Health: Advice on ... Abortion procedures

Wednesday, July 30, 2008

Deciding to have an abortion is one of the most difficult decisions a young women will ever have to make. TheSite.org's Julia Pearlman looks at what the process actually involves and what to expect on the day.

Q: What should a young woman do if she's thinking about having an abortion?

If a young woman is pregnant and is considering an abortion it's important she sees a doctor as soon as possible. In the UK, abortions can be carried out up to 24 weeks but the law is different in Ireland. Waiting times for appointments can vary and will often depend on where the person lives. "If you're having an abortion with the NHS, expect a wait of around three weeks before you first go to your abortion appointment and when you actually get your appointment through for the procedure," says a spokesperson for sexual health charity fpa. If the woman decides to have an abortion at a private clinic she will be seen quickly, but can expect to pay around £500.

Q: What happens once a young woman decides to have an abortion?

She will need to attend a consultation at the clinic where their medical history will be taken and a nurse or doctor will discuss what will happen. She will undergo a scan to see how many weeks pregnant she is. Women wanting an abortion in the UK have to get the signatures of two separate doctors. They can see a doctor in three different places: a general practice, contraceptive clinic or a Brook clinic.

No-one needs to know the woman has had an abortion, or that she's been considering it, including those under the age of 18. It doesn't need to go on any records at the GP's surgery either. Young women don't need the agreement of their partner or parents to have the procedure. If a doctor has a moral objection to abortion, they should refer the patient to another doctor.

Q: What happens on the day of the abortion?

Before a woman has an abortion she will have another chance to talk things through with a doctor or nurse. A blood test will be done and patients might be offered checks for sexually transmitted infections. Finally, a consent form will need to be signed.

Abortions can only be carried out in licensed premises, such as an independent clinic or in a hospital. However, the government has recently launched a consultation over whether to relax abortion rules.

Q: What types of abortion are available to young women?

There are several forms available:

Early medical abortion - Women can take an abortion pill up to nine weeks after conception. This will involve two appointments on two separate days where they will be given a tablet called Mifepristone to take orally, and 36 to 48 hours later they will take another pill orally, or a prostaglandin tablet, which will be placed in the vagina. These two drugs will end most early pregnancies within four to six hours by causing the womb to contract and shed its lining.

Vaccum aspiration method - This suction method can usually be used from seven to 13 weeks. The procedure involves a general or local anaesthetic, or conscious sedation. It normally takes around five to 10 minutes and is done by stretching the cervix to allow a tube to pass through it into the womb. Once the tube is inserted the pregnancy will be removed by suction.

Medical abortion - This procedure can be carried out from nine to 24 weeks. It involves taking the same pills as you would with an early medical abortion. This procedure is like having a late natural miscarriage and may involve an overnight hospital stay. The termination usually takes around 12 hours to happen. If the young woman is 20 to 24 weeks pregnant it will require a two-stage process that involves stopping the heart of the foetus followed by surgical evacuation the following day.

Surgical dilation and evacuation - Is available from 15 to 24 weeks. This procedure will involve a general anaesthetic and takes around 10 to 20 minutes. The cervix is stretched and dilated and the pregnancy removed using forceps and a suction tube. If there are no complications, the patient may be able to return home the same day. After 21 weeks the young person will normally need to spend a night in the clinic or hospital.

Q: At what stage can a young woman change her mind?

It's important to emphasise that young people can change their minds right up to the last minute. If they are having an abortion in a private clinic they may be charged for the consultation, but not for the procedure. It is also worth advising young people to get themselves referred to the waiting list as soon as possible. That will give them a couple of weeks between the first appointment and the procedure to think about it and change their mind if they want to.

- This article was written by Julia Pearlman, senior journalist at YouthNet. A longer version of this article and others about sexual health are available on YouthNet's website www.thesite.org

MORE INFO

- www.thesite.org TheSite.org provides advice on a wide range of subjects affecting young people aged 16 to 24

- www.fpa.org.uk Sexual health charity that allows people to make informed decisions about sex and sexual health

- www.brook.org.uk Provides free confidential advice about sex and sexual health, mainly to under-25s.

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