I'm considering abortion — what do I need to know?

Abortion is the ending of pregnancy and is available up to 24 weeks of pregnancy

Abortions take place in NHS hospitals or in private clinics.

In England, the majority of women can choose to have an abortion, which is funded by the NHS, either at an NHS hospital or at a private clinic. In Scotland most abortions are carried out through the NHS in an NHS hospital.

If you are not sure about how many weeks pregnant you are, you may need to have an ultra sound scan and/or an internal examination.

There are two main methods of abortion: the medical and the surgical method.

Medical abortion

Early Medical Abortions (EMA) (up to 9 weeks of pregnancy)

An early medical abortion (EMA) is one that can be carried out before 9 weeks of pregnancy.

How is an early medical abortion done?

This is a two-stage procedure, which involves separate visits to the unit.

• For the first part of your treatment you will be given a tablet called Mifepristone. This drug can make some people feel sick.
• For the second part of your treatment you will be given more medicine, a drug called Prostaglandin. This will cause the womb to contract and expel the pregnancy. You will be given painkillers for stomach cramp and some anti-sickness medication to take if necessary. At this stage you will be observed for a period of time and then may be allowed home. The pregnancy will be passed over a period of 1 to 6 hours. In some clinics or hospitals you are required to stay until the procedure is complete.
• You will need a follow-up visit if you go home to complete the abortion. This is to ensure that the medication has worked.
• Sometimes, the EMA medication does not work. In this case a surgical abortion would be offered.

A list of any medical conditions that you may have will be taken by the clinic or hospital to make sure the medicines used in this type of abortion are suitable for you.

Surgical Abortion or Vacuum (suction) termination (from 7 to 15 weeks of pregnancy)

Vacuum aspiration, or suction termination, is a procedure that uses gentle suction to remove the pregnancy 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).

To soften the cervix (the entrance of the womb) and make it easier to open, a tablet may be placed in the vagina a few hours before the abortion.

After this type of 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, the same medicines can be used for abortion later in pregnancy. However, the abortion will take longer, and more than one dose of medicine may be needed.

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 (opened) and the pregnancy removed.

The procedure usually takes 10-20 minutes to perform and 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 abortion
• Medically induced abortion:

Risks of an abortion

Abortion poses few risks to a woman's physical health, particularly when carried out during the first 12 weeks of pregnancy.

Risks at the time of an abortion

The risk of problems occurring during an abortion is low. However, there are more likely to be problems if an abortion is carried out later in a pregnancy.

Risks after an abortion

After an abortion, the main risk is infection in the womb. This happens if traces of the pregnancy have not been removed. If you have an infection after an abortion, you may bleed heavily from your vagina and have some period-like pain. Antibiotics are usually used to treat the infection. Repeated abortions can cause damage to the entrance of the womb (cervix). After an abortion, you may have some period-type pains, and some vaginal bleeding, which should gradually lessen after a few days. Most women can return to their usual activities within a day or so. However, seek medical attention if you have severe pain or if bleeding has not stopped after 14 days.

Mixed emotions

Some women will also have an emotional response following abortion. Sometimes a mixture of positive and negative reactions is experienced. For example: Positive Reactions:

• Relief
• Happiness

Negative Reactions:

• Sorrow
• Sadness
• Guilt
• Regret
• Grief
• Loss

In some women these negative reactions can lead to:

• Depression
• Anxiety
• Low self-worth.

Women vary greatly in their emotional responses when considering abortion. To make a fully informed decision it may well be helpful for you to have the opportunity to look at all the options and possible outcomes.

Your may feel that your circumstances affect your freedom to make a decision.

Centres listed on Pregnancy Choices Directory offer a safe place to consider and discuss all your options.

To find out more about abortion, contact an advisor for non-judgemental help & advice — check the list to find your closest source of help.

You may also like to:

• Make an appointment with your GP to discuss abortion options with them.

You may be able to refer yourself to an abortion provider, without seeing your GP, if you prefer:

• Visit your Sexual Health Clinic
• Contact the British Pregnancy Advisory Service
• Contact Marie Stopes International

You will be able to discuss abortion options with all of these abortion providers.

Get answers to other common questions

Centre services

Free services are available — use these links to find confidential help: