Termination of pregnancy

Termination of pregnancy, or abortion, has been legal in England and Wales for many years but must be done in an approved place and with the agreement of two doctors who believe that the woman has good reasons for not wanting to continue with her pregnancy.

This leaflet is written to help you by explaining what the hospital procedure is for terminating a pregnancy, to advise you what choices you have and how you may feel afterwards if you decide to go ahead.

What will happen at your hospital appointment?

A doctor will see you. He or she will want to see the blue form (Certificate A) if your GP has given you one, so please bring this with you.

He or she will ask you questions which are relevant to this pregnancy, e.g.

Your medical condition
Past medical and surgical history
Medication (if you are on any)

The doctor will examine you. An ultrasound scan will be done to determine how advanced your pregnancy is (but you do not have to watch the screen if you do not want to).

The doctor will then discuss the options available to you. He or she will discuss with you the different methods of termination and will agree with you which will best suit you. He/she will explain the procedure and will answer any questions you may have. If you are going ahead with the termination you will be given another appointment to return to the hospital to have it done. This is usually within the next few days.

Can I change my mind?

Just because you have a hospital appointment does not mean you have to proceed with a termination. You can change your mine anytime up until the medical procedure starts. If you feel under pressure, if you feel upset or unsure about what to do, or if you simply need time away from everything to think through your decision, please ask to see the hospital counsellor for an appointment. She will try and see you as soon as possible. Her job is to give you support while you think about your decision. She can advice you about alternatives to termination, such as adoption, or organisations who can support you if you decide to go ahead with the pregnancy. The doctor may also suggest you see the counsellor if he or shee feels this would be beneficial.

How is the termination done?

There are two ways in which a pregnancy can be terminated

Medical method
This method involves drug treatment, taken over the course of 2 days. On the first day you will come into hospital, be given one tablet of a drug called Mifepristone (RU486). Once you have swallowed this tablet you will wait two hours and then leave the hospital. Two days later you will come back for the second part of the treatment. During these two days you can behave entirely normally and go to work as usual. You may have some slight bleeding but it is very unlikely that the termination will take place. If you should experience heavy bleeding you must contact the hospital. When you come back to the hospital you will stay in the ward for about 8 hours and may need to stay in overnight. You will be treated with either a vaginal pessary or tablets depending on how far the pregnancy has proceeded. This procedure will cause the uterus to contract and expel the pregnancy. You will probably have some period-like pains which may be enough for you to be given a painkiller and you will have some vaginal bleeding. It is likely that the termination will occur during the time you are in hospital but the fetus is tiny at this stage of the pregnancy and you may not experience anything much different from your normal period. Provided that you are suitable for the medical procedure, the main advantage is that you do not need to have an anaesthetic or an operation. The process therefore carries less risk to you.
Surgical method
This method of termination is not normally used in this hospital at more than 12 weeks of pregnancy. After being admitted to the ward you may have a tablet or pessary inserted into the vagina. This, as it dissolves, will soften the cervix (neck of the womb). The procedure itself takes about 10 minutes and is done under a general anaesthetic, i.e. while you are asleep. The cervix is stretched open, a thin plastic tube is inserted into the uterus (womb) and the pregnancy is carefully sucked out. After you wake up from the anaesthetic you may feel a little tearful but this and any period-like discomfort you have will soon pass and you will be allowed home later the same day. Vacuum aspiration is a very safe procedure but all operations carry a small risk and this will be explained to you during your consultation. With vacuum aspiration termination there is a small risk that the womb is damaged or that infection may be introduced. If the womb is damaged or infected it may be necessary to have further treatment but usually the termination is over in a single procedure without complications. As a precaution against the possibility of infection however antibiotics are given routinely to all women undergoing this procedure.

After the termination

Whichever method is used, you will bleed for up to two weeks, although this should not be heavy. You will be given an appointment to come back to the hospital within a month after the procedure to check that all is well. You will have an opportunity to discuss any questions you have with the doctor and other staff during that appointment. If you experience any problems before then, or afterwards, please contact the ward directly on extension 2040/2010.

Contraception

Contraception will be discussed with you at your hospital appointment. Hopefully you will have already agreed with your own GP what contraception you will use after the termination. If you have not done so, or there is a delay in getting to see your doctor, you may be given some contraception before you leave the hospital (after the termination).

How will I feel?

For many women there is no easy decision about having a termination of pregnancy and even if it seems clear to you that you ought to go ahead, it is not unusual to also feel some regret and upset as well. If you go ahead with a termination you may experience relief when the procedure is over but you may also find yourself feeling quite low and tearful for a while afterwards. This reaction is quite common and will normally pass given time. If it does not, it may be because you find it difficult to discuss your feelings with anyone, or else there may be no one around to give you support at home. If this is the case, you may want to ask your GP or the hospital staff to find someone who can give you extra help, such as the hospital counsellor.