Termination Of Pregnancy (Abortion)
An abortion is a predetermined medical procedure designed to end a pregnancy. It's also sometimes known as a termination of pregnancy either by medication or surgical intervention.
People choose to end a pregnancy for various reasons. Some may not want children, while others may feel they are not financially able to support a child. In some cases, it may be medically unsafe for them to carry a pregnancy to term. Regardless of your reasons for considering an abortion, the decision is ultimately yours to make. While some women may feel certain about their choice, others may find it more challenging to decide. It can be a difficult situation, but there is support available if you need to discuss your options.
Talking to your partner, friends, or family might be helpful. However, if you are unable to talk to them, you can also consult a GP or an abortion provider like the ones listed below.
They can offer support and information to help you make a decision.
Abortion is a very safe procedure, and the risk of complications during a termination of pregnancy is low. Most women will not experience any problems. However, like any medical treatment, there is a risk that something could go wrong. It is important that the doctor or nurse advising you provides information about the potential risks before you proceed with the procedure.
Complications are more likely to occur if an abortion is performed later in a pregnancy, so if you have made the decision to have an abortion, it is best to have it done as early as possible.
Complications that can occur:
- Haemorrhage (excessive bleeding)
- Infection of the womb (uterus)
- Some pregnancy tissue may remain in the womb, necessitating a medical procedure for removal.
- Damage to the womb or entrance of the womb (cervix)
- Sepsis of the womb
Complications are not common, but there is always a risk. If complications do occur, you may need further treatment, including surgery.
If I have an abortion, will it be harder to become pregnant again later?
Having an abortion does not affect your chances of becoming pregnant again or having normal pregnancies in the future. It is possible to conceive immediately after an abortion. While there is a very small risk to your fertility and future pregnancies if you develop an infection in your uterus, most infections can be treated effectively before they pose a risk.
Ectopic Pregnancy Risk
In any pregnancy, there is a risk that it could be ectopic, which occurs when a fertilised egg implants itself outside the uterus. An ectopic pregnancy poses significant health risks to the pregnant woman and is considered a medical emergency. If left untreated, it can become life-threatening.
If you are considering an abortion, it is essential to have an ultrasound. This procedure not only helps locate and date the pregnancy, allowing your healthcare provider to determine the best method of abortion for you, but it also rules out the possibility of an ectopic pregnancy. This step is crucial because the abortion pill is ineffective for ectopic pregnancies, and the typical symptoms of an ectopic pregnancy can be mistaken for the normal side effects of the abortion pill. Delays in seeking medical help due to this misunderstanding can lead to serious complications, including the rupture of a fallopian tube.
Your risk for ectopic pregnancy increases if you’ve:
- had an ectopic pregnancy before
- become pregnant even though you’ve an IUD or coil in place
When an abortion can be done
If you choose to have an abortion, it is important to do so as early as possible. In England, Wales, and Scotland, most abortions are performed before 24 weeks of pregnancy. However, in very special circumstances, they can be carried out after 24 weeks if there is a serious health risk to the mother or fetus.
Can you get an abortion if you’re under 16?
If you are 16 years old or younger and wish to have an abortion, you have the right to make your own medical decisions. Typically, your parents do not need to be informed if you choose not to tell them. However, a doctor or nurse may suggest that you speak with a parent or caregiver for support, but it is ultimately your choice whether or not to do so.
Abortions can only be performed at NHS hospitals or licensed clinics, and they are typically available free of charge through the NHS. While you are encouraged to discuss any concerns or questions about abortion with your GP, please note that they cannot refer you for the procedure.
In our area, the most recommended way to arrange an abortion is through the BPAS service, as detailed below.
British Pregnancy Advisory Service (BPAS)
This is an independent healthcare charity dedicated to advocating for the care and treatment of women undergoing abortions. They provide support at every stage, from guidance during the decision-making process to aftercare once the procedure is complete.
To arrange an abortion, you first need to book a consultation—either by phone or online—for a medical assessment. This assessment will help determine your pregnancy gestation and suitability for the procedure. You will then be offered either a medical abortion (the abortion pill by post, available up to 10 weeks) or a surgical procedure, with most treatments funded by the NHS. The process includes a scan to confirm gestation, which they will arrange, followed by the organization of your chosen treatment while ensuring all legal requirements are met. They also provide ongoing support throughout the process. If you are less than 10 weeks pregnant, you may have the option to have a medical abortion at home by taking medication.
