AbortionAbortion

Dr Jacqueline WoodmanDr Jacqueline Woodman

The Abortion Act 1967: The Abortion Act 1967:

permits termination of pregnancy subject to certain permits termination of pregnancy subject to certain conditions conditions

abortions must be performed by a registered abortions must be performed by a registered practitioner in a National Health Service hospital or in a practitioner in a National Health Service hospital or in a location that has been specially approved by the location that has been specially approved by the Department of Health Department of Health

Human Fertilisation and Embryology Act 1990Human Fertilisation and Embryology Act 1990introduced a time limit of 24 weeks for certain introduced a time limit of 24 weeks for certain

indications some indications are without limitindications some indications are without limitIn a multiple pregnancy it was legal for a doctor to In a multiple pregnancy it was legal for a doctor to

terminate the life of one or more fetuses leaving others terminate the life of one or more fetuses leaving others alive. alive.

The Abortion Act 1967 and Section 37 of the Human The Abortion Act 1967 and Section 37 of the Human Fertilisation and Embryology Act 1990 do not apply to Fertilisation and Embryology Act 1990 do not apply to Northern Ireland.Northern Ireland.

In England, Wales and Scotland abortion is legal under 24 weeks of In England, Wales and Scotland abortion is legal under 24 weeks of

pregnancy if two doctors agree that it is necessary for one of the pregnancy if two doctors agree that it is necessary for one of the following reasons:following reasons:

having the baby would harm the woman's mental or physical health having the baby would harm the woman's mental or physical health more than having the abortion. more than having the abortion.

having the baby would harm the mental or physical health of any having the baby would harm the mental or physical health of any children she already has. children she already has.

An abortion is also legal at any time in pregnancy if two doctors An abortion is also legal at any time in pregnancy if two doctors agree that:agree that:

the abortion is necessary to save the woman's life or prevent the abortion is necessary to save the woman's life or prevent serious permanent harm to her mental or physical health, orserious permanent harm to her mental or physical health, or

there is a high risk that the baby would be seriously handicapped. there is a high risk that the baby would be seriously handicapped.

Key Facts 2009Key Facts 2009 94% of abortions were funded by the NHS 94% of abortions were funded by the NHS

(compared to 51% in 2002); of these, over half (compared to 51% in 2002); of these, over half (60%) took place in the independent sector (60%) took place in the independent sector under NHS contract   under NHS contract  

91% of abortions were carried out at under 13 91% of abortions were carried out at under 13 weeks gestation; 75% were at under 10 weeks   weeks gestation; 75% were at under 10 weeks  

medical abortions accounted for 40% of the total medical abortions accounted for 40% of the total compared with 35% in 2006 and 19% in 2004    compared with 35% in 2006 and 19% in 2004   

2,085 abortions (1%) were under ground E, risk 2,085 abortions (1%) were under ground E, risk that the child would be born handicapped  that the child would be born handicapped 

Early medical abortionEarly medical abortionfirst 9 weeks of pregnancy (higher risk of first 9 weeks of pregnancy (higher risk of

haemorrhage at later gestations).haemorrhage at later gestations).Oral mifepristoneOral mifepristone36 to 48 hours later, vaginal prostaglandin.36 to 48 hours later, vaginal prostaglandin.These two drugs end most early These two drugs end most early

pregnancies within the following four pregnancies within the following four hours. hours.

Early MethodsEarly Methods Vacuum aspiration (known as 'the suction Vacuum aspiration (known as 'the suction

method')method') Available up to 14/15 weeks of pregnancy.Available up to 14/15 weeks of pregnancy. General or local anaesthetic.General or local anaesthetic. The cervix (the entrance to the womb at the top The cervix (the entrance to the womb at the top

of the vagina) is gently stretched to allow a tube of the vagina) is gently stretched to allow a tube to pass through it into the uterus. Once the tube to pass through it into the uterus. Once the tube is inserted the pregnancy is removed by suction.is inserted the pregnancy is removed by suction.

Day case procedureDay case procedure

Late Methods (after 13 weeks)Late Methods (after 13 weeks)

MedicalMedicalVacuum AspirationVacuum AspirationDilatation and evacuationDilatation and evacuation

ComplicationsComplications

Incomplete evacuationIncomplete evacuationHaemorrhageHaemorrhage

Cervical injuryCervical injuryPerforationPerforationAdherent placentaAdherent placenta

InfectionInfection