Home | Print this page

Unplanned Pregnancy and Abortion Care

Introduction

For many women, getting a positive pregnancy test can be great. But for others an unexpected and unplanned pregnancy is not welcome news. The aim of this leaflet is to help you consider your options and know your rights when pregnancy is not planned. It also deals with some of the questions that are frequently asked about having an abortion. Despite the fact that around 160,000 abortions are performed in England and Wales every year, there is still very little good information and a lot of misinformation about abortion.

Emergency contraception

If you have had sex without using contraception, or if the condom broke, pregnancy can be prevented if you act quickly. Emergency pills can be taken up to three days after unprotected sex, or an IUD can be fitted up to five days after. Emergency contraception is available from your GP, family planning clinics, and most genito-urinary medicine (GUM) clinics or sexual health clinics.

Missed a period?

If you've missed a period and think you might be pregnant, you need to have a pregnancy test as soon as possible. You may be experiencing some of the early signs of pregnancy such as swollen breasts, tiredness, or feeling ill, particularly in the morning, but not all pregnant women have these symptoms. You also can have these symptoms if you're not pregnant. And sometimes when you are pregnant there is still some spotting or bleeding at the time of an expected period. It is important to have a pregnancy test done so you can start thinking about what to do.

Pregnancy Tests

Pregnancy tests vary in how soon they can detect a pregnancy. Some tests can tell when your period is one day late (although it is recommended to wait for five days). You can get pregnancy tests done at a variety of places:

• Your GP should be able to provide a same day pregnancy testing service. Some health authorities no longer do pregnancy tests unless there is a medical reason to do so. Make sure you know how long it will be before you get the result.
• Your local charitable clinic (see Resources section). The fee is £10-£12, but under 25s can get a free test at Brook centres.
• You can buy a home kit from the pharmacist. These cost £8-£10. It is best to buy one that provides two tests. The tests are reliable if instructions are followed carefully. If a test proves negative but you still haven't had a period a week later, repeat the test.

If You're Pregnant And Unsure What To Do

Even if you've been expecting it, a positive can be quite a shock. Deciding what to do may not be easy. You may want to talk about it with someone - your friends, your family, your partner or GP might help. If you'd rather not talk to any of them, you can get advice and counselling from various information and community centres, including the organisations listed in the Resources section. You can also call Women's Health, who may be able to suggest someone you can talk to. At this point, there are three possibilities open to you:

1. You may want to continue the pregnancy. The Department of Social Security and/or Council Housing Department can give you advice about housing and benefits. You need to arrange things early. It's important to see your doctor to arrange antenatal care. There is a helpful booklet called Who's having your baby?, which explains what you are entitled to. (See the Resources section.)
2. You may decide to continue the pregnancy but want to consider offering the baby for adoption. Your GP or local Social Services Department can advise you. You can also get information and help from the British Agencies for Adoption and Fostering, Skyline House, 200 Union Street, London SE1 0LX. Tel: 020 7593 2000.
3. You may want an abortion. The rest of this leaflet gives you basic information about having an abortion, and where to go to get help if this is your decision.

Risks and Complications of Abortion

Before abortion was legalised in 1967, women had to go to the backstreets for abortions. They faced serious risk to their lives and health from dangerous potions and instruments. Following the 1967 Abortion Act, abortion became a safe surgical operation with a low incidence of complications. But it must still be seen in the context of all operations - any medical operation carries some element of risk.

The majority of abortions are done early; 88% were done under 12 weeks in 1995. Early abortions (up to 12/14 weeks by vacuum aspiration or medical abortion using mifepristone) are safe, simple and quick and have a low complication rate.

The risk associated with abortion depends on many factors: how many weeks pregnant the woman is, her age, the type of operation, whether, and how often, she has been pregnant before and her general health. Another important factor is the skill of the doctor performing the operation. If abortions are performed by experienced staff committed to providing a comprehensive abortion service, the likelihood of complications is much reduced.

The most usual complication is infection. Other, less common, problems include retained fetal tissue and perforation of the womb (uterus). On average, women have a 1 in 50 chance of a minor infection and a 1 in 200 chance of a more major infection. Two to three per cent of women have a problem that results in readmission to the hospital or clinic. In the majority of cases, abortions after 14 weeks in the NHS and after about 18 weeks in non-NHS clinics are carried out by bringing on (inducing) labour. Later abortions have a higher complication rate. Between 13 and 18 weeks the risks are double those of early abortion and those done after 18 weeks carry three times the risk.

The incidence of problems has been greatly reduced in recent years by the use of prostaglandins. These are hormones which cause the uterus to contract and open the cervix. In young women, 15-16 year olds, a prostaglandin abortion can be less risky to the cervix than a surgical abortion (called a D&E) because the cervix is much more difficult to dilate surgically. The main risks of later abortions are bleeding, injury to the uterus and infection.

The rate of deaths from early abortions is about 1 in 100,000 in this country. Comparing this to the maternal death rate, abortion is eight to ten times safer than childbirth.

Abortion and Infertility

Unless a major infection occurs, there is no evidence that abortions affect future fertility, cause stillbirths, ectopic pregnancies, low birth weight babies or birth defects. Some studies suggest a slightly increased risk of late miscarriage in subsequent pregnancies, caused by 'cervical incompetence' - the cervix not being able to remain tightly closed during pregnancy. But as techniques for abortion are improved, this should happen less and less. There is also no evidence that repeat abortions carry an increased risk of most problems, although some studies show a slightly higher risk of miscarriage. There is now greater awareness about sexually transmitted diseases such as chlamydia (a bacterial infection) and their effect on fertility. Screening before abortions, and a course of antibiotics if necessary, can cut down the incidence of infection-related infertility.

Taking care of yourself after an abortion is important and any problems should be reported to your doctor or clinic immediately to reduce long term effects on your reproductive health.

Anti-abortionists claim that abortions have grave side effect, in order to deter women from ending an unwanted pregnancy. This is scaremongering and very unethical. The relatively few risks associated with abortion must always be considered in relation to the risks of continuing with an unwanted pregnancy. Only the woman herself can assess this.

Top | Next Page

SOME OF THE INFORMATION ON THESE PAGES HAS NOW BEEN SUPERSEDED

Based on leaflets written by Lesley Dike
and Women’s Reproductive Rights Information Centre. This edition revised by Women’s Health 1999.

This leaflet is protected by Copyright © Women's Health. You may print off one copy for personal use only.