The team will discuss your options and provide information about the risks and potential complications associated with abortion. They can also arrange for a supportive companion to accompany you during appointments if needed, especially for young people under 18. For more information about their services, please visit their website below.
If you would like to speak with BPAS and have an assessment they can be contacted online or by telephone.
Alternative methods to arrange an abortion are:
- Contact a local sexual health clinic and ask for a referral to an abortion service (these can also be called a family planning or GUM (genitourinary medicine) clinic).
- You can also pay to have an abortion privately. The cost will depend on your stage of pregnancy, and the type of abortion you have.
- MSI – They provide NHS and private reproductive healthcare services through a network of clinics across England
You will typically have your first appointment within one week of contacting the abortion provider. This appointment will occur either at a clinic or over the phone. The actual abortion will not take place during this appointment.
During a clinic appointment, you can typically expect to:
- Undergo testing for sexually transmitted infections (STIs) and a blood test.
- Have an ultrasound scan to determine the stage of your pregnancy.
- Be given the option to speak with a specially trained counsellor if you wish to do so.
What happens at a phone appointment?
During a phone appointment, you'll discuss your health and situation with a nurse or midwife. This conversation will help them determine which abortion treatment is suitable and safe for you. Additionally, they will likely arrange for an ultrasound scan to confirm the stage of your pregnancy.
After the first appointment
After your first appointment, you may receive medication to take at home for your abortion, or you might schedule a follow-up visit at a hospital or clinic for the procedure. Typically, the abortion occurs within a week of your initial appointment. It’s important to know that you have the right to change your mind at any point before the procedure starts. Your feelings and choices matter.
Before having an abortion, you will have an appointment to discuss your decision and what to expect next. The type of abortion available to you will depend on several factors, and whenever possible, you should be given a choice about how you would like the procedure to be carried out. Your options will vary based on the stage of your pregnancy and any health concerns you may have.
If you are less than 10 weeks pregnant, it might be possible to have a medical abortion at home by taking medication. There are two main types of abortion: a medical abortion, which involves taking medications, and a surgical abortion, which requires a surgical procedure.
Before proceeding with any type of abortion, you will need to provide your consent.
Medical abortion
A medical abortion, often referred to as an early medical abortion or the abortion pill, involves patients taking a combination of pills that prompt the body to expel the contents of the uterus. This method is most effective in the early stages of pregnancy, typically up to 10 weeks. However, it can also be performed later under certain circumstances and can be conducted in a clinic up to 24 weeks into a pregnancy.
If you are less than 10 weeks pregnant and it is considered medically safe, you may have the option to complete the process at home. With approval from your abortion provider, you can either pick up the pills in person or have them mailed to you, allowing you to carry out the entire procedure at home without needing to visit the clinic.
However, an early medical abortion (EMAH) may not be suitable for everyone. In certain situations, you may need to take one or both of the tablets in a clinic or hospital, particularly if you have medical conditions that make it safer for you to be hospitalised, if you are over 10 weeks pregnant, or if you prefer not to have your abortion at home. If you do take your second tablet (misoprostol) at the hospital, you will need to stay there until the pregnancy has passed, which may require an overnight stay.
This termination method involves taking the two medications below at separate times.
- Mifepristone - This ends a pregnancy by blocking the hormones necessary for it to continue. After taking mifepristone, you can resume your normal daily activities, although some people may experience minor side effects such as headaches, nausea, vomiting, diarrhoea, and light bleeding. If you vomit within two hours of taking the tablet, please contact your abortion service immediately, as you may need to take another dose.
- Misoprostol – This medication causes your body to expel the pregnancy and is taken 24 to 48 hours after taking mifepristone. After taking it, you should start to pass the pregnancy through the vagina about 4 to 6 hours later, as the lining of the womb breaks down. You can take these tablets in one of two ways: by placing the tablet under your tongue for 30 minutes or by inserting it into the vagina. Your abortion service will provide you with specific instructions on when and how to take misoprostol. It’s important to follow their instructions carefully.
If your pregnancy has not ended completely, or if you haven’t experienced any bleeding, or only have very light bleeding after 4 hours, you may need additional doses of misoprostol. It’s important to discuss this with your abortion provider, who can prescribe an extra dose if necessary. In some cases, if the pregnancy does not pass, an operation may be required to remove it.
