Abortion

‘Abortion’ is the term used when someone chooses to go through a medical process to end their pregnancy. It is also known as a 'termination' or a 'termination of pregnancy'.

The decision to have an abortion is an important one. This page will give you information on the choices you have and what is involved.

Why is this important?

  • there are many reasons why a woman might decide to have an abortion, for example, her personal circumstances and ability to care for the child, health risks to the mother, or if there is a high chance the baby will have a serious genetic or physical abnormality
  • if you are unsure, you can talk to a health professional to get some advice
  • an abortion is not the same as a miscarriage, which is where the pregnancy ends without medical intervention.

Who does it affect?

  • about a third of women in the UK will have an abortion by the time they are 45.

Talking to your partner

If you are in a relationship, you might want to talk to your partner about your options. You may want to consider your circumstances together. But even if your partner is the person who you became pregnant with, that doesn’t mean they can tell you what decision to make. It’s your body and your choice.

What does this mean for me

Abortion is a very safe procedure when carried out under the care of a hospital or licensed clinic. The earlier an abortion is carried out, the safer it is.

Lots of studies have found that abortion is unlikely to affect your chances of becoming pregnant in future.

Making your decision

  • the options you have will depend on how many weeks pregnant you are
  • as different women will have different reasons for considering an abortion, it’s important to consider your unique situation. Some people are very clear about their decision whilst others find it really hard, and might take some time to make up their mind
  • you may find it helpful to talk to someone you trust - this might be a friend or family member, or a health professional or support worker. There are lots of organisations that can give you informed, confidential advice and support (see below).

Risks

There are some risks associated with abortions to be aware of. These are rare and usually happen within a short period following the procedure:

  • haemorrhage (excessive bleeding) occurs in about 1 in every 1,000 abortions
  • damage to the cervix (the entrance of the womb) occurs in no more than 10 in every 1,000 abortions
  • damage to the womb occurs in up to 4 in every 1,000 abortions during surgical abortion, and less than 1 in 1,000 medical abortions that are carried out at 12-24 weeks
  • you should seek immediate medical help after having an abortion if you experience heavy bleeding, severe pain or have a high temperature.
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More support

  • BPAS (British Pregnancy Advisory Service) affordable private abortion, contraception and reproductive health services across the UK
  • Marie Stopes and Brook offer free pro-choice counselling - that is, no one will push you to have an abortion, or to continue with the pregnancy. They will listen to you and help you come to a decision, but the decision will be yours
  • Women on web questions and answers on abortion.

Where to go

If you want to have an abortion through the NHS, you’ll usually need to be referred to a specialist service that deals with abortion. You can ask your GP to refer you or you can go to your local sexual and reproductive health clinic. Find your nearest clinic.

In some areas of England you can refer yourself. To find out if you can self-refer for NHS-funded abortion care, call Marie Stopes on 0345 300 8090 (24 hours).

Generally, an abortion should be carried out as early in the pregnancy as possible, usually before 12 weeks and ideally before 9 weeks where possible.

In the UK, it is legal to have an abortion up to 24 weeks. If there is a serious health risk to a mother or baby, this can be extended.

Prepare

During your first appointment with your GP or clinician, you should be given the opportunity to talk about your situation and which method of abortion is suitable for your stage of pregnancy. You will also be advised about any related risks and complications.

You should also be tested for sexually transmitted infections (STIs).

You may also be given information and advice about your contraceptive choices after the abortion.

Before having an abortion, you may also need to have:

  • an ultrasound scan (if there is any doubt about how many weeks pregnant you are)
  • an internal vaginal examination
  • perform routine checks such as blood pressure and heart rate
  • complete a finger prick blood test to check which blood group you are.

You will be asked to sign a consent form before the abortion is carried out.

How does abortion work?

There are several different procedures, depending on what stage of pregnancy you have reached, read about those here.

Questions?

From the first day of your last period. For women with a menstrual cycle of average length, that day is usually about two weeks before conception, which explains why pregnancies are said to last 40 weeks.

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Depending on the length of the pregnancy, a small pregnancy sac may be visible.

Most of the time women can see blood and tissue in their sanitary pad or in the toilet. The (very small) embryo is usually passed within this blood and tissue, and so often goes unnoticed.

At 8-9 weeks pregnant, you might see a sac in the blood and it may be possible to see the embryo (at this stage the embryo is about 2.5 cm) this can be distressing. It is best to flush the toilet and throw sanitary pads away as usual.

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Early abortion procedures

Early medical abortion - up to 9 weeks

An early stage abortion is possible without an internal procedure. Three clinic appointments are needed.

