If your GP or a doctor at a community contraceptive clinic confirms that you're pregnant, and you've decided to have an abortion, you'll be referred to the clinic or hospital where the abortion will take place, and you'll be assessed.
Your assessment
The assessment will be the same if you go directly to an independent provider (such as bpas or Marie Stopes) without going to your GP.
During the assessment you:
- can talk to a doctor about the abortion method that will be used
- can ask any questions that you may have
- might be tested for sexually transmitted infections (STIs) and anaemia (low iron levels)
- might be given an ultrasound scan if there's doubt about how many weeks pregnant you are
bpas (the Britsh Pregnancy Advisory Service) has produced videos explaining what to expect when you visit a bpas clinic. The information may also be useful if you are considering an abortion at a clinic that is not bpas. The videos talk about the consultation, medical abortion and surgical abortion under local or general anaesthetic.
Will I have to stay in hospital?
It depends how many weeks pregnant you are and which abortion method is being used. Normally, you can go home the same day. If it’s a late abortion (between 20-24 weeks), you’ll usually have to stay overnight.
What happens exactly?
Medical abortion
Medical abortions are used from nine to 20 weeks of pregnancy. The first drug that you take, called mifepristone, blocks the production of hormones that enable the pregnancy to continue. A couple of days later, you have a second appointment where you take another drug called prostaglandin, which causes the lining of the uterus (womb) to break down. This causes bleeding about four to six hours later. You may have to stay at the clinic while this happens.
Surgical abortion
There are two methods. Suction aspiration involves inserting a tube into the uterus through the vagina and removing the pregnancy using suction. It’s usually carried out under local anaesthetic, which is injected into the cervix. Most women go home a few hours later.
Dilation and evacuation is used after 15 weeks. The cervix is gently stretched and dilated to enable special forceps and suction to remove the pregnancy. It usually takes between 10 and 20 minutes to perform under general anaesthetic (that means you’ll be asleep while it happens). If there are no complications, you can usually go home that same day.
Does having an abortion hurt?
You'll have some period-type pain or discomfort. The later the abortion, the more painful it may be. You'll be advised about taking appropriate painkillers.
With suction abortions, the injection to numb the cervix can sometimes be painful. The procedure itself can be a little uncomfortable, says Dr Tom Coffey, a GP in Wandsworth. "It’s a bit like having a five-minute cervical smear," he explains.
After any type of abortion, you could also experience some bleeding for up to 14 days afterwards, and period-type pains.
Are there any risks?
There's a risk of infection afterwards, so you may be given antibiotics. In rare cases, the uterus may perforate.
- damage to the uterus happens in less than one in 1,000 medical abortions performed between 12 and 24 weeks, and up to four in 1,000 surgical abortions
- damage to the cervix happens in no more than 10 in every 1,000 abortions
- one in 1,000 women who have an abortion will suffer a haemorrhage (excessive bleeding)
Go back to your doctor or clinic straight away if you get symptoms of an infection after an abortion, including:
- high temperature
- vaginal discharge or
- abdominal pain that doesn’t improve after taking painkillers
There's a small chance that you’ll need further treatment because the abortion hasn’t worked. "If you have signs of still being pregnant afterwards, have another pregnancy test," says Dr Coffey. "If it’s positive, you’ll have a scan to confirm that the termination hasn’t worked, and you’ll have the procedure again."
Will it affect my ability to have a baby in the future?
"Not unless you have recurrent late terminations," says Dr Coffey. The Royal College of Obstetricians and Gynaecologists (RCOG) states that if there are no problems with your abortion it won't affect your chances of becoming pregnant, although you may have a slightly higher risk of miscarriage or early birth.
Research has shown no definite link between a previous abortion and early labour.
Could I get pregnant again immediately afterwards?
Yes. "Some women can get pregnant within four weeks of having a termination," says Dr Coffey. "So make sure you start using contraception immediately afterwards if you want to avoid getting pregnant again."
