In the UK, under The Abortion Act 1967, abortions can only be carried out in a hospital or specialised licensed clinic.
In most cases, an abortion is carried out as a day procedure, and an overnight stay in hospital is not required.
Before the abortion
When you go for your first appointment, you should be given the opportunity to talk about your situation (if you want to). You will be informed about the different methods of abortion, and which method is suitable for your stage of pregnancy. You should also be advised about related risks and complications.
The doctor or nurse will take your medical history to make sure that the type of abortion you are offered is suitable for you. You will be given a blood test to check your blood group and to see whether you are anaemic. You should also be tested for sexually transmitted infections (STIs), and may be given antibiotics to stop an infection from occurring after the abortion.
There are also a number of things that you may require before having an abortion. These include:
- an ultrasound scan (if there is any doubt about how many weeks pregnant you are)
- a vaginal examination
- a cervical smear test (if appropriate)
- information and advice about which method of contraception you should use after the abortion
Finally, before having the abortion, you will be given a consent form to sign.
Methods of abortion
There are a number of different methods of abortion. The type recommended for you will depend on how many weeks pregnant you are. This is usually calculated by counting the number of weeks from the first day of your last period.
The types of abortion are outlined below.
Early medical abortion (up to 9 weeks of pregnancy)
An early medical abortion involves taking two different medicines 48 hours apart. The effect of the medication will be similar to an early natural miscarriage.
After your initial visit to see the doctor, you will have two more appointments on different days. On your first visit you will be given an abortion pill called mifepristone, which blocks the hormone that makes the lining of the womb suitable for the fertilised egg. After taking the first pill, you will be able to go home and continue your normal everyday activities.
Two days later, on your second visit to the hospital or clinic, you will be given the second medicine, prostaglandin. Within four to six hours of taking prostaglandin, the lining of the womb breaks down and is lost, along with the embryo, through bleeding from the vagina. This part of the process can be painful, but a painkiller can be taken.
The medicines that are used during an early medical abortion may make you sick and you may have diarrhoea.
Vacuum aspiration or suction termination (from 7 to 15 weeks of pregnancy)
Vacuum aspiration, or suction termination, is a procedure that uses gentle suction to remove the foetus from the womb. The procedure usually takes 5-10 minutes and can be carried out under a local anaesthetic (where the area is numbed) or general anaesthetic (where you are put to sleep).
The entrance to the womb (cervix) is dilated (opened) to allow access to the contents. To soften the cervix and make it easier to open, a tablet may be placed in the vagina a few hours before the abortion. A small, plastic suction tube connected to a pump is then inserted into the womb and used to remove the foetus and surrounding tissue.
After a vacuum aspiration abortion, you will usually be able to go home the same day. However, following the procedure you may bleed a little for up to 14 days.
Late medical abortion (from 13 weeks of pregnancy)
As well as being used for early abortion, mifepristone and prostaglandin can be used for abortion later in pregnancy. However, the abortion will take longer, and more than one dose of prostaglandin may be needed. This type of abortion is similar to having a late natural miscarriage.
After the procedure, you can return home the same day, but sometimes an overnight stay in hospital is required.
Surgical dilation and evacuation (from 15 weeks of pregnancy)
Surgical dilation and evacuation (D&E) is a procedure that is carried out under general anaesthetic. The cervix is gently stretched and dilated and forceps and a suction tube are used to remove the foetus.
The procedure usually takes 10-20 minutes to perform and, if you are healthy and there are no complications, you may be able to return home the same day. You may have some bleeding for up to 14 days.
Late abortion (20-24 weeks)
There are two options for a late abortion carried out at 20-24 weeks. Both require an overnight stay in hospital.
- Surgical two-stage abortion:
– stage one stops the heartbeat of the foetus and softens the cervix
– stage two (carried out the following day) removes the foetus and surrounding tissue
– each stage requires a general anaesthetic
- Medically induced abortion:
– similar to a late natural miscarriage
– the medicine prostaglandin is injected into the womb, making it contract strongly (as in labour)
– contractions can last 6-12 hours
– you will remain awake during the procedure and may be given medicines to control the pain
– D&E may then be used to ensure that the womb is completely empty
If you bleed heavily, have a lot of pain or a high temperature after an abortion, seek medical help immediately.
