Each stage of pregnancy requires a different method of abortion. When performed by trained professionals in sterile conditions early procedures are virtually risk-free. Later abortion may involve some risk to the woman’s health. In order to make informed decisions women must be made aware of the possible risks and complications.
New methods of abortion and adaptations to make procedures more effective are constantly being developed. In July 1991 the UK Licensing Authority approved a hormone pill called mifepristone for use in early abortion. Recently more abortions have been provided in day-care settings, an innovation pioneered by Marie Stopes International (MSI). More women have been able to have a local anaesthetic or conscious sedation rather than general anaesthetic. However, the methods available and the exact procedures will depend on the service provider.
Medical abortion
When: up to 9 weeks
Where: Clinic / Hospital. Three visits (including the assessment visit).
What happens: The patient is prescribed the hormone pill, mifepristone, which causes the uterus lining to start breaking down. A second hormone pill or vaginal pessary, prostaglandin, taken two days later, increases contractions and bleeding and helps expel the pregnancy, as in an early natural miscarriage. Bleeding may be heavy for one or two days before settling down.
Vacuum aspiration
When: up to 14 weeks
Where: Clinic / Hospital. Usually requires a stay of a few hours after the procedure.
What happens: The patient is usually given a general or a local anaesthetic. The procedure takes 10-15 minutes. A speculum is used to open the vagina so that the cervix can be reached. The cervix is gently eased open and a thin tube, attached to a small pump, is passed through it into the uterus; the small pump is used to draw the contents of the uterus into the tube. In some centres a procedure called Manual Vacuum Aspiration (MVA) is offered, using a hand held syringe to gently evacuate the contents of the uterus. This method was pioneered in the UK by MSI.
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