An abortion is a procedure used to end a pregnancy before it results in the birth of a baby. It may also be referred to as a termination. This can be carried out with either medical or surgical intervention, depending on how many weeks you have been pregnant for.

On this page we will explore the emotional implications of abortion on the parents, from making the initial decision to managing your feelings post abortion. We will also look into the law, the methods available and when you may benefit from professional support.

Why someone may need an abortion

Ending a pregnancy is rarely a decision that is made lightly or without a great deal of thought. There are various reasons as to why someone may need an abortion. Some examples include:

• Personal circumstances - This may include financial reasons, an unstable family environment or concerns for the welfare of existing children.
• Health risk to the mother - If the pregnancy will endanger the health of the mother, it may be advised that she terminates the pregnancy.
• Health risk to the baby - If there is a significant risk that the baby will be born with a life-limiting disability, the parents may choose to end the pregnancy.

 

Of course these are just examples and other factors may contribute to the decision.

Making the decision

Making a decision about having an abortion can be difficult. Seeking support from healthcare professionals, a counsellor, family members or (if applicable) your partner is recommended. Your doctor will be able to talk through your options, which can include keeping the baby, having an abortion or adoption.

It is important to remember that the final decision should be yours; you should not feel pressured into making a decision you are not comfortable with. If you are under the age of 16 and want an abortion you are advised to tell your parents, guardians or other adult. Having said this, if two doctors believe it is in your best interests and are confident you fully understand what is involved, you can have an abortion without telling your parents.

There is a variety of advice and information available to help you reach your decision. Seeing your GP should be your first port of call as they can give you medical advice, explain the procedure and can point you in the right direction should you want more advice. Your discussion will be completely confidential.

If you do not want to talk to your doctor, there are several organisations you can contact such as the Family Planning Association (FPA) as well as trained abortion counsellors. A counsellor will not advise you what to do, instead they will look to help you process your own thoughts and feelings, enabling you to make an informed decision.  

Laws and procedures       

In accordance with UK law, abortions can only be carried out during the first 24 weeks of pregnancy as long as certain criteria are met. The law is known as The Abortion Act 1967 and it covers England, Scotland, Wales but it does not cover Northern Ireland. The act states: 

• Any abortion must be carried out in a hospital or specialist licensed clinic.
• Two doctors must agree that the abortion would cause less damage to the woman’s physical or mental health than continuing the pregnancy.  In some (rare) situations the law allows abortions to take place after 24 weeks. Situations when this may occur include:

• When it is necessary to save the mother’s life.
• To prevent permanent injury (physical or mental) of the mother.
• If there is a high risk that the child would be born with serious disabilities (physical or mental).  The two doctors will ensure that the requirements of the Abortion Act are fulfilled and will then sign a certificate stating this. You can have abortions done privately or through the NHS - having it done privately will incur a fee.

 

However, in accordance with Indian law, Abortion has been legal in India since 1971, when the Medical Termination of Pregnancy Act was passed. The law is quite liberal, as it aims to reduce illegal abortion and maternal mortality.

An abortion can be performed in India until the 20th week of pregnancy. The opinion of a second doctor is required if the pregnancy is past its 12th week.

The Medical Termination of Pregnancy Act was amended in 2002 and 2003 to allow doctors to provide mifepristone and misoprostol (also known as the “morning-after pill”) on prescription up until the seventh week of pregnancy.

An abortion is permitted in the following cases:

• A woman has a serious disease and the pregnancy could endanger her life
• A woman’s physical or mental health is endangered by the pregnancy
• The foetus has a substantial risk of physical or mental handicap
• A woman contracts rubella (German measles) during the first three months of pregnancy
• Any of a woman’s previous children had congenital abnormalities
• The foetus is suffering from RH disease
• The foetus has been exposed to irradiation
• The pregnancy is the result of rape
• A woman’s socio-economic status may hamper a healthy pregnancy
• A contraceptive device failed

Permission

• If a woman is married, her own written consent is sufficient. Her husband’s consent is not required
• If a woman is unmarried and over 18, she can provide her own written consent
• If a woman is unmarried and under 18, she must provide written consent from her guardian
• If a woman is mentally unstable, she must provide written consent from her guardian

Procedure

Abortions can be performed in any medical institution that is licensed by the government to perform medically assisted terminations of pregnancy. Such institutions must display a certificate issued by the government.

Abortions must be performed by a doctor with one of the following qualifications:

• A registered medical practitioner who has performed at least 25 medically assisted terminations of pregnancy
• A surgeon who has six months’ experience in obstetrics and gynaecology
• A person who has a diploma or degree in obstetrics and gynaecology
• A doctor who was registered before the 1971 Medical Termination of Pregnancy Act and who has three years’ experience in obstetrics and gynaecology
• A doctor who registered after 1971 and has been practising in obstetrics and gynaecology for at least a year

The best way to find a gynaecologist is through personal recommendations or by visiting the gynaecology and obstetrics department of a reputed hospital or clinic.

Indian society is quite conservative and pre-marital sex is taboo. Unmarried women seeking an abortion may be confronted by medical staff with hostile attitudes.

 

Before the abortion - what to expect

At your initial appointment you should be given the opportunity to discuss your situation. You’ll be told about the methods available and which method is suitable for you and your stage of pregnancy. At this point you will also be told about any related risks and complications.

Some medical tests and procedures such as blood tests and STI tests may also be carried out. Before the abortion is carried out you will be asked to sign a form of consent.

