If you are unable or do not wish to continue with a pregnancy, your GP or a doctor at a sexual health clinic will refer you to a clinic or hospital for an assessment. This is also where an abortion can take place. In some areas, you can go straight to an independent abortion clinic without being referred.
Your medical assessment before abortion
The assessment will be the same if you go directly to an independent provider (such as the British Pregnancy Advisory Service (bpas) or Marie Stopes) without going to your GP.
During the assessment you:
- can discuss your reasons for requesting an abortion and how certain you are of that decision
- should be offered the chance to discuss your situation with a counsellor
- can talk to a nurse or doctor about the abortion methods that are available
- can discuss contraceptive options to prevent a further unplanned pregnancy
- might be tested for sexually transmitted infections (STIs) and anaemia (low iron levels)
- might be given an ultrasound scan if there's doubt about how many weeks pregnant you are
Independent providers, such as Marie Stopes and bpas, have useful information on the consultation or assessment, counselling, and medical and surgical abortion.
Will I have to stay in hospital after an abortion?
It depends how many weeks pregnant you are and which abortion method is being used. Normally, you can go home the same day. If the abortion takes place after 20 weeks, you'll usually have to stay overnight.
What happens during an abortion?
There are different kinds of abortion, depending on how many weeks pregnant you are. An abortion service should be able to offer you a choice of different kinds of abortion, but this may not always be possible.
A medical abortion involves taking medication to end the pregnancy. It doesn't require surgery or an anaesthetic, and can be used at any stage of pregnancy.
If you have a medical abortion, the first drug you take is mifepristone. This stops the production of hormones that allow the pregnancy to continue.
Up to two days later, you will have another appointment where you take a second drug called prostaglandin. This will either be a tablet you take by mouth, or a pessary put inside your vagina. Prostaglandin causes the lining of the uterus (womb) to break down. This causes bleeding and loss of the pregnancy about four to six hours later. You may have to stay at the clinic while this happens.
Medical abortion carried out up to nine weeks of pregnancy is known as early medical abortion. If a medical abortion is carried out after nine weeks, you may need a second dose of prostaglandin. If you have a medical abortion between 13 and 24 weeks of pregnancy, you will usually need to be in hospital or the clinic.
Surgical abortion involves having a procedure under a local or general anaesthetic. There are two methods of surgical abortion:
Suction aspiration can be used from 7 to 15 weeks of pregnancy. It involves inserting a tube through the vagina and into the uterus, and removing the pregnancy using suction. It's usually carried out under local anaesthetic, which is injected into the cervix. Most women go home a few hours later.
Dilation and evacuation (D&E) is used after around 15 weeks of pregnancy. The cervix is gently stretched and dilated to enable special forceps to be inserted. Suction is then used to remove the pregnancy. It usually takes between 10 and 20 minutes to perform D&E under general anaesthetic (you'll be asleep while it happens). If there are no complications, you can usually go home that same day.
You can find out more about medical and surgical abortion in abortion: how it is performed.
Does having an abortion hurt?
You'll have some period-type pain or discomfort. The later the abortion, the more painful it may be. You'll be advised about taking appropriate painkillers.
With suction abortions, the injection to numb the cervix can sometimes be painful.
You might experience some bleeding and period-type pains for up to 14 days after any type of abortion.
Are there any risks from abortion?
The earlier an abortion is carried out, the lower the risks. The main risk after an abortion is infection in the womb, so you may be given antibiotics. In rare cases, the uterus may perforate (this means it might tear).
The risks associated with abortion are:
- damage to the uterus - happens in less than 1 in 1,000 medical abortions performed between 12 and 24 weeks, and up to 4 in 1,000 surgical abortions
- damage to the cervix - happens in no more than 10 in every 1,000 abortions
- haemorrhage (excessive bleeding) - happens in about 1 in every 1,000 abortions
You should go back to your doctor or clinic immediately if you get symptoms of an infection after an abortion. Symptoms include:
- high temperature
- vaginal discharge
- abdominal pain that doesn't improve after taking painkillers
If you have signs of still being pregnant after the abortion, you should have another pregnancy test. If it's positive, you'll need a scan to confirm that the abortion hasn't worked. The abortion procedure may need to be carried out again.
Will an abortion affect my ability to have a baby in the future?
There is no evidence linking a previous abortion with future pregnancy problems. However, the Royal College of Obstetricians and Gynaecologists (RCOG) states that if you have a number of late-term abortions, there might be a higher risk of miscarriage or early birth.
Could I get pregnant again immediately after an abortion?
Yes. Some women can get pregnant within four weeks of having an abortion. You will be given advice about contraception at the time of your abortion and offered to have your chosen method supplied or fitted immediately, so that you are able to plan any future pregnancy.
Article provided by NHS Choices