What are all the different types of abortion?

People from all different backgrounds and situations may choose to have an abortion. This includes cisgender women, non-binary and genderfluid people, intersex people, and transgender men. Their reasons for doing so can vary, but each decision is a very personal choice and should be respected.

What type of abortions are there?

There are two different types of abortion, and a person should be given a choice of both where possible.

Abortion is generally a safe procedure and is usually safest when performed as early as possible in pregnancy.

Medical abortion

A type of abortion that involves taking two different tablets to terminate the pregnancy.

One tablet contains mifepristone and the other, misoprostol - these are taken 1 or 2 days apart. They are prescribed by a clinician, with the first one given in hospital or a clinic. After taking this first tablet, if a person is under 10 weeks, they are generally able to go home to then take the second tablet after a couple of days. If they are over 10 weeks pregnant, this second tablet will be given in a hospital or clinic.

Mifepristone

Mifepristone blocks the main pregnancy hormone called the progesterone hormone. This results in the lining of the uterus breaking down and preventing the pregnancy from continuing.

Misoprostol

Misoprostol causes cramps and bleeding as the womb contracts, leading to the end of the pregnancy. Sometimes, larger doses of misoprostol are required for the pregnancy to pass.

Usually, several hours after the medication has been taken, the pregnancy comes out through the vagina.

The combination of these two medicines is 97% effective during the first 63 days of pregnancy and is also effective in the second trimester¹. On rare occasions, the medication isn't effective on its own and an operation is required.

Surgical abortion

A surgical abortion involves a minor operation to remove the pregnancy from the womb. This type of abortion can be done either by numbing the cervix with a local anaesthetic when a person is sedated enough to be relaxed but still awake or sedated fully and asleep under general anaesthetic. If someone has the latter, it's unlikely they will remember anything about the procedure when they wake up.

The type of anaesthetic given depends on how far along a pregnancy is, plus the preferences of the pregnant person.

Either a few hours or a day or two prior to surgery, medicine will be taken in preparation to allow the cervix to open.

When it comes to the surgery itself, there are two types:

Vacuum aspiration

Vacuum aspiration removes the pregnancy with gentle suction.

Up to 14 weeks of pregnancy, the procedure can be performed under local anaesthetic and tends to have a fairly quick recovery time, depending on the person and their circumstances.

Dilatation and evacuation (D&E)

Dilatation and evacuation involves using narrow forceps (which enter through the cervix) to remove the pregnancy. This procedure is done between 15-24 weeks of pregnancy.

It may be under general anaesthetic or conscious sedation up to 18 weeks, then under general anaesthetic any time beyond 18 weeks.

Which type of abortion is safer?

The type of abortion someone has (and the decision to have an abortion at all) should be entirely the choice of the person who is pregnant. However, doctors can offer advice and recommendations based on their medical history.

There are factors to consider when deciding the type of abortion to have, but you should trust that you will be in safe hands when visiting a qualified, trusted professional.

There's a chance of side effects with both medical and surgical abortions.

The abortion pill can cause side effects such as:

• Heavy bleeding.

• Cramps.

• Nausea.

• Vomiting.

• Headaches.

• Diarrhoea.

These side effects are common and can generally be treated at home. In more severe cases, there are reports of complications such as sepsis or other infections.

Meanwhile, surgical abortions can cause the same side effects but also come with a risk of longer-term health complications, such as damage to the cervix and uterine lining, infections, or haemorrhaging.

Most abortion side effects tend to be mild and short-lived, and many people do not experience any at all. However, you can discuss this with your doctor or abortion provider beforehand if you're unsure.

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What type of doctor performs abortions?

The Abortion Act states that, in order for an abortion to be legal, it must have been authorised by two registered doctors acting in good faith - this means they must not have been negligent when forming their opinion and must believe there are lawful grounds for termination. They must sign legal documents and agree on one (or more) of the following grounds:

1. The pregnancy has not exceeded 24 weeks and continuing with the pregnancy would involve a greater risk to the physical or mental health of the pregnant person, or their existing family, than if they were to have an abortion.

2. The termination is necessary to prevent permanent injury to the physical or mental health of the pregnant person.

3. Continuing with the pregnancy would put the life of the pregnant person at risk.

4. If the child were to be born, there is a substantial risk of them having physical or mental abnormalities.

Some doctors may not feel comfortable, or it is against their belief systems to sign these forms. If this is the case, they must always refer the patient to someone who can.

There is no legal requirement for the doctor performing the abortion to personally examine the patient before the procedure.

Finding support for abortion

If you are searching for information or support regarding an abortion, you can contact your GP or another doctor in your practice. They can provide confidential, trustworthy advice and signpost you to relevant resources or clinics.

You can also access counselling services at abortion clinics, and find additional info online:

• British Pregnancy Advisory Service (BPAS).

• Brook Young People's Information Service.

• Marie Stopes International.

• Abortion Support Network.

Further reading

1. Mifepristone with buccal misoprostol for medical abortion: a systematic review.