Abortion is legal in England up to 24 weeks (under the Abortion Act 1967). 1 in 3 UK women will have an abortion at some point in their lives.
You may have already decided that an abortion is right for you, or you may be uncertain (or just curious). No matter your current situation this article is here to provide you with the information and resources you need when it comes to abortion in the UK, what to expect when seeking and abortion, and what is involved in the process.
What Is An Abortion?
An abortion is the cessation of a pregnancy by removing a fetus or embryo from the body before it can naturally self-sustain life outside of the uterus.
Abortions are usually carried out within the first 24 weeks of pregnancy (the current UK legal limit) but may be performed later if there is a threat to the pregnant individual’s life or if the child is diagnosed with a severe disability.
Abortion in the UK can be carried out by either a private clinic or through the National Health Services (the NHS for short). It is the current stance of the NHS that ‘The decision to have an abortion is yours alone’ and, if approached, will provide a judgement free treatment environment.
The First Step (Referral)
Abortions in the UK can only legally be carried out by an NHS hospital or a licensed abortion clinic.
Even in the case of licensed clinics, many still perform services primarily through NHS referral (96% in the instance of BPAS clinics) so getting an NHS referral is typically the best course of action.
In order to get an NHS referral you will need to book an appointment with your local GP and let them know you would wish to undergo an abortion procedure. Most doctors will walk you through the rest of the process from there but, rarely, may wish for you to see another doctor for a second opinion if they have any concerns.
Alternatively, you can contact an abortion provider directly. The current UK abortion services are as follows:
Under these services you may still be eligible for an NHS-funded abortion and should be able to discuss your eligibility with the clinic.
If you’re very uncomfortable with contacting your GP and/or an abortion service direct, you can also consider contacting a contraception, family planning, or sexual health clinic in order to obtain your referral. This might be the best option if you really don’t want to discuss abortion with your regular doctor, which can be a deterrent for some.
No matter what your circumstances information about an abortion does not go on your medical records if you request confidentiality and if you are under 16 your parents do not need to be told. This is in keeping with the NHS’s belief that abortion is a personal choice.
What Happens Next?
If you have expressed a need for an abortion then you will next be given an appointment to talk about your decision and what happens next.
If you are sure about your choice then this talk may be very focused on the procedure itself and the post-abortion recovery information.
If you are uncertain, conflicted, or feel you may need additional emotional support, then you will likely be offered additional support systems (and potentially counselling services), resources to help you with your struggles, and information about abortion support organisations (FPA, Brook, BPAS, Marie Stopes UK and the NUPAS).
You may also be offered the option of talking with a trained pregnancy counselor who shares the NHS’s stance on impartiality when it comes to abortion, providing a safe and judgement-free space to discuss your decision.
You do not need to tell anyone else about (or include them in) this process, but some people do find that having a family member or partner/s there for support is useful.
In these meetings you may also:
Be told about the risks and complications of the procedures.
Do a pregnancy test to confirm pregnancy and/or an ultrasound to determine the duration of the pregnancy if needed.
Be tested for STIs or anemia.
Be given an antibiotic to help prevent infections post-procedure.
After this meeting you will be asked to sign a consent form and then be put on a waiting list while your abortion is arranged.
This waiting list is incredibly short – no more than 2 weeks from your initial appointment and usually less. You have the right to change your mind at any point before your procedure.
There are two different types of abortion carried out in the UK and you will be given the choice of which one you’d prefer prior to the procedure. There types are as follows:
Medical Abortion (The ‘Abortion Pill’)
This involves taking medication to terminate a pregnancy. This process does not involve surgery or an anaesthetic, and can be used at any stage of pregnancy.
Note that this medication is not the same as the morning after pill and that buying your own pills online and trying to self-terminate is illegal in the UK, not to mention unnecessary. Abortion, when done by professional services, is currently one of the safest procedures in the field of medicine, meaning you are in safe hands with the NHS’s abortion services and authorized clinics.
Administration of these pills goes as follows:
- You will be given two pills to take, the first being mifepristone. This often happens in the clinic and then you are able to go home immediately after (no overnight stay needed). Mifepristone essentially stops the production of hormones that allows pregnancy to continue occurring.
- 24 to 48 hours later you will be required to attend another appointment in which you will be given misoprostol. Misoprostol varies in administration. The most likely ways to take it are as a pill that you swallow, one that you allow to dissolve under your tongue, or one that is inserted inside your vagina. The pill type will be decided by yourself and your provider in advance.
