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How is it performed? of Abortion
In the UK, abortions can only be carried out in a hospital or licensed clinic.
How an abortion is carried out will depend on how long after conception it takes place. This is usually estimated by counting the number of weeks from the first day of the woman’s last period.
The following is a summary of the most usual methods of providing an abortion and local practices may vary:
Up to 9 weeks
In the first nine weeks of pregnancy the abortion pill may be used. This is also called an early medical abortion. This actually involves taking two drugs 48 hours apart.
The first drug (mifepristone, also known as RU486) blocks the action of the hormone that makes the lining of the womb suitable for the fertilised egg. After this part of the process, women normally go home, returning 48 hours later for stage 2 of the process.
The second drug (prostaglandin) is given 48 hours later and causes the womb to cramp and contract. The lining of the womb breaks down and is lost along with the embryo through bleeding from the vagina. This part of the process can be painful although pain-killing medication can be given.
The drugs used in this process can make some women feel sick and in some cases they may vomit or have diarrhoea.
9-14 weeks
From 9 to 12 weeks of pregnancy, a process called vacuum aspiration (which means gentle suction) can be used to remove the foetus from the womb. During a vacuum aspiration abortion, a narrow plastic suction tube is inserted into the womb through the neck of the womb (the cervix). A pump is then connected to the tube and this sucks out the foetus along with other tissue associates with the pregnancy.
After a vacuum aspiration abortion there can be a little bleeding for up to 14 days.
Vacuum aspiration abortions can be carried out under a local or general anaesthetic. It is not normally necessary to stay in the hospital or clinic overnight after a vacuum aspiration abortion.
14-19 weeks
Between 14 and 19 weeks of pregnancy, a process known as surgical dilatation and evacuation (often referred to as D&E) may be used. This is carried out under a general anaesthetic. The process involves stretching the neck of the womb (the cervix) just wide enough for forceps to be used to remove the foetus.
Vacuum aspiration (see above) may be used afterwards to ensure that no tissue is left inside the womb. There may be some bleeding after the abortion for up to 14 days.
This type of abortion does not usually require an overnight stay in hospital.
20-24 weeks
Between 20 and 24 weeks, there are two alternative methods of abortion.
The first is known as a surgical two-stage abortion as there are two stages to it, each of which requires a general anaesthetic.
Stage 1 involves stopping the heart beat of the foetus and softening the neck of the womb (cervix). Stage 2 is carried out the following day and involves removing the foetus and other tissue associated with the pregnancy using the D&E method explained above.
Surgical two-stage abortions usually require an overnight stay in hospital.
The second option is known as a medically induced abortion (or medical induction abortion) and is similar to a late miscarriage. The drug prostaglandin is injected into the womb and this causes it to contract strongly as in labour. This can last for around 6-12 hours. During the process the woman remains awake and may be given drugs to control the pain.
Afterwards the D&E process explained above may be necessary to ensure that the womb is completely empty.
Medically induced abortions usually require an overnight stay in hospital.
As with all abortions, if when you leave the hospital or clinic you experience heavy bleeding, a lot of pain or a high temperature, you should seek medical help.