After taking the second pill, you will experience contractions; however, your abortion provider will offer pain relief as needed. You may also take ibuprofen or paracetamol, following the recommended safe dosage. Additionally, using a hot water bottle or heat pack can help provide some relief.
If you need to complete the process in the clinic, you will remain there until the abortion is finalized. In some cases, you may need to stay overnight until the pregnancy has passed.
It is normal to experience uncomfortable symptoms after taking misoprostol. Everyone's experience is different, but many individuals commonly report:
- Cramps that are more intense than your usual period
- Heavy bleeding, followed by blood spotting for up to four weeks following the abortion
- Passing blood clots (The pregnancy sac will pass with the clots)
These symptoms normally settle and improve after 4-6 hours, although it can take longer for some people.
Urgent advice: Important: Do not buy abortion pills online
It is difficult to determine if abortion pills purchased online are genuine or harmful. These pills should only be prescribed by a doctor or a registered medical provider.
You can find out more about medical abortion on the following websites.
Surgical Abortion
Surgical abortion is a medical procedure that involves the removal of pregnancy tissue from the uterus. There are several surgical techniques available, including suction aspiration and dilation and curettage (D&C). Each technique is appropriate for different stages of pregnancy and individual circumstances. After the procedure, an ultrasound scan will be performed to ensure that all tissue has been successfully removed.
For more information about the available procedures, please continue reading.
Suction Aspiration/Manual Vacuum Aspiration
This is a minor operation commonly known as vacuum or suction aspiration. It is typically performed as an outpatient procedure, usually under local anaesthesia (where you are awake) or conscious sedation (where you are awake but drowsy) if available. This procedure can be done between 7 and 14 weeks of pregnancy.
The procedure usually takes about 5 to 20 minutes, and there are no wounds or stitches. Most patients only need about an hour to recover, allowing you to leave the clinic unaccompanied and go home right after the procedure.
During the procedure, the cervix (the opening to the womb) will be gently stretched. To help soften the cervix for the procedure, you may be given misoprostol, or narrow rods called dilators may be used to gently open the neck of the womb if necessary to allow the instruments to pass through.
A thin, sterile tube (cannula) is inserted through the cervix into the uterus. This tube is connected either to a hand-held syringe (manual vacuum aspiration or MVA) or an electric suction machine (electric vacuum aspiration, EVA, or machine aspiration) to gently remove the contents of the uterus. If you undergo an EVA/MVA, you will likely receive general anaesthesia, meaning you will be asleep, as it involves stronger suction.
During the suction process, patients may experience cramping similar to period pain, which usually subsides quickly once the procedure is complete. A nurse will remain with you throughout the process for support.
You can find out more about this on the BPAS website below.
Surgical abortion | Vacuum aspiration | BPAS
Dilatation and Evacuation (D&E)/Dilation and Curettage (D&C)
Dilation and Evacuation (D&E) is a common surgical procedure for second-trimester abortions, typically performed between 14 and 24 weeks of pregnancy. The procedure begins with the gentle widening (dilation) of the cervix, which can be done using misoprostol or by inserting thin, soft rods called Dilapan. These rods swell and help open the cervix.
The Dilapan rods are placed in the morning of your surgery if you are 18 weeks or under, or the afternoon before your surgery if you are 19 weeks or over. They are removed during the procedure. If the rods are inserted the afternoon before the surgery, you can go home with them in and return the following morning.
Once the cervix is adequately dilated, the fetus is removed using narrow forceps and gentle suction. This process usually takes about 10 to 20 minutes and is performed under anaesthesia. After the procedure, you will typically stay in the hospital for a few hours to ensure that you recover sufficiently to go home. Depending on your condition, you may be able to leave the same day or may need to stay overnight. It is normal to experience some bleeding for up to three weeks after the procedure.
For the D&E procedure, there are several anaesthesia options available, including local anaesthetic (which numbs the cervix), conscious sedation (where you remain awake but feel drowsy and relaxed), and general anaesthesia (which puts you to sleep). The choice of anaesthesia depends on factors such as the stage of pregnancy, your health, and personal preference, ensuring that you either feel no pain or are fully unconscious during the procedure. If you receive general anaesthesia, you must not drive home and should have someone accompany you for the next 24 hours.
