Types of abortion

An abortion (also known as a termination) is the medical process of ending a pregnancy.

An abortion is different from a miscarriage, which is the loss of your baby before 24 weeks, without medical intervention.

Read more about how to access an abortion in Scotland

There are 2 types of abortion:

  • medical, which uses medication
  • surgical, which involves a small operation

Before undergoing any type of abortion, you’ll be asked to give consent to proceed.

Medical abortion

This involves you taking 2 sets of tablets at different times. You may be able to take 1 or both sets of tablets at home, depending on your circumstances. When you’ve your initial assessment appointment, you’ll be advised what is appropriate for you.

Starting the abortion

To start the abortion, you’ll swallow a tablet called mifepristone. This blocks the hormones that allow pregnancy to continue. After taking mifepristone, you can carry on with your normal daily activities.

Some people do feel side effects after taking mifepristone. These can include:

  • a headache
  • nausea
  • vomiting
  • diarrhoea
  • bleeding

If you vomit less than 2 hours after taking your tablet, contact your local health board abortion service immediately. You’ll need to take more.

Completing the abortion

36 to 48 hours after taking mifepristone, you’ll take the first dose of misoprostol.

There are different ways of taking misoprostol tablets, including:

  • placing the tablet under your tongue for 30 minutes
  • placing the tablet inside the vagina

Your local health board abortion service will give you advice on exactly when and how to take misoprostol. Follow their instructions carefully.

You may need to take further doses of misoprostol if you’ve not experienced any bleeding, or only have very light bleeding after 4 hours.

It’s normal to experience uncomfortable symptoms after taking misoprostol. Different people have different experiences, but people often have:

  • cramps that are more intense than your usual period
  • heavy bleeding
  • passing blood clots

The pregnancy sac will pass with the clots.

Your local health board abortion service will give you painkillers to take as needed. You can also take ibuprofen or paracetamol up to the recommended safe dose. A hot water bottle or heat pack can also provide some relief.

These symptoms normally settle and improve after 4-6 hours, although it can take longer for some people.

Where can I have a medical abortion?

You may be able to take 1 or both types of medications at home. This is called Early Medical Abortion at Home (EMAH). If this option is right for you, you may be asked to collect your medication pack from your local health board abortion service. You can also ask the service can deliver it to you if you prefer.

You’ll be given information on how and when to take your tablets. Make sure you understand the instructions and follow them.

EMAH is not right for everybody. In some circumstances, you may be asked to take 1 or both of your tablets in a clinic or hospital. This commonly happens because you:

  • have medical conditions that mean it’d be better for you to be in hospital
  • do not want to have your abortion at home

After taking your second (misoprostol) tablets in the hospital, you’ll stay there until the pregnancy has passed. This occasionally requires an overnight stay.

Surgical abortion

You may be offered the option of a surgical abortion. This can be done under:

  • general anaesthetic (where you are asleep)
  • sedation (where you are awake, but drowsy)
  • local anaesthetic (where the cervix involved is numbed by injection, but you’re fully awake)

Surgical abortions involve removing the pregnancy through the cervix using gentle suction. The procedure usually takes about 10 minutes.

Mifepristone is not usually required for a surgical abortion. You may be asked to take misoprostol to prepare the cervix for the procedure.

After the procedure, you’ll stay in hospital for a few hours to make sure you’ve recovered enough to go home. Normally, you’ll be able to go home the same day.

Abortion after 20 weeks

In some circumstances, people who need an abortion after 20 weeks of pregnancy will be referred to specialist services in England. Your local health board abortion service should provide help with travel and accommodation costs.

If you’re more than 22 weeks pregnant, the abortion usually requires a two-stage procedure.

In stage 1, you’ll be given an injection to stop the heartbeat of the fetus and medication to soften the cervix (opening of the womb).

Stage 2 is carried out the following day. You’ll have surgery to remove the pregnancy (the fetus and surrounding tissue).

Following the procedure you’ll bleed, usually for up to 14 days. You may notice some other symptoms, like a small amount of fluid leaking from your breasts.

After an abortion

If you’ve had an abortion, whether surgical or medical, you’ll be given a pregnancy test. You should take this 14 or 21 days after the procedure to check that it’s been successful.

Read more about what to expect after an abortion

Risks in an abortion

The risk of complications during an abortion procedure is low. There are more likely to be issues if an abortion is carried out later in a pregnancy. The risks associated with abortions are:

  • haemorrhage (excessive bleeding), which happens in about 1 in every 1,000 abortions
  • damage to the cervix (entrance to the womb), which happens in no more than 10 in every 1,000 abortions
  • damage to the uterus (womb), which happens in up to 4 in every 1,000 surgical abortions

Abortion does not increase the risk of breast cancer or of new mental health problems.

Abortion doesn’t usually affect a woman’s chances of becoming pregnant and having normal pregnancies in the future. If you develop a womb infection, there’s a very small risk to your fertility and future pregnancies. However, most infections are treated before they’re a risk.

Last updated:
17 May 2024