Abortions can only be carried out under the care of qualified doctors who work in NHS hospitals or licensed clinics.
If you're less than 10 weeks pregnant you may be able to have a medical abortion at home after an initial appointment with the hospital or clinic. You may need to go into the hospital or clinic for a scan, for example to find out how many weeks along the pregnancy is. If you do not need a scan, you can usually have a phone or video appointment.
Before having an abortion, you'll need to have an assessment appointment. This usually happens at the hospital or clinic, but you may be offered a phone or video assessment.
During this assessment, you may:
- discuss your reasons for considering an abortion and whether you're sure about your decision
- be offered the chance to talk things over with a trained counsellor if you think it might help
- talk to a nurse or doctor about the abortion methods available, including any associated risks and complications
- be offered an ultrasound scan to check how many weeks pregnant you are
- be offered testing for sexually transmitted infections (STIs)
- need to have other tests such as a blood test, depending on any medical conditions you have or the stage you're at in the pregnancy
When you're sure you want to have an abortion, you'll be asked to sign a consent form and the clinic or hospital will arrange a date for the abortion.
You can change your mind at any point up to the start of the abortion.
There are 2 main types of abortion:
- medical abortion ("abortion pill") – taking medicine to end the pregnancy
- surgical abortion – a procedure to remove the pregnancy
Medical and surgical abortions can generally only be carried out up to 24 weeks of pregnancy.
In very limited circumstances an abortion can take place after 24 weeks – for example, if there's a risk to life or there are problems with the baby's development.
You should be offered a choice of which method you would prefer whenever possible.
Medical abortion
Medical abortion involves taking 2 different medicines to end the pregnancy.
The medicines are prescribed by the hospital or clinic, and you usually take them 1 or 2 days apart.
The pregnancy is passed (comes out) through the vagina. This usually happens several hours after you take the second medicine.
It does not need surgery or an anaesthetic.
It involves the following steps:
- first you take a tablet that contains a medicine called mifepristone, which helps prepare your body for the next medicine. You can usually take this first tablet at home if you're less than 10 weeks pregnant, otherwise you'll need to take it in the hospital or clinic. You'll be able to go home afterwards and continue your normal activities
- usually 1 to 2 days later, you take a second medicine called misoprostol – you put the tablets under your tongue, between your cheek and gum, or inside your vagina. You can usually take the medicine at home if you're less than 10 weeks pregnant – if you're over 10 weeks pregnant you need to take these tablets at the clinic or hospital
- within 4 to 6 hours of taking the second medicine, the lining of the womb breaks down, causing pain, bleeding and loss of the pregnancy
Sometimes you need to take more doses of misoprostol to get the pregnancy to pass.
Occasionally, the pregnancy does not pass and an operation is needed to remove it.
Surgical abortion
Surgical abortion involves an operation to remove the pregnancy from the womb. It may be done with:
- local anaesthetic (to numb the cervix)
- conscious sedation (where you're relaxed but awake)
- deep sedation or general anaesthetic (where you're asleep)
Most people having deep sedation will not remember anything and will not be aware during the operation. If you have a general anaesthetic, you'll be fully asleep during the operation and will not remember anything.
What kind of anaesthetic or sedation you have depends on your circumstances, how many weeks pregnant you are and your own preference.
Before a surgical abortion, you'll be asked to have a medicine to open the cervix. This happens either a few hours or 1 to 2 days before the operation, depending on the medicine used.
There are 2 methods of surgical abortion.
Vacuum or suction aspiration
This can be used up to 14 weeks of pregnancy.
A tube is inserted into the womb through the cervix (the opening to the womb from the vagina), and the pregnancy is removed using suction. The doctor may need to use special instruments to help remove the pregnancy, depending on how many weeks pregnant you are.
Vacuum aspiration takes about 5 to 10 minutes and most women go home a few hours later.
Dilatation and evacuation (D&E)
This is used after 14 weeks of pregnancy. It involves inserting special instruments called forceps through the cervix and into the womb to remove the pregnancy.
D&E is usually carried out under sedation or general anaesthetic. It normally takes about 10 to 20 minutes and you're usually able to go home the same day.
You do not usually need to have any other tests or appointments after a surgical abortion, or a medical abortion in hospital.
If you have a medical abortion at home, you may need to have a special kind of pregnancy test or scan to make sure the pregnancy has ended.
If you have a medical abortion, you may have short-lived side effects from the medicines, such as diarrhoea and feeling sick.
If you have a surgical abortion, the general anaesthetic and sedation medicines can also have side effects.
For all types of abortion, it's likely you'll have some stomach cramps (pain) and vaginal bleeding. Bleeding usually lasts a week or two. Sometimes light vaginal bleeding after a medical abortion can last up to a month.
After an abortion, you can:
- take painkillers like ibuprofen or paracetamol to help with any pain or discomfort
- use sanitary towels or pads rather than tampons until the bleeding has stopped
- have sex as soon as you feel ready, but use contraception if you do not want to get pregnant again as you'll usually be fertile immediately after an abortion
You can usually return to normal activities as soon as you feel comfortable to, including having a bath or shower, using tampons, exercising (including swimming) and heavy lifting.
When to get medical help
Get advice if you:
- have pain or bleeding that does not get better in a few days
- still feel pregnant after about a week
- have a temperature, flu-like feelings or unusual vaginal discharge – these could be signs of infection
- have any other worries
The clinic will give you the number of a 24-hour helpline to call if you're worried. If you cannot find the number, contact a GP or 111.
You may experience a range of emotions after an abortion. This is common.
If you need to discuss how you're feeling, contact the abortion service or your GP.
They will be able to provide counselling or refer you for counselling if you need it.
It's against the law to try to cause your own abortion. This includes buying abortion pills online.
You will not know if pills sold online are genuine and they could be harmful.
Before doing anything, contact an abortion advice service such as the British Pregnancy Advisory Service (BPAS), MSI Reproductive Choices UK, National Unplanned Pregnancy Advisory Service (NUPAS), a GP or sexual health service, who can help you find appropriate care for free and in confidence.