Note: The 1967 UK Abortion Act requires a woman to obtain the signatures of two doctors in order to have an abortion. It is also important to discuss any pre-existing medical conditions. Ireland have recently enacted laws allowing for regular abortion procedures, but it will be some time before all requirements are established. The legislation is not fully secure at present.
There are two kinds of regular abortion procedures – surgical abortions and medical abortions. The method used depends on how long you have been pregnant – the gestational age of the pregnancy. This is why knowing how far you are in your pregnancy is important in making an informed decision. What are your abortion choices?
Dilation & Aspiration (D&A) Abortion
The D&A type regular abortive procedures are used in the first trimester of pregnancy; from 7-13 weeks gestational age. A series of dilators are used to open the cervix.The doctor inserts a long plastic tube, which is attached to a strong vacuum. At the end of the tube is a scraping device called a cannula. The doctor uses this to scrape and suction the inside of the uterus making sure he gets all the fetal parts, placenta, and uterine lining. The abortion procedure takes about 10 minutes. As with any medical procedure there are risks. The short term risks include bleeding, infection and an incomplete abortion. The long term risks are possible future infertility or difficulty with future pregnancy due to uterine scarring. It is important to have a follow-up exam two weeks after the abortion.
Note: Abortions are not normally performed in the UK after 24 weeks. However, the recent enactment allowing for abortion in Ireland has no gestational limits. Again, the Irish abortion legislation is not fully secure at present, with calls for amendments. The D&E abortion procedure is used in the second trimester of pregnancy, from 13-24 weeks gestational age.
Abortion procedures performed in the middle months of pregnancy is a significantly different from the first trimester. The abortive procedure entails a somewhat greater risk. Laminaria, a seaweed type product that absorbs fluid, is used to dilate the cervix. It is usually inserted and left overnight (this does cause cramping). The next morning, the cervix will have dilated and softened. Because the fetus and placenta are well developed, suctioning and scraping are carry greater emphasis. The risk of bleeding and infection are increased. The fetus and placenta are removed in parts with forceps. Suction is then used to scrape the uterus to ensure that no fetal parts remain. Unlike a first trimester abortion, these types of regular abortion procedures are generally performed under sedation.
Medical Abortions (RU486)
This termination procedure is used up to 7 weeks, or 49 days. This abortive drug must be used in the first 49 days or less, counting from the beginning of the last menstrual period. Three pills of RU486 are given at the clinic and the patient is sent home. The abortion pill acts by blocking the progesterone hormone, which is needed to maintain a pregnancy. Without the hormone, the lining of the uterus softens and begins to break down and bleeding begins. Two days later, the patient returns to the clinic and is given two pills of the prostaglandin misoprostol. As the drug takes effect, the patient experiences powerful, painful contractions which begin to work to expel the fetus. This can happen during the 3-4 hours she is at the clinic or after she returns home. Fourteen days later she returns to the clinic to determine whether the medical abortion has occurred. If the termination has failed, surgical type regular abortion procedures must be performed. Side effects may include heavy bleeding, clotting, cramps, nausea, diarrhea and vomiting. Most women will bleed or spot for 9-16 days. Blood clots are often larger than the fetus. Certain conditions or habits can put you at increased risk for complications. Examples include high blood pressure, diabetes, allergies, or heavy smoking. It is important that you communicate this to your doctor.
Abortion Prices: The cost of terminations for women travelling to Britain begins at £350 and rises to £1350 for a later term abortion.