- 4 to 6 hours later the lining of the womb will break down as the pregnancy is biologically ended, resulting in excessive bleeding. Some clinics like you to stay during this process or you might be allowed to go home, this is up to the discretion of your provider and yourself.
Variations to this process are rare, but if you are more than 9 weeks in to your pregnancy then you may be asked to take additional doses of misoprostol and may have an increased chance of having to stay in the clinic for a longer period (perhaps even overnight).
Surgical abortion will involve the use of a surgical procedure (vacuum or suction aspiration or dilation and evacuation) in order to end the pregnancy.
These procedures vary but, in both cases, you will be offered either:
Local anesthetic: Where just the area is numbed.
Conscious sedation: Where you are placed in a relaxed but awake state.
General anesthetic: Where you’re asleep.
Vacuum or suction aspiration does not typically require a general anesthetic, whereas dilation and evacuation must be done with either conscious sedation or a general anesthetic.
The procedures are as follows:
Vacuum or suction aspiration
- Used up to 15 weeks in to pregnancy, during this procedure the cervix is first dilated to relax it. This is typically through a tablet inserted in to the vagina or taken orally a few hours prior to the procedure.
- Pain relief will then be given, in keeping with your chosen method. This will usually be oral at first and then an injection to the cervix or other areas of the body where required.
- A tube will be inserted through the cervix and in to the womb with the necessary contents then being removed by the tube via suction.
- This typically takes 5 to 10 minutes and patients are allowed to leave the clinic a few hours after the process.
Dilation and evacuation
- This is used after 15 weeks of pregnancy and will, again, involve the cervix being dilated. However, the time given for dilation may take additional hours or perhaps a full 24 hours to make the procedure as safe as possible.
- Conscious sedation or a general anesthetic will then be administered before forceps are inserted through the cervix and in to the womb in order to end the pregnancy.
- This procedure typically takes 10 to 20 minutes and patients may be able to go home the next day but may also be requested to stay overnight.
In both cases ongoing medical support will be provided and complications addressed if they occur (don’t worry though: they’re super rare).
After the abortion some people may experience pain or nausea linked to the procedures used and the medication given. If, for example, you’ve had a general anesthetic then you might feel a bit disorientated for a while afterwards.
Stomach cramps and vaginal bleeding are commonly expected. This can last up to 1 to 2 weeks but can be self-managed with ibuprofen and sanitary towels or pads (fabric ones, if you want to be eco-friendly). It is not recommended that you use tampons to manage this bleeding.
If you experience heavy bleeding or unusual vaginal discharge then don’t hesitate to contact a medical professional. You will likely be given access to a 24-hour helpline post-abortion to advise on any worries you have.
Post-Abortion complications are as follows, and should always be addressed if you think you’re suffering from one:
An infection of the womb: This occurs in 1 of every 10 abortions and is treated with antibiotics.
Some residue remaining in the womb: Which may need further surgical attention and happens in up to 1 in every 20 abortions.
Excessive bleeding: Extremely rare (1 in every 1000) but requires urgent attention and perhaps a blood transfusion.
Damage to the cervix: 1 in every 100 cases.
Continued pregnancy symptoms: This might mean that there was an abortion failure, which needs to be addressed (1 in every 100 procedures), or may be down to something else.
If you have strong emotions after the abortion you should also contact the abortion services or discuss post-abortion counselling with your GP. There are options out there, so there is no need to struggle alone.
However, it should be noted that current evidence shows that people who have had abortions show no increase in the chances of mental health problems compared to those who continue their pregnancy, so do not feel as if a lack of support requirement is somehow reflective of your personal character.
Please note that having abortions typically has no impact on your ability to get pregnant again and that most people can get pregnant immediately after their abortion.
Of course, you’ll likely not want to have intercourse straight after an abortion (nor is it advised), but it is important that, when you do, you employ safer sex methods as you would in any other instance.
And That’s All
I hope that this article has left you feeling informed about abortion in the UK and the options available.
Again, allow me to emphasize that abortion up until 24 weeks is always an option for you and that you will be given an impartial, medically-centered experience with options for ongoing support if needed.
We are, in many ways, lucky to have such a safe, accepted, and confidential system in place. Allow it to serve you if needed.