ABORTION METHODS
At the clinic, doctors usually give the patient a check-up and blood test to determine her general health. Patients may be screened for sexually transmitted infections like Chlamydia, which can increase risk of infection after an abortion.
This involves inducing cramping in the womb to make it expel its contents. A combination of two drugs is used. This method usually takes two appointments.
First mifepristone, also known as RU-486, is administered. This drug stops progesterone, the hormone which makes the womb lining hold on to the foetus, from reaching the womb.
On the second appointment either misoprostol or gemeprost are administered, usually by insertion into the vagina. These contain prostaglandin, a hormone that causes the womb to push out its contents.
The abortion usually occurs after the second appointment. The patient will experience cramping and bleeding, which an NHS pamphlet describes as “like a very heavy period with clots of blood”.
In some cases, a surgical procedure might be necessary to remove womb contents that have not been completely expelled.
Possible complications include haemorrhage, sickness, diarrhoea, fever and chills, damage to the cervix or damage to the womb. However the incidence of complications is low. Approximately 0.2% of women experience them. Complications and risks are greatly reduced if the pregnancy is terminated earlier.
The combination of drugs ensures a successful abortion. Mifepristone on its own has a lower rate of success in causing an abortion.
The 2006 abortion statistics for England, Scotland and Wales show that 30% of abortions were medical, an increase from 24% in 2005.
Some have argued that medical abortion can be extremely traumatic for women as they witness the expellation of the contents of the womb, even though the foetus is usually not recognisable.
Note about misoprostol
Misoprostol has been a subject of controversy because it was originally meant for treating stomach ulcers. It has not been licensed by the UK government for use in abortions, but the NHS says studies have shown it effective and safe. US company Searle, the makers of Misoprostol, have released statements saying they do not support its use as an abortion drug or to induce labour. However misoprostol is much cheaper than other prostaglandins and is used in many countries as an abortion drug.
Suction aspiration (vacuum aspiration)
In this form of abortion the contents of the womb are sucked out using either an electric pump or a hand-operated syringe.
If a pump is used, the patient is usually under general anaesthetic. A hormone called prostaglandin may be used to make it easier for the doctor to open the patient’s cervix, reducing risk of damage. An instrument called a speculum is inserted into the vagina and the cervix is cleaned. The cervix is then stretched using dilators of varying sizes. Then a plastic tube is inserted into the womb and the womb contents are sucked out using a pump.
An abortion using a syringe does not require the cervix to be stretched and is usually carried out with local anaesthetic only.
This method is less commonly used, usually only for women who are over 15 weeks pregnant. Under general anaesthetic, the foetus is cut with forceps and suctioned out using an electric pump.
For both types of abortion, antibiotics may be administered to prevent infection. Up to one in ten women can contract an infection after an abortion. Patients will experience bleeding and cramps for up to around 17 days after the procedure.