Abortion

What is abortion?

Abortion is the term used by the medical profession to describe any early ending of a pregnancy. However, most people refer to an abortion that happens spontaneously as a 'miscarriage', and use the term 'abortion' when a woman chooses to end the pregnancy. This is also called termination of pregnancy, and is legal under British law up to the 24th week of pregnancy, provided it is carried out by a doctor. Under the present law, two doctors must agree that, in their opinion, if the pregnancy were continued there would be:

A risk to the life or the physical or mental health of the pregnant woman or any existing children which is greater than if the pregnancy continued.

A risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped.

What should I do if I decide to terminate a pregnancy?

There are two ways of getting an abortion:

Through the NHS. This is free, but you will need to be referred to a gynaecologist by your GP or from a family planning clinic, young people's clinic or sexual health clinic.
Through a private clinic. You can refer yourself to a private clinic such as Marie Stopes or the British Pregnancy Advisory Service. You will probably be seen more quickly than through the NHS. The cost varies according to which clinic you go to and the stage of the pregnancy but is likely to be several hundred pounds.

The procedure is the same whether you go through the NHS or a private clinic. You will have an initial appointment, at which a doctor will confirm that you are pregnant and determine the length of your pregnancy. This will enable him to decide the most appropriate method of termination for you.

What happens during an abortion?

There are several different methods available. The method used will depend on the length of time you have been pregnant.

Early abortions:

a) Early medical abortion, otherwise known as the abortion pill. This is only available in the first nine weeks of pregnancy. It involves three visits to the clinic during which time you will be given two different drugs two days apart. These drugs, in combination, cause an early miscarriage. The follow-up visit is essential as, in rare cases, the procedure will have been unsuccessful and an alternative method will be needed.

b) Vacuum aspiration, under local or general anaesthetic. This method is usually chosen for pregnancies of between seven and 14 weeks' gestation (length). A thin plastic tube is inserted into the uterus (womb) through the cervix (neck of the womb), and gentle suction is used to empty the contents of the uterus into the tube.

Abortion over 14 weeks

a) Surgical dilation and evacuation (D&E). This procedure is available for pregnancies of between 13 and 19 weeks' gestation, and is carried out under a light general anaesthetic. The cervix is opened and narrow forceps are used to empty the uterus. Any remaining tissue from the walls of the uterus is removed using suction.

b) Surgical two-stage abortion. This method is used for pregnancies of between 20 and 24 weeks' gestation. Each stage requires a general anaesthetic so at least an overnight stay in the clinic will be needed. During the first stage, the heart of the fetus is stopped and the cervix is softened. The second stage takes place the next day, and the abortion is carried out using the D&E method.

c) Medical induction. This method can be used for pregnancies of between 17 and 24 weeks' gestation. The experience is similar to a late miscarriage. A drug, prostaglandin, in injected into the uterus under a local anaesthetic. This induces labour which then lasts for 6-12 hours. After the abortion has taken place, the doctor may have to use suction to make sure the uterus is completely empty.

What happens after an abortion?

The immediate effects will vary depending on the method used. You may experience period-like pains and bleeding for up to 14 days after the procedure. There is a slight possibility of infection, and you should seek medical advice if bleeding is heavy, pain prolonged, or if you have a raised temperature. It is important to resume contraception to prevent further unwanted pregnancy because ovulation will occur before your next period.

Who can I talk to about the abortion?

If you do decide to have an abortion, you should be offered counselling before and afterwards. Ask any questions at the clinic, consult your GP or practice nurse, or contact one of the organisations listed below.

Useful sources of information and help:
Marie Stopes International, 153 Cleveland Street, London, W1P 5PG. Telephone: 0207 574 7400. E-mail: services@stopes.org.uk
Website: http://www.mariestopes.org.uk
Brook Advisory Centre, 165 Grays Inn Road, London, WC1X 8UD. Telephone: 0207 7617 8000
Family Planning Association, 2-12 Pentonville Road, London, N1 9FP. Telephone: 0207 837 4044. Website: http://www.fpa.org.uk
British Pregnancy Advisory Service. Abortion actionline: 08457 304030 Website: http://www.bpas.org
ARC (Support for termination for abnormalities), 73-75 Charlotte Street, London, W1P 1LB. Telephone: 020 7631 0285. Helpline: Telephone/Fax: 020 7631 0280. E-mail: arcsatfa@aol.com

This patient information leaflet has been adapted from an original published by Clinnix Pro, Synigence PLC