Abortions in Scotland
An abortion (also known as a termination) is the medical process of ending a pregnancy.
There are 2 types of abortion:
- medical, which uses medication
- surgical, which involves a small operation
The decision about which type of abortion you have will partly depend on how many weeks pregnant you are.
An abortion is different from a miscarriage, which is when a pregnancy ends without medical intervention.
When can an abortion be carried out
The Abortion Act 1967 covers the UK mainland but not Northern Ireland.
It's legal to have an abortion during the first 24 weeks of pregnancy, so long as certain criteria are met. The law states that 2 doctors must agree that an abortion would cause less risk to a woman's physical or mental health (or that of her children) than continuing with the pregnancy.
The law states an abortion may be carried out after 24 weeks when:
- it's necessary to save the woman's life
- it's to prevent grave permanent injury to the physical or mental health of the pregnant woman
- there's substantial risk of the child being born with serious disabilities
Most abortions in Scotland, around 96.7%, are carried out before a pregnancy reaches 13 weeks. Almost all, around 99.5%, are performed before 20 weeks.
Making the decision
The earlier an abortion is carried out, the easier and safer the procedure is. However, you should take enough time to consider all your options to be as comfortable as possible with your decision.
Before deciding, you may wish to discuss your situation with healthcare professionals like your local sexual and reproductive health service. You may also want to speak with your family members or a partner.
The final decision about whether or not to have an abortion is yours, and you shouldn't be pressured into making that decision.
Emotional support
Considering and/or having an abortion can cause a wide range of emotions. You may experience a number of different feelings. Some people feel relieved, others feel sad or guilty, and many feel a combination of these. Having some mixed feelings is normal.
Research suggests that abortion does not lead to long-term emotional or psychological problems.
If you need to discuss how you're feeling, you can ask your NHS health board’s abortion service to refer you for counselling. You can do this before or after your abortion. You can also contact a counselling service yourself.
NHS abortions
Abortions in Scotland are usually provided by NHS health boards.
If you want to have an abortion through the NHS, you should contact your local abortion service. Appointment arrangements may vary depending on where you live.
Assessment appointment
When you're referred for abortion, you'll be asked to attend an assessment appointment.
If you're under 12 weeks pregnant, this is likely to be done by phone. If you prefer, you can request to attend the clinic for an in-person appointment.
If you're more than 12 weeks pregnant, you'll be asked to attend the clinic for your assessment appointment.
During the assessment appointment you'll be asked for your medical history so the medical professional can make sure the type of abortion you're offered is suitable for you.
You'll also be:
- offered the opportunity to talk about your situation
- told about the different methods of abortion suitable for you
- told about the risks of different types of abortion
- given information and advice about which methods of contraception you could use after the abortion
Depending on your circumstances, the medical professional assessing you may ask to do some other tests. These might include:
- an abdominal or vaginal ultrasound scan to check how many weeks pregnant you are
- blood tests to check your blood group and for anaemia
- a test for sexually transmitted infections (STIs)
Not everyone needs to have these additional tests.
How an abortion is carried out
There are different methods of abortion. The type recommended for you will depend on how many weeks pregnant you are.
Before undergoing any type of abortion, you'll be asked to give consent to proceed.
Risks in an abortion
Abortion poses very few risks to a woman's health, particularly when carried out during the first 12 weeks of pregnancy.
Abortion doesn't usually affect a woman's chances of becoming pregnant and having normal pregnancies in the future.
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), no more than 10 in every 1,000 abortions
- damage to the uterus (womb) happens in up to 4 in every 1,000 surgical abortions
After an abortion
After an abortion, the main risk is infection in the uterus (womb). This can be caused when all of the pregnancy tissue has not been passed or removed.
An infection after abortion may cause you to bleed heavily or have a discharge from your vagina and lower abdominal pain. Antibiotics will be used to treat an infection.
If an infection isn't treated, it could result in a more severe infection of your reproductive organs. This could include pelvic inflammatory disease, which can cause infertility or ectopic pregnancy.
The risk of an infection can be reduced by taking antibiotics at the time of a surgical abortion.
If you think you may have an infection following abortion, you should immediately contact your abortion service for advice.
After an abortion, you may be advised not to have vaginal sex and to avoid using tampons while the bleeding continues.
You should have a reliable type of contraception arranged before starting to have sexual intercourse again, as your fertility will return to normal very quickly.
Your abortion service will give you information on different methods and help you find the right one for you. You can also talk to your GP or local sexual and reproductive health service about contraception.
Northern Ireland residents coming to Scotland for an abortion
Residents of Northern Ireland can access abortion services in Scotland for free, on the same terms as people who live in Scotland. If you are in Northern Ireland and want to travel to Scotland for an abortion, you should first contact the NHS Board for the area where you're planning to have your abortion. The procedure for arranging an appointment varies depending on the NHS Board.
Contact NHS abortion services in Scotland
Confidentiality
If you come to Scotland from Northern Ireland for an abortion, the procedure can be kept confidential.
No paperwork will be sent to your home or to your GP without your consent.
You'll be given a letter outlining the treatment you received so you can give it to a doctor if you need emergency care. If you like, the clinic can also send a letter to your GP.
As an NHS patient you have the right to confidentiality. This means you have a right to:
- have your information stored securely
- access your health information
- know how the NHS uses your information
- know how the NHS shares your information
- object to the NHS using your information
Find out more about confidentiality in NHS Scotland
Symptoms after taking medication
After taking the abortion medication (misoprostol), you should be prepared for the possibility of the following symptoms:
Depending on the procedure you have, it may be a good idea to avoid travelling for 24 hours.
You can talk to your healthcare provider about what to expect.
After the procedure, the NHS Board in charge of your care will provide aftercare information, along with a clinic number in Scotland.
If you've any concerns after your return to Northern Ireland, you can call the clinic number.