Methods

Abortions can be carried out medically (using medication) or surgically (involving a small operation). The method your doctor will recommend will depend on what stage of your pregnancy you are. Below is a brief description of each method:

Early medical abortion (up to nine weeks of pregnancy)

This involves taking two different medications between 36 and 48 hours apart. The medicine works to break down the lining of the womb so it (and the embryo) can leave the body. The results are similar to those of an early natural miscarriage.

Vacuum aspiration (from seven to 15 weeks)

This procedure can be done under local or general anaesthetic. It uses gentle suction to remove the foetus from the womb and usually takes between five and 10 minutes.

Late medical abortion (from nine to 20 weeks)

The same medicines used in early medical abortion can be used at a later stage of pregnancy, but at a higher dosage. This acts in a similar way to a late miscarriage.

Surgical dilation and evacuation (from 15 weeks)

Also known as D&E, this procedure requires a general anaesthetic. Forceps and a suction tube are used to remove the foetus. As long as there are no complications, you should be able to return home the same day.

Late abortion (from 20 to 24 weeks)

There are two options for this stage of pregnancy, both require an overnight stay at hospital. The first option is a surgical two-stage abortion. Stage one softens the cervix and stops the heartbeat of the foetus. Stage two takes place the following day and involves the removal of the foetus. Both stages take place under general anaesthetic.

The second option in a medically induced abortion, using medicine, makes the womb contract. A D&E may also be needed to ensure the womb is entirely empty.

How will I feel after?

The way you’ll feel after you have the abortion will depend on a variety of things, including your personal circumstances. Your hormones will be changing back to their pre-pregnancy state, this in itself can lead to feelings of sadness. It’s important to remember that everyone is different and there is no right or wrong way to feel. You may experience a number of different emotions.

Some people are surprised at how strong their emotions are, despite believing they made the right decision. Depending on past experiences, the abortion may also bring up old feelings. Others simply feel relief that the pregnancy is over and do not suffer a great deal of distress.  

In some cases the procedure can be akin to trauma in the mind. This can result in a number of symptoms and emotions post abortion, including:

• Anxiety - You may feel an increase in your general anxiety levels, or your anxiety may revolve around pregnancy (you may worry that you’ll get pregnant again or worry that you won’t be able to get pregnant again).
• Depression - Feeling numb and experiencing symptoms of depression can occur for some, post abortion.
• Flashbacks - As some of the termination methods take place while fully conscious, some people experience flashbacks.
• Guilt - This can be a common feeling, even when you are happy that the decision you’ve made is right for you.

 

As many of these feelings are similar to those experienced in post-traumatic stress syndrome (PTSD), some call this set of symptoms ‘post abortion stress syndrome’ or PASS. This has not been officially recognised within the medical community however. Many experts agree that abortion is not unlike any other stressful life event that can cause trauma in some people.

Again, it’s important to stress that there is no right or wrong way to react or feel in this situation. If you are struggling with your feelings or finding it difficult to cope, you may benefit from post abortion support from a professional.

Post abortion support

Regardless of your political, philosophical or religious views on termination, the experience has the potential to affect you on a psychological level. Similarly, even when the decision is in your best interest, there may be an element of conflict you feel you need to address to feel comfortable with your choice. In these cases, talking to a professional can be useful.

Discussing your thoughts and feelings with a counsellor can help you make sense of your emotions post abortion. The counselling process can also provide you with the tools you need to better cope with any residual negative feelings.

If the termination has left you feeling depressed, anxious, or you’re experiencing flashbacks, your counsellor can work with you to facilitate change. You can look to uncover the underlying cause of these feelings and how to cope with triggering thoughts/situations.

If some time has passed since the procedure, remember that it is never too late to express your feelings or talk to a professional. Whatever your situation, it’s important to know that counsellors will not judge you or make assumptions. It can be helpful to find a therapist who has experience in abortion counselling.

Self care

Being kind to yourself after the termination is important, especially if you are feeling negative about the situation. Acknowledging your feelings is the first step. Although it may seem easier to bury emotions or avoid them, giving yourself the time and space to experience them is the best way to diminish them. Allow yourself to express any sadness, guilt or anxiety you’re feeling. You may find it helpful to write your feelings down.

If the decision was made with your partner, it is important to support each other. Terminations affect both parents and talking about what happened and how you both feel can help. If you made the decision alone, talking to your friends, family or a counsellor will stop you from bottling up any feelings.

If you have any feelings of guilt, try not to be hard on yourself. Remind yourself that you are brave for making a difficult decision and that you’re a good person. Remind yourself of your reasons and that you made the best decision under the circumstances.

Think ahead to the future. Life events like these may make an impact, but they needn’t dictate the route your life will take moving forward. Take care of yourself physically - ensure you are getting plenty of sleep, gentle exercise (when your doctor says you can) and nutritious meals. Abortions are physical procedures, so allow your body time to re-adjust too.

What should I be looking for in a counsellor or psychotherapist?

Whilst there are no official rules and regulations in place that stipulate what level of training and experience an abortion counsellor needs, we do recommend that you check your therapist is experienced in the area for which you are seeking help.

Another way to assure they have undergone specialist training is to check if they belong to a relevant professional organisation that represents counsellors dealing with abortion.

Overall your counsellor should be in a position to go through all of your options with you without bias. Rather than give you advice, a good counsellor will offer support both as you make your decision, and after the procedure.