Question 1

What is abortion?

Accepted Answer

An abortion is the deliberate medical process of ending a pregnancy. An abortion is also known as a 'termination' or 'termination of pregnancy'. At MSI Reproductive Choices we offer two types of abortion care: medical abortion (abortion pills) and surgical abortion. Both procedures are very safe, and 1 in 3 women will have one.

Medical abortion involves taking two types of medicine at different times, to end a pregnancy. The first medication, mifepristone, stops the pregnancy from growing by blocking the hormone progesterone, and causes separation of the pregnancy from the wall of the womb.

The second medication, misoprostol, causes the softening and opening of the cervix (neck of the womb) and contractions of the womb so that the pregnancy passes through the vagina. You will experience cramping and bleeding similar to a miscarriage. The second medication is taken in the clinic. In some of our centres, the second medication can be given to you to take at home, depending on whether you are eligible. Not all of our centres and clinics are currently providing this service.We will talk you through the available options at your appointment.

At MSI Reproductive Choices, medical abortion is available up to 9 weeks + 6 days of pregnancy (9 weeks + 3 days in smaller clinics).

Read our page on medical abortion where the procedure is explained in a little more detail.

Surgical abortion involves the pregnancy being removed through the vagina by an experienced doctor, using a suction method. After 14 weeks + 6 days of pregnancy, cervical preparation medication and slender specialised instruments will also be used. Your gestation (how many weeks pregnant you are) and your medical history will determine the surgical abortion procedure offered to you.

At MSI Reproductive Choices, surgical abortion is available up to 23 weeks + 6 days of pregnancy.

Read our page on surgical abortion where the procedure is explained in a little more detail.

If you are pregnant and you would like to talk through your options, please call us on 0345 300 8090.

Question 2

Which abortion is right for me?

Accepted Answer

The type of procedure you can be offered will depend on a few personal factors. Your gestation (how many weeks pregnant you are), past medical history, gynaecological history, medications and personal choice will all help determine which method is best for you.

The National Institute for Health and Care Excellence NICE published two decision aid leaflets that can help you decide which option is best for you.

At MSI UK we offer the following treatments:

Medical Abortion (abortion with pills): up to 9 weeks and 6 days gestation
Surgical Abortion: available from 6 weeks, up to 23 weeks and 6 days gestation

Read more at this link: How to choose your abortion treatment

If you’d like to talk through your options you can speak with your GP, or call us on 0345 300 8090 for a confidential chat.

Question 3

Are abortions safe?

Accepted Answer

Abortion is very safe, when performed in a Department of Health and Care Quality Commission registered clinic, with specialists performing approved treatment, like at MSI Reproductive Choices.

The World Health Organisation says that the risk of death from a safe abortion is lower than death caused by a penicillin injection, or by continuing with pregnancy^*.

Like any surgical procedure or medical treatment, abortion does carry some risks, and we will explain these to you clearly during your consultation with us.

^{*World Health Organisation (2012), Safe Abortion: Technical and Policy Guidance for Health Systems (second edition), p.49. Available at: http://apps.who.int/iris/bitstream/10665/70914/1/9789241548434_eng.pdf}

Question 4

How quickly can I get an abortion?

Accepted Answer

If you have decided that abortion is the best option for you, we recommend calling us as soon as you can. We will usually be able to see you within a week of booking your appointment, but wait times can fluctuate depending on the time of the year.

Treatment must be booked in advance, as we don’t offer walk-in on the day appointments.

You can call us on 0345 300 8090 to arrange your abortion care appointment.

Question 5

How much does abortion cost?

Accepted Answer

Up to 98% of our clients in the UK will have an abortion that is funded by the NHS, meaning they don’t pay anything. If you’re not eligible for NHS funding, we also provide private abortion treatment.

Read a list of our fees here

Question 6

Can I travel from overseas for an abortion at MSI Reproductive Choices?

Accepted Answer

If you live in a country where abortion is restricted, you can travel to a MSI Reproductive Choices centre or clinic in England for an abortion.

We can give you advice on your pregnancy options over the phone or in person. However, we recommend you contact us ahead of travelling so that we can:

Answer any questions you might have on treatment options, prices, travel and accommodation.
Arrange for you to have counselling over the phone, face-to-face or point you in the direction of local counselling services.
Arrange for you to discuss your treatment options with an experienced nurse.

Please call us anytime on one of the following numbers – we are here for you 24 hours a day:

Callers from Northern Ireland: 0345 300 3737
Callers from Republic of Ireland: 1 800 200 374
Callers from outside the UK: 0044 1454 457542

If you're travelling from abroad to one of our centres, we will tend to book consultations and treatment appointments on the same day (subject to our appointment availability and your medical history). We'll give you comprehensive information about what to expect following your abortion and how to manage any symptoms you may experience. We advise against travelling long distances home the same day of treatment, and we strongly recommend you try to stay overnight locally with friends or family if possible.

Read ‘How should I prepare for an abortion’ for more information on what to do before and after your treatment.

