Abortion has become legal for the first time in Northern Ireland.
The Abortion Act 1967, which regulates terminations in England, Scotland and Wales, has never applied in Northern Ireland, meaning abortion law there has been more restrictive than in the rest of the UK.
Until now, abortion was only allowed if a woman's life was at risk or there was a danger of permanent and serious damage to her physical or mental health.
The UK Government will take responsibility for introducing new regulations to provide greater access to abortions by next April.
The news has been praised by pro-choice campaigners, but BPAS are warning that the new legislation might take a while to come into effect.
“We are delighted to see abortion decriminalised in Northern Ireland, but there is a big difference between services being legal and services being accessible,” says Katherine O'Brien, Associate Director of Communications and Campaigns BPAS.
“We know that there are many clinicians in Northern Ireland who want to be able to provide abortion care for their patients, but it is unlikely services will become widely available immediately. The government is launching a consultation on the next steps, and we hope this will focus on commissioning services and training for medical professionals.”
What is an abortion?
According to the NHS an abortion is the medical process of ending a pregnancy so it doesn't result in the birth of a baby.
It is also sometimes known as a termination.
The pregnancy is ended either by taking medications or having a minor surgical procedure.
One in three women will have an abortion in their lifetime.
How to have an abortion
If you’ve ever found yourself unexpectedly pregnant, you may well have typed the words ‘how to have an abortion’ into Google, but with over 115million results, it can be overwhelming, not to mention time-consuming to wade through the bumpf. Particularly at a time when you’re likely feeling pretty stressed.
So what do you do if you find yourself in a position where you are considering an abortion?
In England, Scotland, Wales and now Northern Ireland, women have fair access to abortions before 24 weeks of pregnancy, as provided in the 1967 Abortion Act.
Abortions can only be carried out in an NHS hospital or a licensed clinic, and are usually available free of charge on the NHS.
According to Ash Alam, consultant gynaecologist at www.london-gynaecology.com though it will depend where you live and the facilities available there are three main ways to get an abortion.
“The most common reason for an abortion is risk to mental health of the mother and these abortions can legally be carried out up to 24 weeks gestation,” he explains.
1 - Private provider abortion - “Women can obtain an abortion privately by contacting their nearest private provider,” Mr Alam continues. “This may be the local private hospital.
“Sometimes abortions can be difficult to obtain privately as abortion providers are restricted and limited by law to licensed clinics,” he adds.
2 - Private abortion via a charitable providers such as BPAS and Marie Stopes.
3 - NHS procedure. “This will either be via their GP or if their CCG has direct contract provision with providers such as BPAS and Marie Stopes, women may be able to ring these providers directly for an NHS appointment,” Mr Alam explains.
“The most important thing for women to know is that they rarely need to see their GP first but can refer themselves directly into NHS funded care,” a spokesperson for BPAS adds.
From here, you will be given a consultation, where a medical expert will talk you through the process and explain the aftercare.
“Typically a woman will have an assessment at a hospital or clinic to confirm a pregnancy, and an ultrasound can be performed to confirm how far along she is,” explains Dr Diana Gall, from Doctor-4-U.
“Once confirmed you will have the opportunity to talk about the reasons behind wanting an abortion, and even talk to a counsellor if you think that may help.
“Other tests will be taken to check for STIs, and blood type, and you will have the methods of abortion explained to you so you understand what will happen and any associated risks.”
What are the different types of abortion?
There are two kinds of abortion: surgical, and medical (also sometimes referred to as the abortion pill).
According to Dr Gall the type of abortion a woman will have depends on how far pregnant she is, personal choice, and possibly any medical contradictions.
“A medical abortion involves taking medication to terminate a pregnancy whereas a surgical abortion involves a minor surgery to terminate a pregnancy,” she explains.
“Both types of abortion can be carried out up until 24 weeks pregnant, though in exceptional circumstances such as risk to the mother’s life if pregnancy is carried out, this may be extended.”
Medical abortion - A medical abortion, or abortion pill is actually two pills. “The first pill (Mifepristone) blocks the hormone progesterone and without this the pregnancy cannot continue,” explains Dr Gall. “A day or two later you will take the second pill (Misoprostol) which will cause a loss of pregnancy similar to a miscarriage along with cramps and bleeding.”
If a medical abortion is carried at after nine weeks gestation you will be more likely to have to stay at the clinic until it is completed, Dr Gall adds.
Surgical abortion - There are two types of surgical abortion. “Vacuum aspiration which can be completed up to 15 weeks pregnant involves dilating the cervix and using a tube to remove the pregnancy from the womb via suction while the woman is on pain relief or sedated,” Dr Gall says.
“This method usually only takes five to 10 minutes and most women are able to leave shortly after by themselves.”
The second surgical method, dilation and evacuation, is used between weeks 15 and 24 of a pregnancy. “A woman is usually placed under general anaesthetic or sedation, and again the cervix is dilated,” Dr Gall explains.
“Rather than a tube however, the pregnancy is removed with forceps and takes slightly longer (10 to 20 minutes), and you should be able to go home the same day but you will not be able to drive yourself if you have been given general anaesthetic.”
According to Mr Alam the further on from 13 weeks the procedure is carried out, the more difficult the procedure becomes and the greater the risk of complications.
How will an abortion affect my body?
Each woman is different, and the effects of the procedure could depend on whether you opt for a medical or surgical abortion.
“If the medical abortion is carried out early on in pregnancy then the bleeding expected is not too dissimilar to a heavy period and therefore women may not need to take time off work,” explains Mr Alam. “However bleeding can continue for several days which may be distressing.”
Mr Alam says after a surgical abortion bleeding can continue for several days and women may need to take one or two days off work especially if a general anaesthetic is used.
According to Dr Gall after a medical abortion you may experience side effects such as nausea and diarrhoea.
“With either abortion types you are likely to experience stomach cramps, and bleeding for a couple of weeks up to a month. Painkillers can help with any pain or discomfort, but normally the obstetrician should provide you with a short course of antibiotics on leaving to help with this and to help prevent any infections,” she says.
“You can go back to work as normal the following day given that you feel up to it, though this will be your choice.”
What are the risks of abortion?
In general, the later the abortion is performed with the medical or surgical procedure the more likely the need for time to be taken off work with bleeding pain or complications.
According to the NHS, most women won't experience any problems, but there is a small risk of complications, such as:
Infection of the womb – occurs in up to 1 in every 10 abortions
Some of the pregnancy remaining in the womb – occurs in up to 1 in every 20 abortions
Excessive bleeding – occurs in about 1 in every 1,000 abortions
Damage to the entrance of the womb (cervix) – occurs in up to 1 in every 100 surgical abortions
Damage to the womb – occurs in 1 in every 250 to 1,000 surgical abortions and less than 1in 1,000 medical abortions carried out at 12 to 24 weeks.
Having an abortion won't affect your chances of becoming pregnant again and having normal pregnancies in the future.
What happens after an abortion?
“After abortion women can experience a range of emotions,” Mr Alam says. “They may require extra emotional support or counselling and most abortion providers have access to support if required.”
If you’re worried about any of the side effects of an abortion or need extra support emotionally it’s worth getting in touch with your abortion provider.
The BPAS aftercare service is open 24 hours a day, 7 days a week on 03457 30 40 30.
Marie Stopes also has a 24-hour aftercare line on 0345 122 1441.