What to do if you need an abortion
In England, Scotland, and Wales, we are lucky enough to have some of the most liberal laws in Europe when it comes to safe and accessible abortion provision. You can legally have a pregnancy terminated up to 24 weeks of gestation, and after that time abortion is permissible if the life of the person carrying the child is in danger. You can get an abortion with the consent of two medical professionals, for example if continuing with the pregnancy involves a risk to the mental health or physical health of the woman, or if the foetus would suffer severe mental or physical abnormalities if born.
Of course, whatever the situation of the pregnant person, the decision to have an abortion is never an easy one, nor is it likely to ever be taken lightly by the pregnant person. Indeed, discovering you are pregnant when you have not planned or prepared for it can be an emotional and stressful time. Whatever decision you make, you are likely to need advice and ongoing support.
If you do decide you wish to terminate your pregnancy, what are your options? Who should you go to for support, and where can you get a termination carried out? On top of that, how does it even work? Can you take a pill, or does an abortion involve an operation?
You don’t need a doctor’s referral and if you’re registered on the NHS system you can still have an abortion on the NHS
Firstly, the options available to you will depend on where you are in the country, as there is a lot of regional difference between services. Some abortion providers, such as Marie Stopes, have a 24 hour helpline you can call to discuss your options, and you can call this without having gone to a doctor. The charity also has counsellors available as well as expert nurses, who can talk you through your options and help you decide what is best for you.
“It’s a non discriminatory and completely confidential service,” says Vix Proctor, head of communications at Marie Stopes UK. “This means you make the decision, and we provide all the information you need to make that decision. We won’t offer an opinion, we simply provide you with the resources you need to decide.”
Going directly through an abortion service provider isn’t your only option, both for help deciding, and as your first step to getting an abortion. You can go directly to your GP and discuss your options with them, and they will then refer you to a provider, or you can go directly to any abortion service. You don’t need a doctor’s referral and if you’re registered on the NHS system you can still have an abortion on the NHS.
“Within the UK, if you’re registered on the NHS system, if you have an NHS number, and have a GP, you can definitely always get NHS funded treatment,” says Vix. “If you don’t want to go through the NHS you can go down the private/self funded route, and for some people they prefer to choose that option, say if, for example, they know their GPs personally.”
Of course, you can have an abortion on the NHS and still have it kept entirely confidential, although depending on your medical history and certain conditions sometimes the NHS would advise that your abortion goes on your medical record.
Regardless of which abortion clinic you go to or get referred to, the options are the same
Marie Stopes isn’t the only abortion provider in the UK. BPAS and NUPAS are two of the principal ones, and some NHS trusts have their own, and all have similar set ups. “We understand women need full support,” says Vix. “We all have counselling services available, pre and post abortion.”
Depending on you live and where you go to in the first instance, you may get a completely different provider to someone else in a different town, but this shouldn’t make any difference to your level of care, or the general experience. Abortion services are funded by clinical commissioning groups, who are responsible for distributing services in a local area. If you go to a GP surgery or an STI clinic they normally have a direct route to an abortion service provider, along with close links, to ensure continuity of care. Another good service you can use is Brook, who are very good with signposting young people to the services they need.
So once you’ve decided which route you are going down, what happens next? “If you’re calling our helpline,” says Vix, “one of our advisors would ask you if you’d thought about your options, and if you’d like to talk to a counsellor about it first.” Marie Stopes offers face-to-face counselling at some centres, and they also have a telephone counselling service from 8am-9pm. If, after your discussion on the phone, you decide you definitely want to terminate the pregnancy, the nurse will book you your nearest, or quickest, appointment, depending on your circumstances.
Regardless of which abortion clinic you go to or get referred to, the options are the same. You can have a medical abortion, which is a pill based treatment, up to nine weeks. If you are more than nine weeks pregnant you have to have a short surgical procedure that happens in the theatre. Whatever option you have, doctors will work with you to find the best option for you, depending on your circumstances and your medical history.
“We want you to have time to recover and make sure you’re fully fit to leave the centre. You go into a recovery room after the procedure and there are nurses and doctors on hand to monitor you”
“With the pills, you have a pre assessment phone call, where we take your medical history and learn about medication you’re on,” says Vix. “Then you take two pills, and you normally take them 24 or 48 hours apart, depending on your preference or availability.”
On the day of your appointment you go to the abortion centre and have a scan with a nurse to confirm the pregnancy, and then you will be walked through the upcoming procedure. Once your consent is gained, the nurse will proceed with administration of the first tablet. The process until that point is very similar with the surgical procedure. The actual procedure in the case of a surgical abortion takes around 15 minutes to carry out. That being said there is a lot of preparation and it is not an easy day. “We understand that,” says Vix, “so we want women to take their time. We want you to have time to recover and make sure you’re fully fit to leave the centre. You go into a recovery room after the procedure and there are nurses and doctors on hand to monitor you.”
One of the things you have available to you after treatment at Marie Stopes is a 24hr post-operation care line, so if you have any concerns or worries there is a nurse on call 24 hours a day to give trained medical advice. Most providers also offer a free counselling service for women who have had an abortion with that provider, so that you feel supported and are able to properly process what you have been through.
Often, says Vix, women are scared of going to their GP in the first instance because they feel guilty, and that they have left themselves down by getting pregnant. While of course this is not the case at all, for those who don’t want to go to their GP, seeking out counselling services can be a good idea. “A lot of women say they thought they were going to get told off, but that is definitely not the case,” adds Vix. “We provide a service to help you control your choices. With a helpline you can talk to someone who will be an expert in the field, so you can get the right information about treatment options. And of course, if you feel able, you can simply go to your GP.”