There has been much discussion around abortion in the UK spurred on by concern that the legal right to have one over in the US (Roe v. Wade) will be officially overturned.

This has highlighted how important it is to know about how the process works here.

In England, Scotland and Wales, you can legally have an abortion at up to 23 weeks and 6 days of pregnancy, in line with the Abortion Act 1967. They can be carried out after 24 weeks in limited circumstances, for example, if the mother's life is at risk or the child would be born with a severe disability.

By law, those having an abortion are still required to explain their reasons for wanting one, and two doctors need to make sure the requirements of the Abortion Act are met.

The 1967 Act did not extend to Northern Ireland, and despite the decriminalisation of abortion in 2019 there, abortion services are still limited.

In March, the UK government announced it intended to prepare work on further regulations to make sure abortion services are available for women and girls in Northern Ireland. "It is unacceptable that access to basic abortion healthcare is not available as it is across the rest of the UK," Secretary of State for NI Brandon Lewis said.

However, with the deadline passing (31 March) for the services to be commissioned, last week the UK government took further action to ensure full abortion services in NI.

It is legal for women and girls from Northern Ireland to travel to England to access abortion services.

Read more: Piers Morgan faces backlash for saying 'no woman wants to have an abortion'

What is an abortion?

An abortion is a procedure to end pregnancy, according to the NHS. It is also sometimes known as a termination. The pregnancy is ended either by taking medications or having a surgical procedure.

Around one in three women in the UK will have an abortion in their lifetime.

How to have an abortion

You may well have typed the words ‘how to have an abortion’ into Google before, but with millions and millions of results, it can be overwhelming, not to mention time-consuming to wade through different materials. Particularly at a time when you’re likely feeling pretty stressed.

So what do you do if you find yourself in a position where you are considering an abortion?

Abortions can only be carried out in an NHS hospital or a licensed clinic, and are usually available free of charge on the NHS.

As previously explained by Ash Alam, consultant gynaecologist at www.london-gynaecology.com it will depend where you live and the facilities available there.

“The most common reason for an abortion is risk to mental health of the mother and these abortions can legally be carried out up to 24 weeks gestation [the period of time inside the body] ,” he said.

Read more: Over 95% of women who have an abortion do not regret it, study finds

The three main ways to get an abortion on the NHS, as listed by the health service include:

• Self-referring by contacting an abortion provider directly: the British Pregnancy Advisory Service (BPAS), MSI Reproductive Choices UK, the National Unplanned Pregnancy Advisory Service (NUPAS) or your local NHS sexual health website can tell you about eligibility and services in your area

• Speaking to a GP and ask for a referral to an abortion service: the GP should refer you to another doctor if he or she has any objections to abortion

• Contacting a sexual health clinic (sometimes called family planning or GUM (genitourinary medicine) clinics) and ask for a referral to an abortion service

You can also pay to have an abortion privately, with costs varying depending on the stage of the pregnancy and the type of procedure.

“The most important thing for women to know is that they rarely need to see their GP first but can refer themselves directly into NHS funded care,” a spokesperson for BPAS said.

From here, you will be given a consultation, where a medical expert will talk you through the process and explain the aftercare.

“Typically a woman will have an assessment at a hospital or clinic to confirm a pregnancy, and an ultrasound can be performed to confirm how far along she is,” Dr Diana Gall, from Doctor-4-U, previously explained.

“Once confirmed you will have the opportunity to talk about the reasons behind wanting an abortion, and even talk to a counsellor if you think that may help.

“Other tests will be taken to check for STIs, and blood type, and you will have the methods of abortion explained to you so you understand what will happen and any associated risks.”

Read more: Women should be approved for abortions over Skype to ‘prevent distress’, say doctors

What are the different types of abortion?

There are two kinds of abortion: surgical, and medical (also sometimes referred to as the abortion pill).

According to Dr Gall the type of abortion a woman will have depends on how far pregnant she is, personal choice, and possibly any medical contradictions.

“A medical abortion involves taking medication to terminate a pregnancy whereas a surgical abortion involves a minor surgery to terminate a pregnancy,” she explained.

“Both types of abortion can be carried out up until 24 weeks pregnant, though in exceptional circumstances such as risk to the mother’s life if pregnancy is carried out, this may be extended.”

Medical abortion - A medical abortion, or abortion pill is actually two pills. “The first pill (Mifepristone) blocks the hormone progesterone and without this the pregnancy cannot continue,” said Dr Gall. “A day or two later you will take the second pill (Misoprostol) which will cause a loss of pregnancy similar to a miscarriage along with cramps and bleeding.”

If a medical abortion is carried at after nine weeks gestation you will be more likely to have to stay at the clinic until it is completed, Dr Gall added.

Surgical abortion - There are two types of surgical abortion. “Vacuum aspiration which can be completed up to 15 weeks pregnant involves dilating the cervix and using a tube to remove the pregnancy from the womb via suction while the woman is on pain relief or sedated,” Dr Gall said.

“This method usually only takes five to 10 minutes and most women are able to leave shortly after by themselves.”

The second surgical method, dilation and evacuation, is used between weeks 15 and 24 of a pregnancy. “A woman is usually placed under general anaesthetic or sedation, and again the cervix is dilated,” Dr Gall explained.

“Rather than a tube however, the pregnancy is removed with forceps and takes slightly longer (10 to 20 minutes), and you should be able to go home the same day but you will not be able to drive yourself if you have been given general anaesthetic.”

According to Mr Alam the further on from 13 weeks the procedure is carried out, the more difficult the procedure becomes and the greater the risk of complications.

How will an abortion affect my body?

Each woman is different, and the effects of the procedure could depend on whether you opt for a medical or surgical abortion.

“If the medical abortion is carried out early on in pregnancy then the bleeding expected is not too dissimilar to a heavy period and therefore women may not need to take time off work,” said Mr Alam. “However bleeding can continue for several days which may be distressing.”

For those who experienced prolonged bleeding, women may need to take one or two days off work especially if a general anaesthetic is used.

According to Dr Gall after a medical abortion you may experience side effects such as nausea and diarrhoea.

“With either abortion types you are likely to experience stomach cramps, and bleeding for a couple of weeks up to a month. Painkillers can help with any pain or discomfort, but normally the obstetrician should provide you with a short course of antibiotics on leaving to help with this and to help prevent any infections,” she says.

“You can go back to work as normal the following day given that you feel up to it, though this will be your choice.”

Read more: Milla Jovovich opens up about her 'emergency abortion' but what is that?

What are the risks of abortion?

In general, the later the abortion is performed with the medical or surgical procedure the more likely the need for time to be taken off work with bleeding pain or complications.

According to the NHS, most women won't experience any problems, but there is a small risk of complications, such as:

• infection of the womb (uterus)

• some of the pregnancy remaining in the womb

• excessive bleeding

• damage to the womb or entrance of the womb (cervix)

Having an abortion won't affect your chances of becoming pregnant again and having normal pregnancies in the future.

What happens after an abortion?

“After abortion women can experience a range of emotions,” Mr Alam said. “They may require extra emotional support or counselling and most abortion providers have access to support if required.”

If you’re worried about any of the side effects of an abortion or need extra support emotionally it’s worth getting in touch with your abortion provider.

You can request a non-urgent aftercare call from BPAS online, or for more information call them on 03457 30 40 30.

You can also contact Marie Stopes here.

For further information on abortion, visit mariestopes.org.uk, bpas.org or see the NHS page on abortion.

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