Abortion : London Health

Every year, more than 190,000 abortions are carried out in England and Wales.

What is an abortion?

An abortion is the process of ending a pregnancy using medical intervention; this is also commonly known as a termination. Abortion is different to miscarriage because miscarriage does not involve medical intervention.

Making a decision

Choosing whether or not to have an abortion is an extremely difficult decision for most people and it can cause emotional stress. Many people grow up with very strong views on abortion but these can be altered when you are put in the position of falling pregnant; there are many reasons why people may consider an abortion. If you are struggling to make a decision, try to talk to the people close to you and avoid making spur of the moment, rushed decisions. If you feel you can’t talk to somebody you know, you can contact charities such as Childline and Marie Stopes.

Abortion and the law

In some cultures, abortion is illegal; however, in the UK adoption is legal as long as it complies with regulations set out by the 1967 Abortion Act. The Abortion Act states that abortions must be carried out during the first 24 weeks of the pregnancy, the abortion must be carried out in a hospital or licensed clinic and the abortion must be approved by two doctors, who confirm that the abortion will cause fewer mental and physical health problems than having a baby.

Abortion and the NHS

Most abortions in the UK are carried out on the NHS; in order to have an abortion on the NHS you must be referred by two doctors (usually this involves your GP and a doctor from the clinic or hospital you go to for the abortion). It is important to be aware that some doctors will not refer patients for abortions because it goes against their individual beliefs; if this is the case, they will advise you to see another doctor who will be able to refer you. If you don’t want to use the NHS there are several private clinics that are registered to carry out abortions.

Why do people have abortions?

There are a huge number of reasons people may consider abortion, which include social, economic, health and emotional factors. Reasons cited in the 1967 Abortion Act include:

  • Significant risk to the health of the mother
  • Risk of the child suffering from a serious illness such as a physical or mental disability
  • Significant risk to existing children of the expectant mother

In addition to these factors, many women have abortions because they feel they cannot provide a safe and comfortable environment for a newborn child; this could be due to a lack of financial security, illness, having a violent partners, having drug or alcohol problems or simply being too young to cope with a new baby.

What actually happens during an abortion?

Prior to having an abortion you will usually be invited to talk to the doctor about your situation; they will make sure you are certain of your decision and if you are, they will explain the possible abortion methods and discuss the procedure and follow-up care with you. If you are at all uncertain they may advise you to take time to think and then come back at another time if you have decided to go through with the abortion. You may be required to have some quick tests and then you will have to sign a consent form.

There are a number of different methods which can be sued to carry out an abortion; the one the doctor uses will usually depend heavily on how many weeks gone you are. Possible methods are outlined below:

Early medical abortion

This method is used during the first 9 weeks of pregnancy; it involves taking two doses of medication 48 hours apart. The first tablet is called mifepristone; this blocks the action of the hormone that prepares the lining of the womb for the fertilised egg. Two days later, you will be given medication called prostaglandin, which causes the lining of the womb and the embryo to be broken down; these are then lost through bleeding from the vagina. This part of the process may be painful and you may also feel nauseous; you can take over the counter painkillers to ease pain.

Vacuum aspiration (also known as suction termination)

This method is used between 7 and 15 weeks of pregnancy; it involves using suction to remove the foetus from the woman’s womb. The procedure is very quick, lasting only 10 minutes and it can be carried out under local or general anaesthetic. Most patients are allowed to go home later on the same day as the procedure.

Late medical abortion

This is similar to the early medical abortion but it is used from 13 weeks of pregnancy onwards. The procedure is the same but more than one dose of prostaglandin medication may be needed and the abortion will take longer than the early medical abortion. Most women are able to go home on the same day, but some may need to stay overnight in hospital.

Surgical dilation and evacuation

This method is used from 15 weeks onwards. It involves dilating the cervix and removing the foetus from the womb using a suction tube and some forceps. Most women are able to go home on the same day; they may experience bleeding for a period of up to 2 weeks following the procedure.

Late abortions

If a woman is more than 20 weeks pregnant there are two options available to them; these include a medically induced abortion and a surgical two-stage abortion. A medically-induced abortion involves injecting prostaglandin directly into the womb; this causes the womb to narrow suddenly and the foetus is released (this is similar to labour and it can last several hours). A surgical two-stage abortion involves two stages which are carried out on consecutive days. The first stage involves stopping the foetus’ heart from beating and relaxing the muscles around the cervix; the next day, during stage 2, the foetus is removed using a suction tube and forceps.

Are there any risks associated with having an abortion?

Every procedure carries risks and abortion is no different; however, there are very few risks related to abortion, especially during the early weeks of pregnancy. Possible risks include:

Risks during the procedure:

  • Haemorrhages
  • Damage to the cervix
  • Damage to the womb

Risks after the procedure:

  • Infection in the womb (this may result from all the tissue attached to the foetus not being removed during the procedure)
  • Emotional troubles

It is important to point out that these risks are all very rare.

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