The pregnancy is ended either by taking medicines or having a surgical procedure. Some people choose to have an abortion as the pregnancy was not planned, whilst some people choose to have an abortion because there is a problem with the pregnancy.
Deciding to have an abortion
The decision to have an abortion is yours alone. Some women may be certain they want to have an abortion, while others may find it more difficult to make a decision. All women requesting an abortion can discuss their options with, and receive support from, our abortion care team.
Where can I get an abortion?
Abortions can only be carried out under the care of an NHS hospital or a licensed clinic, and are usually available free of charge on the NHS.
There are 3 main ways to get an abortion on the NHS
- You can self-refer by contacting the RVI.
- Speak to a GP and ask for a referral to an abortion service – the GP should refer you to another doctor if he or she has any objections to abortion.
- Contact a local Sexual Health Clinic and ask for a referral to an abortion service.
RVI appointment line
When you call you will be asked some brief questions about your general health, as well as the date of your last period (you may not know this).
We will check with you before we call you on your phone, email you or contact your GP.
Lines are open 9am – 1pm. Please leave a message if you are happy to be called back from the hospital. The number we call you back on is a withheld number.
Important
If you do not want to tell anyone, your details will be kept confidential.
If you’re under 16, your parents do not usually need to be told. The doctor or nurse may encourage you to tell a parent, carer or other adult you trust, but they will not make you.
We are happy to offer an appointment if you are unsure and would like to discuss your options.
British Pregnancy Advisory Service (BPAS)
As an alternative to NHS care, you can contact British Pregnancy Advisory Service (BPAS) online or by telephone.
Can everyone have an abortion?
In England, Wales and Scotland, almost all abortions are carried out before 24 weeks of pregnancy. Here at the RVI we perform abortions up to 20 weeks of pregnancy and in special circumstances up to 24 weeks.
Types of abortion
Before having an abortion, you’ll have an appointment to talk about your decision and what happens next.
Whenever possible, you should be given a choice of how you would like the abortion to be carried out.
The choice for the type of abortion is dependent upon how many weeks pregnant you are. There are two main options.
Medical abortion
Medical abortion involves the following steps
- First you take a tablet that contains a medicine called mifepristone, which helps prepare your body for the next medicine. Once you’ve taken the medication in the hospital, you’ll be able to go home and continue your normal activities
- Usually 1 to 2 days later, you take a second medicine called misoprostol. The tablets are placed under your tongue, between your cheek and gum, or inside your vagina. You can usually take the medicine at home if you’re less than 10 weeks pregnant – if you’re over 10 weeks pregnant you need to take these tablets at the clinic or hospital
- Within 4 to 6 hours of taking the second medicine, the lining of the womb breaks down, causing pain, bleeding and loss of the pregnancy.
Sometimes you need to take more doses of misoprostol to make the pregnancy pass. Occasionally, the pregnancy does not pass and an operation is needed to remove it.
Surgical abortion
Surgical abortion involves an operation to remove the pregnancy from the womb. There are 2 main types of surgical abortion.
Manual vacuum aspiration
This is a procedure performed as an outpatient under local anaesthetic or conscious sedation if available. There is Entonox (gas and air) for you to use throughout the procedure and it involves passing a hand held suction device through your cervix into your womb to remove the pregnancy tissue. You are able to go home straight after the procedure.
Suction Aspiration/Dilatation and Evacuation (D&E)
This procedure is performed in theatre while you are under general anaesthetic (asleep). You attend the ward early in the morning and are usually able to go later that day after your procedure.
You will need medication to help prime your cervix to make it soft to help aid the procedure. If you are under 14 weeks this is by placing 2 tablets under your tongue or gum on the morning of your surgery.
If you are over 14 weeks this will involve placing thin, soft rods called Dilapan through your cervix which swell and help open your cervix.
They are placed the morning over your surgery if you are 18 weeks or under or the afternoon before your surgery if you are 19 weeks and over and are removed at the time of your procedure. If you have them inserted the afternoon before you can go home with them in and return the following morning.
What happens at my first appointment?
Your first appointment might be in the hospital or on the telephone. We will take some medical details and then you will have an ultrasound scan to work out how many weeks pregnant you are.
Abortions are safer the earlier they’re carried out. Getting advice early on will give you more time to make a decision if you’re unsure.
The scan is usually an abdominal scan where the scan probe is placed on the abdomen. It is helpful to have a full bladder when this is done. Sometimes a transvaginal scan is needed where an ultrasound probe is placed inside the vagina. The scan measures the size of the pregnancy so that we can be sure how many weeks pregnant you are.
After the scan, your options will be discussed and additional information given. We will also discuss contraception with you so that we can help you to prevent a further pregnancy if you do not wish to have a baby.
What should I do before I come to the Ward 40 day unit?
