Abortion: your questions answered

Abortion care is available free on the NHS for most people in the UK.

An abortion can take place up to 24 weeks of pregnancy.

In some cases, an abortion may take place after 24 weeks, for example if there’s a serious risk to your health or a substantial risk of the fetus being born with a serious disability.

The weeks of pregnancy are usually counted from the first day of your last period – not from when you had the sex you got pregnant from. For example, if it’s 5 weeks since day 1 of your last period, you’re 5 weeks pregnant. If you have irregular periods, or no periods, or the stage of pregnancy isn’t clear, an ultrasound scan can be done to check how many weeks pregnant you are.

In England, Scotland and Wales you can access abortion care by:

• Referring yourself for an NHS abortion, without seeing a doctor or nurse first. See Further information section below.
• Contacting your GP or a local contraception or sexual health service. They can refer you to a local NHS abortion care service.
• Paying for an abortion from a private abortion care provider. Costs vary.
   

In Northern Ireland:

• If you’re less than 10 weeks pregnant, call 03457 30 40 30 for a referral to an abortion care provider. If you’re not certain you want an abortion you can ask for counselling to help you decide.
• If you’re more than 10 weeks pregnant, or an abortion isn’t available in your local area, abortion services can be accessed in England free of charge, with travel costs covered. Call the central booking system on 0333 234 2184 for more information.
   

Abortion is safer the earlier it takes place, so even if you’re not certain about your decision, it’s a good idea to get a referral. You’ll always be given time to make up your mind, if you need it.

Different procedures are available depending on how long you’ve been pregnant, your medical suitability and your preferences.

You can usually expect to have a choice of medical or surgical abortion.

Medical abortion

Medical abortion (sometimes called the abortion pill) involves taking 2 types of pills to end the pregnancy. The first pill is called mifepristone and the second pill is called misoprostol. It doesn’t involve surgery or an anaesthetic.

It may take place at home, a hospital or a clinic, depending how many weeks pregnant you are and what you prefer.

You may see the products of the pregnancy. Your abortion care provider will talk to you about what to expect.

Medical abortion up to 10 weeks of pregnancy

• England and Wales: You can take both types of medicine at home, if you and your abortion care provider agree this is right for you. You’ll get clear instructions on how to use the medicine.
   
• Scotland: It’s usually possible to take both types of medicine at home up to 12 weeks of pregnancy, if you and your abortion care provider agree this is right for you. You’ll get clear instructions on how to use the medicine.
   
• Northern Ireland: you’ll need to attend a clinic or hospital to take the first pill (mifepristone) but can take the second pill (misoprostol) at home.

To start the process, you’ll swallow a mifepristone pill. This blocks the pregnancy hormone. If you take it at a clinic or hospital, you’ll be able to go home straight after and you can carry on with your normal activities.

Occasionally there’ll be some bleeding after taking mifepristone but usually there won’t be any other effects.

Usually 1-2 days later, you’ll take misoprostol. You can usually take this at home.

Misoprostol can be put in the vagina or taken by mouth. It causes strong, painful abdominal (tummy) cramps and heavy bleeding through the vagina. Bleeding usually starts around 2 hours after taking the misoprostol but may start sooner or later.

The pregnancy is passed with heavy bleeding like an early miscarriage. This usually happens within 4–6 hours but may be quicker or take longer. You may be offered another dose of misoprostol.

You’ll have a phone number to call if you’re worried or want to talk to someone at any time during the abortion.
 

Medical abortion after 10 weeks

The medicines used for abortion before 10 weeks are also used for medical abortion later in pregnancy. The abortion may take longer, and extra doses of the second medicine (misoprostol) may be needed. The second medicine is usually taken 36-48 hours after the first. You’ll usually take it in the clinic or hospital and stay until the abortion is complete.

You usually return home on the same day, but some people may have to stay overnight, particularly when the abortion is later in the pregnancy.

If you’re less than 12 weeks pregnant, you’re usually able to go home straight after taking the second medicine, depending on the provider and your preference. In Scotland, you can usually take both medicines at home up to 12 weeks of pregnancy.

Surgical abortion

This always takes place in a clinic or hospital. You usually go home on the same day. You won’t see the products of the pregnancy unless you choose to.

You’ll be offered treatment with medicine to help soften and open the cervix. Later in pregnancy, this can also be done with dilators (matchstick-sized rods). This may be a few hours or 1–2 days before the abortion and may cause some bleeding and pain.

Vacuum aspiration – up to 14–15 weeks of pregnancy, depending on provider

Vacuum aspiration (sometimes called suction abortion) involves a small tube being inserted into the vagina, through the cervix (entrance to the uterus) and into the uterus to remove the pregnancy by suction.

