The following provides information and looks at a variety of frequently asked questions in relation to termination services.
Making a decision about what to do when faced with an unplanned pregnancy is very difficult and often the final decision still causes distress. Having all the facts helps to support the decision will help. The information below relates to termination of pregnancy. If you have not made your decision and want to talk to someone in private then your own doctor, or the sexual health services in your area are a good source of advice and support.
All areas across Lancashire offer all women a free termination service, though this does not mean women are not able to avail themselves of a private service if they choose.
A referral for Termination can be made through a woman’s own doctor and nurses within sexual health services who will be able to explain what abortion services are available locally, discuss all the different options such as treatment options and arrange an appointment with a termination provider. In some areas there are other people, such as youth and community workers who can refer you to a service and in some cases self referral is available.
There is often a limited local NHS Hospital Trusts service, in addition to private or charitable providers who undertake terminations on behalf of the trust and are free to all women. The full list of these is below:
This varies, normally; an appointment can be arranged for an initial consultation within five days of the initial request. The woman will then be offered another appointment for the actual abortion, usually within a week of their first consultation.
The ‘Fraser guidelines’, laid down by Lord Fraser in Gillick v West Norfolk and Wisbech AHA (1986), allow a doctor to give contraceptive advice and treatment to a minor without consulting their parents - although the practitioner should be satisfied that the young person cannot be persuaded to inform them. The guidelines are widely construed to cover termination procedures as well (bbc.co.uk 2004; 13 May).
Therefore, those under the age of 16 under the right circumstances can avail themselves of a termination without parental consent. There are additional expectations of the provider in relation to those under 16 and in practice it is rare that there is no adult in attendance acting as an advocate.
There are two main methods of abortion. Medical abortion involves taking a combination of drugs, and surgical abortion involves a minor operation. Most abortions can be provided on a day care basis, which means an overnight stay is not needed.
An Early Medical Termination (EMT) is available up to and including 9 weeks of gestation (some providers will undertake this method up to 12 weeks).
For this treatment women will need to visit the termination service provider twice, either on the same day, or one to three days apart.
The woman will need to take two tablets (mifepristone) initially, which work by blocking the action of a hormone, which in turn affects the lining of the womb (uterus). Very few women will miscarry in the intervening 24-hour interval before the next appointment. For those who don’t miscarry then another appointment is required when prostaglandin’s will be given to encourage the uterus to contract (cramp) which results in a miscarriage. A Late Medical Termination uses a similar method but only a few centres provide this option.
Surgical Termination - Vacuum aspiration simply means suction; the method involves a tube being eased through the cervix (neck of the womb) into the uterus a pump action (either manual or electrical) is then used to draw up the products of conception from within the uterus.
Women are generally under anaesthetic, but lots of centres now offer conscious sedation and local anaesthetic.
Legal abortion is a relatively safe procedure particularly when experienced doctors provide it. However, no clinical procedures are completely free from risk. Abortion is less risky to a woman's health than continuing a pregnancy and having a baby, especially when provided in the first 12 weeks.
Serious physical problems during the abortion are rare and only occur in one or two out of every thousand abortions. Minor complications are a little more common. Retained products can occur in up to 2 in 100 cases for surgical abortion and 3 in 100 for medical abortion. Infection occurs in less than 5 in 100 cases.
There is a small extra risk of subsequent miscarriage and preterm delivery after abortion and a small extra risk of mental health problems after abortion compared with after childbirth. About 10% of women consult a doctor about pain or bleeding in the first month after an abortion, requiring antibiotics.
Although women may regret having to have an abortion many women feel relieved once it is over and, looking back, view the decision to end the pregnancy as regrettable but necessary. A small number - about three per cent - have long-term feelings of guilt and some of these feel that the abortion was a mistake, this may be as a result of not taking time to make the right decision.
The Abortion Act 1967 came into effect on 27 April 1968 and permits termination of pregnancy subject to certain conditions. Regulations under the Act mean that abortions must be performed by a registered practitioner in a National Health Service hospital or in a location that has been specially approved by the Department of Health Healthcare Commission.
An abortion may be approved providing two doctors agree in good faith that one or more of the following criteria apply: