Abortion

If you have made the difficult decision to terminate your pregnancy and you are sure of your decision, you should arrange to have a termination sooner rather than later. Even if you are a minor (under 16), you can make the decision to have an abortion on your own, but whatever your age and situation, it must be approved by two doctors who have to agree that it would be more harmful to your mental or physical health to continue with the pregnancy than it would be to terminate it. 

The legal limit and debate
Abortion is legal in the UK up to 24 weeks, but most hospitals and clinics will not perform an abortion after the 18-20 week mark unless either there is a serious threat to the woman's life or the unborn child is likely to be severely handicapped. 

There are now increasing calls to reduce the legal limit for abortion to 20 weeks due to advances in technology that affect both our view of the humanity of the fetus and its chances of being viable, i.e. capable of surviving outside the womb, before the 24-week limit (there have been cases of babies being born alive after botched abortions, and of premature babies born as early as 21 weeks surviving, though this is rare). 

Elsewhere in Europe, the limit is much lower: 12 weeks in France and 10 weeks in Germany. Abortion is illegal in Northern Ireland unless the woman's life is at risk, and in Ireland unless the woman's life is at risk (from suicide, among other medical factors).

Get help fast
- If you are considering an abortion, make an appointment with your GP, Family Planning Clinic or Brook Centre (for under 25s) who can refer you for a termination on the NHS. If you can, talk to your partner or a member of your family about it. 
- A doctor or nurse can refuse to approve an abortion, but they cannot refuse to refer you to another health professional for an abortion. 
- Depending on availability, you may have to wait for an appointment. According to the Family Planning Clinic, you should be offered a first appointment within five days (and never longer than 14 days) at the hospital or clinic where your abortion will take place (to confirm your pregnancy, whether you are eligible to have an abortion and to assess whether any other procedures are necessary, for example sexually transmitted infection (STI) testing and treatment). The abortion should be carried out within a week of this first visit (and never more than two weeks). 
- Make sure you see a doctor or health professional as soon as possible so that you don't exceed the time limit of 18-20 weeks beyond which most doctors will not perform an abortion unless there is a valid medical reason for doing so.
- If you do not wish to, or cannot, get an abortion on the NHS, private abortions cost around £500. 
- Note that pregnancy is usually worked out from the first day of your last normal menstrual period.

There are two methods of terminating an unwanted pregnancy: drugs (up to 9 weeks) or surgical methods.

Early medical abortion (the abortion pill) 
Termination by abortion pill can be carried out up to 9 weeks into pregnancy (the same drugs are also used to assist abortions up to 24 weeks). It requires medical surveillance from a doctor. 
- You can either see your GP, who can refer you to a clinic, or contact a Family Planning Clinic or Brook Centre directly.    
- During your first appointment, you will discuss whether abortion is the right step for you and the different options available. 
- You will then then have two appointments on different days two days apart where you will take a drug called mifepristone to terminate the pregnancy, then, on the second visit, a drug called prostaglandin to break down the lining of the womb, which will make the embroyo come out (this takes 4-6 hours). 
- You may not be suitable for an early medical abortion if you are over 35, if you smoke, suffer from high blood pressure or heart problems, if you are asthmatic or suffer from fybroid.

Vacuum aspiration or suction termination
This type of surgical termination can be carried out from 7-15 weeks. It removes the fetus from the womb using gentle suction. The process takes 5-10 minutes and is carried out under local or general anaesthetic. You can usually go home the same day, but you may experience bleeding for up to 14 days.

Late medical abortion (from 13 weeks of pregnancy)
From 13 weeks onwards, late medical abortion (which is similar to a late natural miscarriage) can be carried out using the same drugs, mifepristone and prostaglandin, that are used for early medical abortion. The process takes longer, more than one dose of prostaglandin may be required, and you may be required to stay in hospital overnight.

Surgical dilation and evacuation (D&E) (from 15 weeks of pregnancy)
This procedure is carried out under general anaesthetic from 15 weeks onwards. It involves stretching and dilating the cervix and removing the fetus using forceps and a suction tube. It usually takes between 10-20 minutes, and if there are no complications and you are healthy, you may be able to go home the same day. Bleeding can be experienced for up to 14 days afterwards.

Late abortion (20-24 weeks)
Late abortions (carried out between 20 and 24 weeks) are performed using one of two different methods. The first is surgical two-stage termination, which first stops the fetus' heartbeat and softens the cervix, and then removes the fetus and surrounding tissue using dilation and evacuation (see above). This is all carried out under general anaesthetic and usually requires an overnight stay in hospital. The second method is medically induced abortion, which involves injecting prostaglandin into the womb, causing contractions like labour, and then using dilation and evacuation (see above) to remove the fetus and surrounding tissue. It lasts between 6-12 hours and you remain conscious throughout (you can be given pain relief). You will usually need to stay overnight in hospital.

Abortion facts: 
- Over one in four pregnancies end in abortion. 
- Around 200,000 abortions take place in the UK each year. 
- The majority of abortions (90 out of 100) are carried out before 13 weeks.
- After an abortion, you will be offered information on support and birth control.

Abortion is a last resort and should be resorted to as an emergency. It can have serious consequences for your mental and physical health.

Useful links
The Family Planning Association www.fpa.org.uk
Brook Advisory Centres www.brook.org.uk
Abortion Rights www.abortionrights.org.uk