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Termination of pregnancy (abortion)Published by Bupa's health information team, June 2008. This factsheet is for women who are planning to have a termination (abortion), or who would like information about it. A termination (abortion) involves taking medicines or having surgical treatment to end a pregnancy. Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important that you follow your doctor's advice.
About terminationIn the UK it's legal for termination to be carried out up to 24 weeks of pregnancy, but most hospitals and clinics won't consider termination beyond 18 to 20 weeks. Deciding to have a terminationMaking a decision about having a termination is often difficult and your reasons may be social or medical. You might wish to discuss your reasons for seeking a termination with someone you can trust - for example a family member, or a close friend. Alternatively you may choose to discuss your circumstances with your GP or a professional counsellor. You must contact your GP or a family planning clinic if you are seeking a termination. Your doctor will determine from the date of your last menstrual period how many weeks pregnant you are and explain the risks of having a termination. Your doctor will refer you to a specialist clinic or hospital. If you prefer, you can contact a private clinic directly. Before you have a termination, two doctors must agree that, on balance, continuing the pregnancy could be more harmful for you. For this reason, it's important that you have a medical form with the signatures of two doctors agreeing that the termination should be done. Types of terminationThere are two types of termination - medical and surgical. The type of termination you have depends on how many weeks pregnant you are and any pre-existing medical conditions. Medical termination
Surgical terminationSurgical terminations may be done under local anaesthesia. This means your cervix (neck of the womb) is completely numb and you stay awake during the procedure. Alternatively, it may be done under light general anaesthesia. This means you will be asleep during the procedure. Preparing for your surgical terminationIf you are having general anaesthesia, you will be asked to follow fasting instructions. Typically you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand. You should bring some sanitary towels with you to the hospital or clinic. You may have urine and blood tests, and swabs taken from your vagina to check for sexually transmitted infections. You may also be given prophylactic antibiotics to help reduce your risk of infection. An ultrasound scan may be done to check your pregnancy. You will not see any pictures during the scan. You will usually be asked to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead. You may be given a prostaglandin before the operation to help soften the cervix. This is usually given as a tablet (pessary) placed into your vagina. About surgical terminationVacuum aspirationVacuum aspiration is used for pregnancies between seven and 12 weeks. A tube is inserted into your womb through the cervix and suction is applied to remove the womb contents. This procedure takes 10 to 15 minutes and recovery time is one to two hours. Dilation and evacuation (D&E)D&E is used for pregnancies between 12 and 19 weeks. A speculum is inserted into your vagina to view the cervix and a slender rod (called laminaria) is used to gently open your cervix. The pregnancy may be removed using forceps and a curved instrument (a curette) is used to scrape the lining of the womb. Suction is applied to remove the tissue. This procedure takes about 30 minutes and is usually done under general anaesthesia. The removed tissue is examined to make sure the termination is complete and disposed of sensitively. What to expect afterwardsYou will need to rest until the effects of the general anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off. You will have some vaginal bleeding so you will need to wear a sanitary towel. If your blood group is rhesus D negative, you may be offered an anti-D injection after your termination. Ask your doctor for more specific advice about this injection. You will usually be able to go home when you feel ready. You will need to arrange for someone to drive you home. You should try to have a friend or relative stay with you for the first 24 hours. You will need to have a check-up in the first two weeks after your termination. Your doctor may arrange to see you at a follow-up appointment, or ask you to see your GP. Recovering from surgical terminationIf you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine and if you have any questions, ask your pharmacist for advice. General anaesthesia temporarily affects your co-ordination and reasoning skills, so you must not drive, drink alcohol, operate machinery or sign legal documents for 48 hours afterwards. If you are in any doubt about driving, please contact your motor insurer so that you are aware of their recommendations, and always follow your doctor's advice. You will have some vaginal bleeding for at least two weeks and your next period, may be earlier or later than usual. You shouldn't use tampons for at least one month after having a surgical termination to help lower your risk of infection. You shouldn't have sex until the bleeding has stopped. It's important that you use some contraception straight away. Ask your doctor for advice about suitable contraception. You can start taking the oral contraceptive pill immediately and you should use condoms when having sexual intercourse to reduce your risk of sexually transmitted infections. If you develop any of the following symptoms contact your GP as you may have developed an infection:
It is normal to experience emotional reactions, including feelings of relief, guilt, sadness and a sense of loss after having a termination and it's important that you try to talk to someone close about these feelings. What are the risks?Terminations are commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure. Side-effectsThese are the unwanted but mostly temporary effects of a successful treatment, for example feeling sick as a result of the general anaesthetic. You will have some abdominal pain, cramping and vaginal bleeding for the first two weeks. Occasionally, the bleeding and discharge continue for up to a month. ComplicationsThis is when problems occur during or after the operation. Most women are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT). Specific complications of surgical termination are uncommon but can include:
The exact risks are specific to you and differ for every person, so we have not included statistics here. Ask your doctor to explain how these risks apply to you. Further information
Related topics
Sources
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed Mr Robin Crawford, MD, FRCS, FRCOG, Consultant Gynaecologist, and by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Publication date: June 2008.
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