You’ll be offered a choice of suitable pain relief methods, but not all methods are available in every setting. Depending on what you prefer and how many weeks pregnant you are, you may have:

• a local anaesthetic
• moderate (conscious) sedation (you’re relaxed and sleepy, and may not remember everything that happens)
• deep sedation or a general anaesthetic (you’re asleep).

Vacuum aspiration takes about 5–10 minutes. You’ll usually go home an hour or so afterwards.

Surgical dilation and evacuation (D&E) from 14–15 weeks of pregnancy, depending on provider

Special medical instruments and suction are used to remove the pregnancy. The procedure takes 10–20 minutes. You’ll be offered a general anaesthetic or sedation. Most people return home on the same day.

Abortion after 20 weeks

Abortion at this stage involves either the surgical dilation and evacuation method, or medical abortion.

After 22 weeks, or sometimes earlier, depending on the provider, a doctor will give an injection to stop the heart of the fetus before the abortion.

You’ll be given treatment to soften and dilate (open) the cervix, 1 or 2 days before a surgical abortion.

A medical abortion at this stage takes time and you’ll have to stay in the hospital or clinic, sometimes overnight.

No. A doctor or nurse doesn’t have to take part in abortion, but you can expect them to refer you to another doctor or nurse who’ll help. Guidance from the General Medical Council, the Nursing and Midwifery Council and The Royal Pharmaceutical Society of Great Britain states that the personal beliefs of doctors, nurses or pharmacists shouldn’t affect patient care.

If your doctor or nurse isn’t helpful, try to see another doctor or nurse at your general practice or contact a local contraception or sexual health clinic near where you live. See How to get help with your sexual health. You can also self-refer without seeing a doctor or nurse first (see above, How do I get an abortion?).

Your information and treatment are confidential. This means your abortion care provider won’t tell anyone else without talking to you about it first.

You can expect them to tell you how your information will be stored and who’ll have access to it. Tell your provider if you don’t want them to share information with your GP.

If you have a face-to-face consultation, you’ll usually be seen separately from a partner or other person accompanying you, for at least part of the consultation.

No. You’ll be encouraged to involve your parents, carers, or a supportive adult but you can still have an abortion even if you don’t tell them. The doctors will check no one is pressuring you to have an abortion and that you fully understand what’s involved.

All information, advice and services are confidential. However, health professionals will tell social services if they think you, or another person, are at significant risk of sexual abuse or emotional or physical harm. They should always try to talk to you about this first.

A clinic or hospital may ask that you bring an adult (aged 18 or over) with you to your appointment who can take you home and stay with you after the abortion.

No. It’s your decision whether or not to have an abortion. Your partner, or the person you got pregnant with, has no legal rights. You can go ahead with an abortion without a partner’s knowledge or agreement. Partners have never successfully prevented abortion by legal action.

If you feel you’re at risk of harm if a partner finds out about you having an abortion, or if someone is pressuring you to have an abortion you don’t want, tell your abortion provider.

Waiting times vary but you can usually expect to have your abortion within 2 weeks. You should be seen as soon as possible if you need an abortion for urgent medical reasons. If you have any concerns, speak to your provider.

If you have a medical problem, you may have to wait longer for more specialist advice.

Abortions are carried out under care of an NHS hospital or a specialist abortion clinic.

Medical abortions before 10–12 weeks usually take place at home but can also take place at the hospital or clinic.

Surgical or later medical abortions will take place at the hospital or clinic.

Most abortions won’t require an overnight stay.

You’ll have an initial assessment – this may be by video or phone call, or in person. The abortion may be on the same day or a different day, depending on the type of abortion that’s best for you and whether you need more time to decide.

During the consultation you can expect:

• to talk things through, including time to ask questions
• an offer of extra support if you want it, including counselling and more time to decide  
• information about abortion, which types are suitable for your stage of pregnancy, and where it will take place
• information about any possible side effects, risks or complications
• information about what to expect during and after the abortion
• a chance to talk about contraception choices. Your abortion provider can usually give you your chosen method. If not, they’ll tell you where to get it.

You’ll be asked about your last period and your medical history to ensure you’re offered a suitable abortion method.

You may be offered, if required:

• A blood test to check your blood group.
• A blood test to check for anaemia.
• A check-up for sexually transmitted infections.
• an ultrasound scan to check your pregnancy dates (you can see the scan picture if you want but don’t have to). The scan may be done through the abdomen (tummy) or be an internal scan (through the vagina). It shouldn’t be done in an antenatal (pregnancy care) setting.

Whatever method of abortion is chosen, you’ll have some period-type pain or discomfort. The later the abortion, the more painful it might be. You’ll always be offered, and advised about, appropriate pain relief.

It can vary, but bleeding for 1–2 weeks after an abortion is normal. Bleeding after medical abortion can sometimes last for several weeks. Bleeding may be spotting or heavy but usually gets better each day. If you have very heavy bleeding (soaking through 2 maxi pads an hour, for 2 hours in a row) seek advice straight away.

