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Surgical termination of pregnancy for foetal anomalies 

MSI Reproductive Choices UK 20230605_0491

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Surgical termination of pregnancy for foetal anomalies 

We are sorry that you are facing the painful prospect of ending your pregnancy after a prenatal diagnosis of fetal anomaly.  

We’re here to support you through your decision: our nursing and counselling team are available to you every step of the way.  

How to access our services 

Our service is available to: 

  • Eligible patients under the care of an NHS antenatal service and have received a diagnosis of fetal anomaly. 
  • Eligible patients self-referring after receiving a diagnosis of fetal anomaly. 

Our teams will support you (and your partner) at every step of the treatment. Counselling is also available before and after treatment. 

Preparing for your pre-assessment appointment 

Surgical termination of pregnancy is carried out under anaesthesia, and it will involve 1 or 2 visits to one of our clinics.  

During your first consultation (pre-assessment appointment), you will talk with a nurse or midwife who will explain the procedure, answer your questions, and carry out some routine pre-operation checks.  

If you are over 19 weeks of pregnancy, the cervix (neck of the womb) will need to be prepared on the day before the surgical termination to make the procedure as safe as possible. If you are over 22 weeks of pregnancy, you may be offered an additional procedure called feticide. 

What does the surgical termination of pregnancy involve? 

When you arrive for your treatment, you will be seen by a nurse or midwife who will carry out the final pre-operation checks. If you are less than 19 weeks of pregnancy, you will need to take tablets called ‘misoprostol’ to prepare the cervix ahead of the surgical termination. This can take 1-4 hours depending on how many weeks pregnant you are.  

You may be offered a private waiting room where you can stay with your partner while you are waiting. When your procedure time arrives, a nurse or midwife will take you into another room to change, and then lead you into the treatment room. You will then be introduced to the treatment room team including the surgeon and anaesthetist and have the opportunity to ask any remaining questions you may have. The anaesthetist will insert a cannula in your arm or hand and use this to give anaesthesia. The procedure will take between 10-20 minutes, after which your recovery will continue on a shared ward.  

Surgical termination: treatment types

MSI offers surgical termination under anaesthesia up to 23 weeks and 6 days of pregnancy. 

Surgical treatment aftercare 

After the treatment, you will be moved to the shared recovery ward to complete your post-operative recovery. Most people find they wake up with period-like cramps and may be bleeding heavier than a normal period. We will give you painkillers to make sure you are comfortable. The nurse or midwife will explain your aftercare and provide you with written information to take home which includes signs and symptoms that may need medical attention. Once you are ready for discharge, you may reunite with your partner outside of the shared ward. Most people will be ready to go home around 1 hour after the procedure and someone will need to drive you home. 

Physically, most people find it is like recovering from a heavy period – there will be a heavy loss that should reduce each day, sometimes with fresh bleeding and clots at the beginning but usually reducing to a darker loss or discharge after a week. For most people it settles completely after 2-3 weeks. Your normal periods may take a while to come back, but it is usually after 5-8 weeks. At the beginning you may find simple painkillers like paracetamol or ibuprofen useful, or often a hot water bottle or warm bath is helpful to reduce cramps. Other than not driving for 24 hours after the anaesthetic, it is safe to otherwise do whatever you feel comfortable with – this includes exercise, showers, baths, swimming, using tampons or resuming sexual intercourse.  

Please be aware that your fertility can return immediately, and some people find they need additional time to come to terms with what has happened. Occasionally, especially in later pregnancies, your breasts may leak some milk. This should settle quickly but is likely to be helped with a comfortable support bra and simple pain killers if necessary. 

You may experience a range of feelings when you get home. Some people describe feeling relief, sadness, anger, intense grief and anxiety. Be assured that it is normal to feel these emotions.  We offer a counselling service if you would like to talk to someone. To book an appointment, please call our advice line on 0345 300 8090. The charity Antenatal Results and Choices (ARC) is also a helpful, independent organisation providing emotional support. You can also contact your hospital team or your GP. 

Useful resources 

ARC is a charity that offers non-directive, individualized, practical information and emotional support to expectant parents who are told that their baby is not developing as expected and are making decisions on how the pregnancy should proceed. ARC also provides specialised bereavement support for those who have ended a pregnancy after a diagnosis. 

SANDS is a charity that offers support to anyone affected by the death of a baby. You can call them on 0808 164 3332 or visit their website: