Abortion

The only person who can decide whether an abortion is right for you, is you yourself. It’s really important to remember that the decision is up to you, because lots of people have very strong views about abortion – whether it’s right or wrong – but none of them are you, and it’s your choice.

Lots of people are against abortion, because of moral or religious views. They have a right to be against it, but they don’t have a right to force other people to think the same way, or to stop anyone from getting an abortion.

People who are against abortion often say that it has bad effects on the people who have them – for example, they say abortion causes mental health problems, or that people who have abortions find it harder or impossible to get pregnant in the future. This isn’t true. Lots of studies have found that abortion does not cause long-term mental health problems, or problems with getting pregnant. There’s no link between abortion and breast cancer, either.

Even though one in three women in the UK will have an abortion during her lifetime, many people who have had an abortion don’t talk about it. But you almost certainly know someone who has had an abortion, even if they haven’t told you that they have.

If you’ve done a pregnancy test and found out you are pregnant, you need to decide what you want to do next. Our pages on having a baby and adoption have lots of information about two possible options for you.

If you don’t want to have a baby, or go through with an adoption, you can choose to have an abortion.

Some people are very clear about their decision to have an abortion. Some people find it really hard, and might take some time to make up their mind.

But either way, it’s really important to be sure of your decision. You can talk to other people to help you decide – your friends, a family member, a counsellor, your partner – but in the end it has to be your decision. No one can make you have an abortion if you don’t want to, and no one has the right to force you to stay pregnant if it’s not what you want.

It’s OK to have different emotions about having an abortion, too. Because some people have strong anti-abortion feelings, sometimes people who have them feel like they are doing something wrong. At Brook we really believe that abortion is not bad or wrong. We think anyone who has decided to have an abortion should be treated without judgement, because it is their decision.

People from all walks of life have abortions every day for every reason imaginable. Sometimes, even people who are against abortion might decide to have an abortion if they get pregnant and don’t want to be – and that’s OK too. Everyone has the right to choose and everyone has the right to confidential and safe medical treatment.

Whether the decision to have an abortion is simple or hard for you, you can talk it over with someone you trust if you want to.

If you’re going to ask a friend or family member for advice, please make sure you trust them completely, because if you want it kept a secret (which is your right), you don’t want them telling other friends or people you know. It’s fine to want to keep your decision private.

You can have an abortion without your parents’ or carers’ permission, even if you are under 16 years of age. Some people can talk to their parents about their decision to have an abortion and can get support from them. Some people don’t want to tell their parents, because they are afraid of what they might say, or because they don’t want their parents to know they had sex. You don’t have to tell them if you don’t want to.

If you are in a relationship, you might want to talk to your partner about your options. It is up to you. But even if your partner is the person who you became pregnant with, that doesn’t mean they can tell you what decision to make. It’s your body and your choice.

There are specially trained counsellors who can give you a chance to talk about your decision. If you go to your GP, you can ask to be referred to a counsellor. The charities British Pregnancy Advisory Service (BPAS) and Marie Stopes have counsellors you can talk to before an abortion. Their counsellors are pro-choice – that is, they will not push you to have an abortion, or to continue with the pregnancy. They will listen to you and help you come to a decision, but the decision will be yours.

If you are looking for support around making a decision, be careful – some places pretend to offer ‘impartial’ and ‘unbiased’ advice, but actually they use counselling to persuade people not to have abortions. Sometimes they tell people that having an abortion is linked to breast cancer, or mental health problems – neither of which is true. These places are called crisis pregnancy centres, and when Brook investigated them in 2014, we found they were trying to make up people’s minds for them, rather than helping them make their own decision.

If you’re in England, Scotland or Wales, you are entitled to an abortion paid for by the NHS and there are a number of ways you can get one. UK citizens travelling from Northern Ireland to England for abortion can also have the procedure paid for by the NHS.

You can start with your GP if you are comfortable to do so (or another GP if you don’t want to see your normal doctor), a Brook service or another sexual health service, and telling them that you need an abortion.

These services will not perform the abortion themselves but can refer you to a specialist service that can. (Brook can also help you by offering pregnancy tests, information about all your options, and counselling before or after an abortion.)

Alternatively, in many parts of the country you can refer yourself straight into abortion services without going to see your GP. Visit either British Pregnancy Advisory Service (BPAS) or Maries Stopes for further details.

The next step after this will involve an assessment with a doctor or nurse. They can answer any questions or address any concerns you might have.

After this assessment they will make an appointment for you to return to have the abortion. This process, from start to finish, should not take longer than two weeks.

A few important points to remember:

• Whoever you go to see, they should not judge you or make you feel bad about your decision
• If a doctor disagrees with abortion, then she or he does not have to be involved in referring you. However, they should make arrangements for you to see another doctor who will be happy to arrange the appointment
• You do not have to have the consent of your partner although you may wish to discuss it with them
• You have the right to delay or cancel or appointments if you wish. It’s always good to let the organisation know if you are going to cancel or delay your appointment so the time can be offered to someone else
• You have the right to change your mind about having the abortion at any time during the process
• You should be offered extra support, such as counselling if you want it, to help you make your choice

If someone is under 16 but is considered able to consent to their own medical treatment, they can consent to an abortion without being forced to tell a parent or carer. However, a doctor will try to involve a parent or another adult to provide support.

Young people under 16 are also allowed to access contraception without having to get permission from a parent or carer, as long as the doctor thinks they can understand and consent to this.

It’s important to know that the law is different across the British Isles:

England, Wales or Scotland

Two doctors need to agree that continuing the pregnancy will cause you significant physical or mental distress. Once they have agreed, you have until 24 weeks into the pregnancy to have an abortion. It’s a good idea to go and see a doctor as soon as possible if you know you are pregnant and have made up your mind to have an abortion. Abortion is one of the safest medical operations there is, and complications are very rare. Earlier abortions are even safer than later ones, and can be done using a pill before nine weeks – see our section on different types of abortion.

Northern Ireland

Abortion became legal in Northern Ireland in October 2019. Following this change in legislation, there is now a period of consultation and details of how abortion services will operate are due to be published in 2020.

UK citizens travelling from Northern Ireland to England for abortion can have the procedure paid for by the NHS. Those in economic need can also apply to have their travel costs funded. BPAS provides information on funded abortion and travel costs for those travelling from Northern Ireland. The Abortion Support Network can help with travel costs and can find accommodation if you need to stay overnight.

Jersey

You can have an abortion up to 12 weeks into the pregnancy if two doctors agree it is causing you distress. Abortion is legal up to 24 weeks if the foetus has a severe incurable problem, or if your life is in danger. If your pregnancy has gone past 12 weeks but is under 24 weeks, you can travel to England to have an abortion, but you will have to pay for the operation. The Abortion Support Network can help.

Isle of Man

They passed a new law in 2018 decriminalising abortion and making it available at the request of the pregnant person up to 14 weeks, and later in limited circumstances.

Republic of Ireland

They changed the law on abortion in 2018 and it is now possible to access abortion up to 12 weeks and later if there is a serious health risk or there is a fatal foetal abnormality. Because of the time limit people are still travelling from Ireland to England for abortions in a range of circumstances. The Abortion Support Network can help with the price of the abortion and can find accommodation if you need to stay overnight.

Visit our page on abortion and the law for detailed information about the law in each country.

There are two ways of ending an unwanted pregnancy; a medical abortion (which involves taking medicines) or a surgical abortion (which requires a surgical procedure).

The type of abortion you can have depends on several factors but you should always be able to choose the method you would prefer as long as it suits your medical needs. The doctor or nurse advising you will tell you which methods are suitable based on your medical history, how many weeks the pregnancy is and whether you prefer to be awake or asleep for the procedure.

Up to 10 weeks: Early medical abortion – sometimes known as ‘the abortion pill’

Early medical abortion can involve two visits to a clinic and is performed in the first ten weeks of pregnancy.

This method involves taking two medicines which end a pregnancy. It’s not the same as emergency contraception, which can be taken to try to prevent pregnancy from happening in the first few days after unprotected sex.

The first medication you will be given is mifepristone, which ends the pregnancy. The second medication is misoprostol and can be given at the same time as the first medication or you will return to the clinic between 1 to 3 days later. Your doctor or nurse will inform you whether you need to come back for the second medication. The second medication causes your womb to expel the pregnancy through cramping and bleeding and this usually takes between 4 and 6 hours but sometimes longer. You will be offered pain relief and you should be able to go home the same day.

You will have cramps and bleeding and are likely to spot blood for up to fours weeks following the abortion.

Read this guide from the British Pregnancy Advisory Service (BPAS) for more information on medical abortion.

Up to 15 weeks: Vacuum aspiration – sometimes known as ‘the suction method’

For this procedure either a general (asleep) or local (awake) anaesthetic would be given. The procedure only takes about 5-10 minutes and there is no wound or stitches.

The cervix (the entrance to the womb at the top of the vagina) is gently stretched to allow a thin tube to pass through it into the womb. Once the tube is inserted the pregnancy is removed by suction. Most people only take an hour or so to recover and go home the same day.

Read this guide from the British Pregnancy Advisory Service (BPAS) for more information on surgical abortion.

Abortions after 15 weeks

Abortion after 15 weeks is less common and most abortions happen in the first 13 weeks of pregnancy. However, sometimes people need to have an abortion later on in pregnancy. They might find that they need to travel out of their local area to do so, as abortion after 15 weeks is not always as easy to access. Again, it’s important to talk to a doctor as soon as possible.