If you don’t have a period within 4–6 weeks of the abortion, see your doctor or clinic in case the pregnancy hasn’t ended. This is uncommon.

Yes. Abortion is a very safe procedure. Serious problems are rare.

Like any medical procedure, abortion can have risks (see below), but the earlier in pregnancy it takes place, the safer it’s likely to be.

You’ll be told about any possible risks and complications.

Complications and serious problems aren’t very common.

The exact risks vary, depending on the type of abortion and how many weeks pregnant you are. Your abortion care provider will give you more details to help you make an informed choice.

There’s a small risk of problems such as:

• excessive bleeding (haemorrhage)
• side effects from the medicines used
• damage to the uterus (womb) in surgical abortions and later medical abortions
• damage to the cervix (entrance to the uterus) in surgical abortions
• an infection after the abortion, which could lead to serious complications if not treated.

If complications do occur, further treatment such as a blood transfusion or surgery may be needed.

All operations using a general anaesthetic carry some risks, but serious problems are rare.

All methods of abortion carry a small risk of failure to end the pregnancy. This usually means that surgery will be needed to complete the abortion.

Sometimes a small amount of pregnancy tissue remains in your uterus (womb) after the abortion. This is known as retained products of conception. It isn’t dangerous. You’re likely to have cramping pain and heavy bleeding a little while after the abortion. Sometimes this resolves on its own but sometimes you might need further treatment.

Pregnancy remains from an abortion in a clinic or hospital are disposed of in a sensitive way. If you have specific wishes about what you’d like to happen to the remains, talk to your healthcare team before you have your abortion.

If you have a medical abortion at home, your abortion care provider can talk to you about what to expect, depending on how many weeks pregnant you are.

Contact your abortion care provider straight away if you have any of the following. They may be symptoms that you’re still pregnant or have an infection.

• Ongoing pregnancy symptoms (such as nausea or sore breasts).
• Pain low down in your tummy that doesn’t improve with simple pain relief, or gets worse.
• Unusual vaginal discharge or any vaginal discharge that smells unpleasant.
• Bleeding that doesn’t get better in a few days.
• Feeling unwell.
• A high temperature or fever.

You can expect:

• Written information about what you’re likely to experience, for example what pain and bleeding to expect, how long it might last, and how to recognise any complications, including signs the pregnancy hasn’t ended.
• A 24-hour helpline number.
• Painkillers, if you want them.
• The opportunity to get your chosen method of contraception.
• An anti-D injection within 72 hours of an abortion if your blood group is rhesus negative and you’re over 10 weeks pregnant. It may also be offered after a surgical abortion before 10 weeks. It helps prevent problems in any future pregnancy.
• An opportunity to go back and talk about any worries or concerns, or your feelings about the abortion (see below, How will I feel?).

After a medical abortion at home, you may be asked to do a pregnancy test at home, 2–3 weeks after the abortion.

After a surgical abortion or medical abortion in a clinic or hospital, a follow up assessment isn’t usually needed.

You can usually start normal activities as soon as you feel comfortable and ready.

It depends on your individual circumstances and how comfortable you are with the decision. You may feel relieved, sad or have mixed feelings.

It’s rare to have any long-term psychological problems and those who do often had similar problems before the abortion. It’s important to seek help and support if you’re feeling upset or distressed about the abortion, whether it’s at the time or later on.

You can talk to:

• the counsellor at your abortion care service
• your doctor or practice nurse
• a doctor or nurse at your contraception or sexual health clinic
• Abortion Talk, a confidential pro-choice helpline for anyone affected by abortion: 0333 0909 266 (7pm–10pm, Mon, Weds, Thurs)
• Informing Choices NI: 028 9031 6100 (Northern Ireland only).

You can have sex as soon as you feel comfortable.

After an abortion, your normal fertility returns almost immediately.

If you start contraception straight after the abortion, you’ll be protected from pregnancy straight away.

If you’re having a medical abortion, you may be able to have a contraceptive implant fitted or a contraceptive injection at the time of taking the first medicine.

Your abortion care provider should give you information and advice about contraception. They should either provide your chosen method or tell you how you can get it.

No. Abortion doesn’t cause or increase your risk of breast cancer.

If there are no serious and untreated complications, having an abortion won’t affect your chances of getting pregnant in the future. Complications aren’t common.

The National Sexual Health Helpline can give you information about local abortion services. The number is 0300 123 7123. It’s open Monday to Friday from 9am-8pm and at weekends from 11am-4pm.

You can also check your local sexual health service website.

The following providers, offer NHS and private abortion care:

• bpas (bpas.org.uk, 03457 304030)
• MSI Reproductive Choices (msichoices.org.uk, 0345 300 8090)
• NUPAS (nupas.co.uk, 0333 004 6666).