You will get pain during or after an abortion and for some women this can be strong so it’s a good idea to make sure that you have a small supply of simple painkillers like paracetamol and or ibuprofen at home. You will bleed so it’s also important to make sure that you have some sanitary pads and wear underwear that’s suitable for this.
You will not be able to bring any children in the day unit during your appointments but you can bring an adult friend or family member.
Where should I go in the RVI?
The day unit (Ward 40) is based opposite Ward 41 entrance on level 4 of the Leazes wing at the RVI hospital (entrance off Richardson Road).
There is a doorbell at the entrance to the Day Unit and a member of the team will welcome you.
After an abortion
After an abortion, you’ll probably need to take things easy for a few days. It’s likely you’ll have some discomfort and vaginal bleeding for up to 2 weeks but for some it can be longer.
You do not usually need to have any other tests or appointments after a surgical abortion, or a medical abortion in hospital.
If you have a medical abortion, you may have short-lived side effects from the medicines, such as diarrhoea and feeling sick.
If you have a surgical abortion, the general anaesthetic and sedation medicines can also have side effects.
After an abortion, 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
- Start using contraception anytime (although we advise to start this immediately where possible).
- Have a bath or a shower
- Undertake your usual exercise.
If you have a medical abortion you will be asked to take a pregnancy test 3 weeks after the procedure. 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.
When to get medical help
Get advice if you
- Have worsening pain or bleeding after your abortion
- Still feel pregnant after about a week
- Have a temperature, flu-like feelings or unusual vaginal discharge – these could be signs of infection
- Have any other worries.
Please get in touch with the team, your own GP or NHS 111.
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
You can start contraception immediately after a termination. The nurse will discuss this with you on your first visit to the unit and can supply some methods immediately.
Information about contraception can be found on the NHS website.Contraception can be provided through the hospital, your GP or Sexual health services. You can arrange an appointment on 0800 500 3019.
Are there any risks with an abortion?
Abortions are generally very safe and most women will not experience any problems. But like any medical treatment, there’s a small risk that something could go wrong. The risk of complications increases the later in pregnancy an abortion is carried out.
Most women will not experience any problems, but there is a small risk of complications.
Complications that can occur
- Infection of the womb (uterus)
- Some of the pregnancy remaining in the womb
- Excessive bleeding
- Damage to the womb or entrance of the womb (cervix).
If complications do occur, you may need further treatment, including surgery.
Having an abortion will not affect your chances of becoming pregnant again and having normal pregnancies in the future. You may be able to get pregnant immediately after an abortion. You should use contraception if you do not want to get pregnant.
Medical abortion
Before 14 weeks of pregnancy the main risks of medical abortion are:
- Needing another procedure to remove parts of the pregnancy that have stayed in the womb: this happens to about 70 out of 1,000 women.
- Serious complications such as heavy bleeding, damage to the womb, or sepsis: this happens to about 1 out of 1,000 women.
From 14 weeks of pregnancy, the main risks of medical abortion are:
- Needing another procedure to remove parts of the pregnancy that have stayed in the womb: about 13 out of 100 women.
- Infection or injury to the womb: this happens to a small number of women.
Surgical abortion
Before 14 weeks of pregnancy, the main risks of surgical abortion are:
- Needing another procedure to remove parts of the pregnancy that have stayed in the womb: this happens to about 35 out of 1,000 women.
- Serious complications such as heavy bleeding, damage to the womb, or sepsis: this happens to about 1 out of 1,000 women.
After 14 weeks of pregnancy, the main risks of surgical abortion are:
- Needing another procedure to remove parts of the pregnancy that have stayed in the womb: about 3 out of 100 women.
- Very heavy bleeding: between about 1 and 10 out of 100 women.
- Infection: this happens to a small number of women.
- Injury to the womb or entrance to the womb (cervix): this happens to a small number of women.
Research
At the RVI, we have a large research team and often work with Newcastle University. All of our consultant team are actively involved in research and may discuss the possibility of you getting involved in research at any of our clinics.
Whilst we are very grateful for those who choose to participate, this is not essential and please feel free to decline. This will not affect your care.
What can I do if I am not happy with my care?
Please get in touch with the team.
Patient Advice and Liaison Service (PALS)
Should you have any suggestions or concerns, please make these known to a member of the team in the clinic or by letter to the hospital. We welcome suggestions to help improve our services.
The PALS service aims to advise and support patients, families and carers and can help to deal with matters quickly on your behalf. This service is based at the Royal Victoria Infirmary Hospital.
Further support
Abortion recovery care and helpline (ARCH) was started with women who experienced abortion and struggled following this.
ARCH are dedicated to promoting the emotional and psychological well-being of women, men and families after an abortion by the provision of counselling and supportive help.