The exact procedure offered to you will be explained by a doctor or nurse before the abortion goes ahead. Here are the procedures that you may undergo:

• Medical abortion can be carried out up to 24 weeks of pregnancy. You will be admitted to the clinic and be given two medications. The first medication is mifepristone, which ends the pregnancy and the second medication is misoprostol which expels the pregnancy. You will have contractions but should be given pain relief and looked after by a doctor or nurse until the pregnancy has passed. You will stay in the clinic until the abortion is complete. In some cases you might have to stay overnight until the pregnancy has passed.
  
• Surgical dilation and evacuation (from 15 weeks of pregnancy) is a minor operation, and is usually done under general anaesthetic (meaning you will be asleep). It usually takes around 10-20 minutes. The opening to the womb, called the cervix, will be gently stretched, and the foetus will be removed using a suction tube. You might be able to go home the same day if it all goes well, or you might need a stay overnight in hospital. Afterwards, you may bleed a bit for up to three weeks.

Read this guide from the British Pregnancy Advisory Service (BPAS) for more information on surgical dilation and evacuation.

It is likely you will be offered blood tests, STI tests and an ultrasound scan. The blood test is to check if you are anaemic and to find out your blood group. The ultrasound scan will help the doctors know exactly how far along the pregnancy is, so they know the best type of procedure to use.

You may also have a vaginal examination to check that you are healthy. If you’ve not had one before, don’t worry – just let the nurse or doctor know, and they should tell you what to expect, and will be extra careful with you.

You may have a chance to talk about different types of contraception with a doctor or nurse, so that you can choose a method which works for you.

Finally, you will be asked to sign a consent form, to make sure you understand what is about to happen. You can still change your mind about having an abortion even after you have signed the form – just let the clinic or hospital staff know as soon as you do.

Most abortions take place in one day, with no need to stay overnight. When you go to the abortion clinic, make sure to take all your documents with you, like any letters from your GP or the sexual health clinic.

For some types of abortion, you might have to fast (not eat) on the day – the abortion provider will make sure you know what to do, so just follow their instructions.

If you take any other types of medicine, for example if you have an inhaler for asthma or if you carry an epipen for allergies, make sure to take this with you, too.

You can take one person along for support, who can sit with you in the waiting room, and meet you afterwards. This can be anyone you like – a parent, relative or friend. If you are having a general anaesthetic you will probably be asked to bring an adult to go home with to ensure you are looked after.

It’s a good idea to take some sanitary towels with you, along with a clean pair of underwear. You might experience bleeding – like a heavier than usual period – after an abortion, and it’s best to be prepared.

Sadly, some people who are against abortion protest outside clinics, and try and tell people going in to clinics that abortion is wrong and they shouldn’t have one. This can be really upsetting. Taking someone with you can help. If you’re worried, you can call the clinic and ask for an escort inside, or see if there is another entrance you can use.

Immediately after an abortion, you might feel a bit woozy, or wobbly. If you can, it’s good to be able to have some rest, and some time to relax and recover. If you are in any discomfort, you can take painkillers like aspirin or paracetamol – you can ask at the clinic about what you can take.

Some bleeding is normal after an abortion, but if the bleeding hasn’t stopped after two weeks, you should go and see a doctor or contact the clinic you were treated. If the pain becomes really bad, and/or if you are bleeding very heavily, you should also go to a doctor as soon as you can or call NHS 111.

Please use sanitary towels rather than tampons if there is any bleeding – and wait until your next period to use tampons again. It’s also a good idea not to have sex for two weeks after an abortion.

You can get pregnant immediately following an abortion so if you don’t want to get pregnant, it’s important to use contraception. Talk to Brook, or to a sexual health clinic, to find out which type of contraception works best for you.

Read this helpful guide from the British Pregnancy Advice Service on how you might feel physically – and emotionally.

The majority of people who have abortions say that the main emotion they feel afterwards is relief.

That’s not true in all cases, and if you feel sad or upset you can talk to a counsellor (see below for places you can go to get help). Watch out for crisis pregnancy centres, which sometimes pretend to help with mixed feelings but actually make people feel guilty after having an abortion. How you feel will depend on who you are and what your life is like, and everyone will have a different experience.

In most people’s cases, any feelings of sadness will fade in time, and many studies have found that abortion has no long lasting effect on mental health. If you find you are still really sad, though, please see a doctor or a counsellor, as it could be depression or another mental health issue which is affecting you.

Read this helpful guide from the British Pregnancy Advice Service on how you might feel physically – and emotionally.

There are risks with any medical or surgical procedure and your doctor or nurse should explain them clearly to you before you go ahead with an abortion. Each procedure has a different set of risks and you should be given written information about those risks.

After an abortion, there is a small risk of infection. You may be given antibiotics after an abortion to stop infections. The symptoms of infection include pain in your pelvic area (like extra bad period pains), and heavy bleeding from your vagina.

If you need help quickly you can contact these organisations:

• For medical advice contact NHS by dialling 111 24 hours a day, 365 days a year
• For help if you’re under 18 contact Childline on 0800 1111
• For urgent emotional support contact the Samaritans on 08457 90 90 90