Abortion

If you find that you are pregnant but you don’t want to be and are too late to take emergency contraception, your options are:

• Continue with the pregnancy and keep the baby (see pregnancy and parenthood page)
• Continue with the pregnancy and have the baby adopted
• Terminate the pregnancy (have an abortion)

If you decide you cannot continue with the pregnancy, it is important to get advice quickly. You do not need to contact your GP. You can make your own appointment by calling the Women’s Health Unit self-referral line on 01698 366926. This referral line is open Monday – Friday, 9am – 3pm. You will be given an appointment for a telephone consultation. This appointment will include:

• Time to talk through your decision to have an abortion.
• Options for treatment.
• Discussion about types of contraception available for the future.
• Options for screening for STIs.
• A date for the abortion. If necessary, we may ask you to come in for an ultrasound scan first.

Having an unintended pregnancy can be a very difficult and often emotional time. It is important to ensure that you make the right decision for you at the point you are in your life. More information is available in this short film about the procedure.

Helping you to prevent unintended pregnancy in the future is an important part of the service offered. Most methods of contraception can be started immediately or very soon after a termination of pregnancy.

The different types of medical abortion

Early Medical Abortion at Home (EMAH). During your first consultation, we will assess if you are suitable to undergo EMAH. If you are suitable for this option, and wish to do the treatment at home, we will arrange an appointment for you to attend the clinic and we will explain the medication to you, and make sure you know what to expect. Your treatment pack will contain medicines needed for the treatment, painkillers and antibiotics. The pack will also contain full medication instructions, and contact phone numbers for advice. You will have heavy bleeding and pass the pregnancy at home, usually a few hours after the second part of the treatment. We usually advise that you have someone with you for support on the day of the second medication.

To be suitable for early medical abortion at home, you will need to meet certain criteria:

• Be under 12 weeks pregnant at the time of treatment
• Be 16 years of age or over
• Be in good general health, with no significant previous pregnancy problems
• Have a phone so you can call for advice if needed
• Have access to transport so that you can go to clinic/hospital if you are concerned
• Agree to do a follow-up test after 3 weeks.

Medical abortion in the hospital setting involves 2 appointments, usually 2 days apart. On your first appointment, we will give you the 1^st medication (Mifepristone), this is a tablet that you swallow. This blocks the hormones going to the pregnancy. We will complete consent and permission forms, and give you the details for your hospital admission.

What will happen between my visits?

• Before attending for your second medication, you may have light bleeding and experience period type pains. In most cases these symptoms are only slight and nothing to worry about.
• Please do not use tampons.
• There is a small chance that your bleeding may become heavier and you may have more severe pain. It is possible that you could pass the pregnancy at this stage but this is very unlikely. If you are worried at any time, please contact the unit or NHS 24 for support and advice.
• You can use simple pain killers such as paracetamol if you experience cramps or pain
• It is very important that you keep the second appointment, even if you have experienced bleeding after the first medication.

You will have the 2nd medication (Misoprostol) on the day you attend hospital for admission. This is a set of 4 tablets which you put into the vagina. These tablets will cause you to start bleeding and pass the pregnancy.

Make sure you have something to eat before you attend for your appointments. You are welcome to bring 1 person of your choice with you.

You cannot bring children to your treatment appointments, so if you have children you will need to make childcare arrangements.

Deciding to have a termination

In Great Britain (Scotland, England and Wales) the law (Abortion Act 1967, as amended by the Human Fertilisation and Embryology Act 1990) allows a woman to have an abortion (termination) up to 24 weeks of pregnancy, if two doctors agree that it is less likely to cause harm to her physical or mental health than continuing with the pregnancy.

Most abortions (80-90%) are carried out before 13 weeks of pregnancy. Only about 1% is carried out after 20 weeks.

Within Lanarkshire we can offer abortion up to 20 weeks of pregnancy, women who are over 20 weeks are referred to BPAS. These very late abortions require the medical team to have highly specialised skills and are usually only carried out in England.

The right to refuse

A doctor or nurse has the right to refuse to take part in the procedure if they do not believe in abortion. However, they should always refer you on to another doctor or nurse who will help. The General Medical Council guidance for doctors makes it clear that a doctor’s ‘personal beliefs’ should not affect patient care. There is similar guidance provided by the Nursing and Midwifery Council for nurses, and by The Royal Pharmaceutical Society of Great Britain for pharmacists. If your doctor is not being helpful, try to see another doctor or nurse at your general practice or visit your local sexual health clinic.

Confidentiality

The decision to have an abortion is a matter between you and your healthcare team. All information and treatment are confidential whatever your age. This means that information cannot be shared with anyone else without your agreement unless we have serious concerns about your immediate safety.