For more detailed information, you can visit the BPAS website below.
Surgical Abortion | Dilatation and evacuation | BPAS
If you’ve had an abortion, whether surgical or medical, you’ll be given a pregnancy test. You should take this 14 or 21 days after the procedure to check that it’s been successful. If this is positive, please contact the day unit. If this is negative, you can expect your usual menstrual period to restart 4-6 weeks after the abortion. We will advise you if this is not the case with certain types of contraception.
If the abortion was carried out at a clinic or hospital, you do not usually need to have any other tests or appointments after an abortion.
If the abortion was done at home, the abortion provider usually arranges a follow-up appointment. This appointment can be done by phone or text message. They may also send you a special pregnancy test to make sure the pregnancy has ended.
After an abortion, you’ll probably need to take things easy for a few days, you may experience symptoms like:
- tummy cramps or pain for a few days
- vaginal bleeding – this can last for several weeks after a medical or surgical abortion
- The medicines used in a medical abortion can also cause diarrhoea and make you feel sick. This usually goes away within 1 day.
- If you have a surgical abortion, the general anaesthetic and sedation medicines can also have side effects like nausea, sore throat, headache, tiredness, confusion, shivering, and dizziness, often lasting a day or so, with sedation having fewer effects as breathing/circulation are less impacted.
If you've had an anaesthetic, make sure someone else is around to help, in case you feel sleepy
To treat these, you can:
- Take painkillers like ibuprofen or paracetamol to help with any pain or discomfort
- Use period towels or pads (not tampons) until the bleeding has stopped as they can help you see how much you're bleeding
- Start using contraception anytime (although we advise to start this immediately where possible).
- Have a bath or a shower
- Undertake your usual exercise.
You may experience a range of emotions after an abortion. This is common and if you need to discuss how you’re feeling, contact the abortion service or your GP. They will be able to provide counselling or refer you for counselling if you need it.
Contraception and future pregnancy
After an abortion, your chance of getting pregnant again usually goes back to what it was before. You can often conceive soon after the procedure, sometimes within the same menstrual cycle. Your overall health, age, and use of birth control can also affect your ability to get pregnant in the future. If you have any concerns about your reproductive health after an abortion, it’s best to talk to a healthcare professional.
You can start using contraception immediately after an abortion, as it is possible to get pregnant right away. Most contraceptive methods, including IUDs, implants, injections, and pills, become effective within five days if initiated promptly. Long-acting reversible contraceptives (LARCs), such as IUDs, are highly recommended because they significantly reduce the likelihood of repeat abortions. Many services offer contraception during the abortion visit for convenience, providing options like coils, pills, implants, and injections, which ensure that you are protected from future pregnancies quickly.
You can find out more on the BPAS website below.
For more information on what to expect after an abortion, as well as services that assist with aftercare, please visit the following websites.
While abortions are generally very safe, like any medical procedure, there is a risk that complications can occur. We have compiled a list of the most common symptoms to watch for that may indicate complications.
Watch for:
- Heavy Bleeding: Soaking through two or more heavy-flow pads per hour for two or more consecutive hours, or passing large clots (bigger than a lemon).
- Fever: 38°C/100.4°F+
- Chills, extreme shivering or cold/clammy skin
- Flu-like feelings
- Foul-smelling discharge
- Dizziness or confusion
- Severe Abdominal Pain: Intense cramping or pain, especially if it's localized, worsening, or doesn't respond to pain relief.
- Persistent pregnancy symptoms: (like nausea or feeling pregnant) a week or two after the procedure, or heavy bleeding/cramping that doesn't improve.
If you have symptoms like these, they could indicate an infection, incomplete abortion, sepsis, or injury that requires immediate medical attention. While some cramping and bleeding can be normal, worsening symptoms or signs of infection necessitate urgent care. If a womb infection goes untreated, there is a risk of developing pelvic inflammatory disease (PID), which can increase the likelihood of infertility or an ectopic pregnancy, where an egg implants outside the womb.
If you have concerns and require urgent medical advice, please choose from the options below.
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Contact your abortion provider
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Call 999 or go to A&E (if you are bleeding heavily or having severe symptoms and need immediate action)
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For urgent emotional support, contact the Samaritans on 08457 90 90 90
For advice, information or emotional support services please check out the websites below.