Abortion

Not all pregnancies are an occasion for celebration. Whether it has happened accidentally, whether you are a victim of assault or un-consensual sex or you just aren’t ready for this now, access to abortion means women have the right to chose whether they continue with a pregnancy up to 24 weeks gestation in the UK (laws in Northern Island are woefully behind the curve but hopefully will be changing with increase pressure.

As with anything emotive, this issue strikes heated debate. I am not here to debate whether abortion is right or wrong but to give facts about your options and where to seek help if you are not sure what you want to do.

One thing I will say straight off, this is 100% YOUR body and YOUR choice. If anyone is forcing you to go ahead with a termination and you are not happy to do this, please let your health provider know.

If you decide to go ahead with an abortion (and you can change your mind at any time up to the actual process being performed you have three options to contact:

• contact an abortion provider directly – the British Pregnancy Advisory Service (BPAS), Marie Stopes UK and the National Unplanned Pregnancy Advisory Service (NUPAS) can tell you about eligibility and services in your area
• speak to your GP and ask for a referral to an abortion service – your GP should refer you to another doctor if he or she has any objections to abortion
• visit a contraception clinic, family planning clinic, sexual health clinic or genitourinary medicine (GUM) clinic and ask for a referral to an abortion service

According to the NHS website you should not have to wait more than 2 weeks from the first appointment. You can roughly date your pregnancy from the first day of your last period (it can just be rough as they will usually do an ultrasound to check the dates). You can ask advice from any of the following:

• your GP or another doctor at your GP practice
• a counselling service at the abortion clinic
• organisations such as the FPA, Brook (for under-25s), BPAS, Marie Stopes UK and NUPAS – but beware of so-called “crisis pregnancy centres” that claim to provide impartial advice but often do not

That last one worried me a little. Please be aware, as I have said, that this is a highly emotive subject. You have every right to impartial and factual information. As soon as anyone mentions religion or baby killing please get out of there and contact your GP or one of the charities above.

There are two procedures which can be done. One is a medical abortion where you are given two pills 24 or 48 hours apart which will cause you to miscarry. You could bleed for up to 2 weeks. Things are usually back to ‘normal’ within a month or so but you may find the next period is a little strange.

The second procedure is a surgical abortion which involves surgery through the cervix to expel the pregnancy tissue. It is done under local (the area is numbed) or general (you will be put to sleep for a few minutes) anaesthetics depending on which one you are given. The NHS webpage described the procedures as:

• Vacuum or suction aspiration

Can be used up to 15 weeks of pregnancy. It involves inserting a tube through the entrance to the womb (the cervix) and into your womb. The pregnancy is then removed using suction.

Your cervix will be gently widened (dilated) first. A tablet may be placed inside your vagina or taken by mouth a few hours beforehand to soften your cervix and make it easier to open.

Pain relief is usually given using medicines that you take by mouth, and local anaesthetic, which is numbing medicine injected into the cervix. You may also be offered some sedation, which is given by injection. A general anaesthetic isn’t usually needed.

Vacuum aspiration takes about 5 to 10 minutes and most women go home a few hours later.

• Dilatation and evacuation (D&E)

Used from around 15 weeks of pregnancy. It involves inserting special instruments called forceps through the cervix and into the womb to remove the pregnancy.

The cervix is gently dilated for several hours or up to a day before the surgery to allow the forceps to be inserted. D&E is carried out with conscious sedation or general anaesthetic. It normally takes about 10 to 20 minutes and you might be able to go home the same day.

As with anything there are a few risks to having an abortion listed below from the NHS website, but it shouldn’t impede the risk of any future pregnancies. These risks are below:

• infection of the womb – occurs in up to 1 in every 10 abortions
• some of the pregnancy remaining in the womb – occurs in up to 1 in every 20 abortions
• excessive bleeding – occurs in about 1 in every 1,000 abortions
• damage to the entrance of the womb (cervix) – occurs in up to 1 in every 100 surgical abortions
• damage to the womb – occurs in 1 in every 250 to 1,000 surgical abortions and less than 1 in 1,000 medical abortions carried out at 12 to 24 weeks

Support

Whether you feel you need it or not, it is heavily recommended that you have some counselling before, during and after an abortion, especially if you are unsure of what is the best option to take. Friends can also sometimes provide help where it is least expected. It’s thought 1 in 3 women will have an abortion at one period of their lives and sometimes shared experience can be reassuring and helpful. That said, you may wish to only speak to a professional which again, is your choice.  Most charities will provide a post-abortion service where you can speak to someone about your experience.

Women (I include anyone here as well who doesn’t identify as female anymore) have always had the bum deal when it comes to dealing with these things. The main thing to remember is you always have a choice and you always have support.