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 medical assessment before abortion
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 any other clinic. The videos talk about the consultation, medical abortion, and surgical abortion under local or general anaesthetic.
Will I have to stay in hospital after an abortion?
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 during an abortion?
There are different kinds of abotion, depening how far along in the pregnancy you are. An abortion service should be able to offer you a choice of different kinds of abortion, but this may not always be possible.
A medical abortion involves taking medication to end the pregnancy. It doesn't require surgery or an anaesthetic, and can be used at any stage of pregnancy.
If you have a medical abortion, the first drug you take is called mifepristone. This 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. This will either be a tablet you take by mouth, or a pessary put inside your vagina. Prostaglandin 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.
Medical abortion carried out up to nine weeks of pregnancy is known as early medical abortion. If a medical abortion is carried out after nine weeks, you may need a second dose of prostaglandin. If you have a medical abortion between 13 and 24 weeks of pregnancy, you will usually need to be in hospital.
Surgical abortion involves having a surgical procedure and a local or general anaesthetic. There are two methods.
Suction aspiration can be used from seven to 15 weeks of pregnancy. It 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 (D&E) is used after around 15 weeks of pregnancy. 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.
You can find out more about medical and surgical abortion in abortion: how it is performed.
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.
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 from abortion?
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
- 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 an abortion 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 after an abortion?
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."