreasing cohort of skilled D&E practitioners in the UK, such that in many cases women cannot be offered a choice between a rapid, safe and relatively pain-free abortion and a prolonged, riskier and undoubtedly painful and distressing experience. Training of a new cohort of doctors who are prepared to perform D&E is urgently needed. See page 249