You will be asked to take two different medicines 36-48 hours apart.

  • On your first visit you will be given an abortion pill to block the hormone that makes the lining of the womb suitable for the fertilised egg. A few women will have mild cramps and a little bleeding at this stage. If you have heavy bleeding or significant pain, you should contact the hospital or clinic where you had your appointment. If it is out-of-hours, you should go to the nearest A&E department.
  • Two days later, you will be given the second medicine and within four to six hours, your womb will expel the pregnancy. This part of the process can be painful, but you can take a painkiller. Bleeding may be heavy and you may notice some clotting. Some women can find this distressing so you should talk to your clinician in advance about what to expect.

Some services have facilities for this process to happen at the clinic. Some women prefer to go through this process at home. This can be your choice.

Vacuum aspiration or suction termination - 7 to 15 weeks

This method uses gentle suction to remove the foetus from the womb. The procedure usually takes 5 to 10 minutes and can be carried out in a day surgery unit under either sedation local anaesthetic or general anaesthetic. If you have sedation or general anaesthetic you will need to have someone with you after the procedure and you will not be able to drive home yourself.

You will usually be able to go home the same day.

  • your cervix (womb entrance) will be widened. This may be made easier by an oral or vaginal tablet a few hours before that softens your cervix
  • a small, plastic suction tube connected to a pump will then be inserted into your womb and used to remove the foetus and surrounding tissue.

Following the procedure, you will usually experience vaginal bleeding for up to 21 days.

In most cases, the bleeding will be quite heavy for two to three days before settling down. You may experience cramps for which you can take painkillers at home.


Later abortion procedures

Surgical dilation and evacuation (D&E) - 15 to 24 weeks

This is a surgical procedure carried out under general anaesthetic. It usually takes 10-20 minutes and, if you are healthy and there are no complications, you may be able to return home the same day.

Your cervix will be gently stretched and dilated. Forceps and a suction tube will be used to remove the foetus and tissue within the womb.

You may experience vaginal bleeding for up to 21 days afterwards.

Late medical abortion - 9 to 20 weeks

This method uses the same medication as an early medical abortion but will take longer and more than one dose of medication may be needed.

You will usually be able to return home on the same day. However, sometimes an overnight stay in hospital may be required.

In a small number of cases (less than 1 in 20), the placenta or afterbirth does not pass. In this case, you may need to have a small operation under a general anaesthetic to remove the placenta.

Late abortion - 20 to 24 weeks

There are two options and both require an overnight stay in hospital and are carried out under general anaesthetic.

1. Surgical two-stage abortion:

  • stage one stops the heartbeat of the foetus and softens the cervix
  • stage two (carried out the next day) involves removing the foetus and surrounding tissue.

2. Medically induced abortion (similar to a late natural miscarriage)

  • medicine is injected into your womb, making it contract strongly (as in labour). Contractions can last 6-12 hours. You will remain awake during this stage and will be given medicines to help control the pain if needed
  • your cervix will be gently stretched and dilated and forceps and a suction tube will be used to remove the foetus and tissue within the womb.

All of these procedures can feel invasive and distressing, so you may want to consider having someone nearby to support you when you leave hospital. It’s also important to talk to your clinician about what to expect during and after any procedure.

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An ultrasound scan uses high frequency sound waves to create an image of part of the inside of the body. Ultrasound scans can give a more accurate estimation of the length of the pregnancy than counting the weeks from the last period.

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The Abortion Act 1967 covers England, Scotland and Wales but not Northern Ireland.

It states, abortions can usually only be carried out during the first 24 weeks of pregnancy as long as:

  • abortions must be carried out in a hospital or a specialist licensed clinic
  • two doctors must agree that an abortion would cause less damage to a woman's physical or mental health than continuing with the pregnancy. (Likely to be your GP and the doctor at the clinic where the abortion will take place.)

The law states an abortion may be carried out after 24 weeks in rare cases where:

  • it is necessary to save the woman's life
  • it would prevent grave permanent injury to the physical or mental health of the pregnant woman
  • there is substantial risk that the child would be born with serious physical or mental disabilities.

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This is usually picked up during the routine ultrasound screening tests that are part of antenatal care.

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Yes, the abortion will usually go on your health record if you have been referred by your GP. If you self refer, the clinic may encourage you to allow them to inform your GP but this is not automatically done as it is a confidential service.

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No, your fertility should return to normal after an uncomplicated abortion. In fact, women can be experienced an increase in their fertility soon after a termination so it is important to start contraception straight away to prevent another pregnancy from happening.

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