The cost of an abortion with us may vary depending on where you’re travelling from – take a look at our fees page for more information.

In 2017, the UK Government committed to cover the cost of abortion care for women from Northern Ireland who are treated in England. Read our Travelling from Ireland page for more detailed information on this.

Question 7

How should I prepare for my abortion?

Accepted Answer

Once you’ve chosen your treatment option, there are a few things you should do to prepare for your appointment:

1. Arrange travel

It is important to arrange your return travel before you come to your appointment.

Please do not use public transport after your abortion treatment, and please do not drive yourself home if you have had medical abortion treatment, or a surgical abortion with sedation or general anaesthetic.

We strongly recommend that someone travels home with you after treatment, and stays with you for the next 24 hours.

If you’re travelling from overseas, we advise you stay overnight locally – please see question ‘Can I travel from overseas for an abortion at MSI Reproductive Choices?’ for more information.

2. Bring a companion with you

Due to the current COVID-19 pandemic we have had to reduce the footfall within our centres to keep all clients and team members safe.

To encourage social distancing, all clients are asked to attend the clinic by themselves. We will allow clients to be accompanied by one companion in exceptional circumstances only, and this must be prearranged and discussed during your consultation. Please read our COVID-19 Guidance for more information.

3. Clothing and accessories

It is best to wear something loose and comfortable for your appointment. Bring a jumper in case you feel cold. For surgical abortion, you may find it more comfortable to wear a baggy t-shirt as you will be asked to remove your trousers. You will be given a wrap to cover you before entering the treatment room.

If you’re having a surgical abortion, we also ask that you do not wear:

nail varnish, gel nails, or Shellac on finger nails
false (acrylic nails)
tongue piercings

This is because it can interfere with some anaesthetic equipment.

4. Essential things to bring

When you come to your treatment appointment, please bring with you:

Any medication that you are currently taking (including inhalers).
Any information you have from your doctor about any medical conditions.
Your referral letter from your doctor or family planning clinic if you have one.
Any notes you may have been given from a previous consultation.
An extra pair of comfortable underwear.
Sanitary pads suitable for a heavy flow (not tampons or menstrual cup).
Your glasses and contact lens kit if you use contact lenses. You may be asked to remove your contacts before the procedure.
Your payment method if you are having private (non-NHS) services.

5. Bathing

For your comfort, we recommend that you have a shower or bath before leaving home on the day of your appointment. You should not have a bath for 48 hours following your surgical or medical abortion as this could increase the risk of infection. As you may be feeling light-headed following your abortion, for your safety please do not have a shower without someone there with you.

6. Drug and alcohol use

Whether you’re having a surgical or medical abortion, please do not use recreational drugs or drink for 24 hours before your appointment. This is because it could affect your treatment and result in your appointment being moved to another day. Please also avoid drinking alcohol for 48 hours after your treatment. If you have consumed either of these and you have any concerns, please let our staff know.

7. Eating and drinking

If you’re having a surgical abortion with general anaesthetic or sedation, it’s very important that your stomach is empty before the procedure. Please make sure you stop eating six hours before your treatment. If you are having a morning procedure that means no food after 2am the night before. If your procedure is in the afternoon you can have a light breakfast (e.g. toast, or a bowl of cereal) six hours before your procedure. But please avoid heavy meals as they may not have passed through your stomach in time for your appointment. You can chew gum and suck boiled sweets up to when you get called through for your procedure.

Please make sure you stop drinking two hours before your procedure. Anything you do drink before your procedure should be a clear liquid, such as water or apple juice. Do not drink milk or anything milk-based, such as tea or coffee.

If you have any questions about these guidelines, please call us on 0345 300 8090.

You will be able to eat and drink as normal after your treatment.

8. Arrange childcare

To be as sensitive as possible to others who may be in the waiting areas, please do not bring any children with you to your appointment. We do not have any facilities for children in our centres, so please arrange childcare if you can.

9. If you are breastfeeding

Small traces of some of the medication taken as part of your medical or surgical abortion could pass into the breast milk. In most cases it is fine to continue breastfeeding following your abortion medication, or after you have recovered from any anaesthetic. Please call us on 0345 300 8090 if you are breastfeeding and would like further support and advice.

Find out about medical abortion

Find out about surgical abortion

Question 8

Do I need to discuss abortion with my GP?

Accepted Answer

If you would prefer to speak to your GP, they can talk you through your options and refer you to abortion care services. However, you don’t have to discuss it with your GP if you don’t want to, and we are not required to tell them about your appointment either.

It’s entirely your decision if you want your GP to be notified. You may be able to self-refer for an appointment by calling our advice line on 0345 300 8090.

Question 9

How will I feel after my abortion?

Accepted Answer

Everyone is different, and can feel a range of emotions around their decision to end a pregnancy. If you need to talk through your feelings at any time after your abortion, we can arrange a counselling appointment for you. Please call our advice line on 0345 300 8090 to speak to us about this.

Question 10

Can I get abortion counselling?

Accepted Answer

While most women are very sure of their decision to have an abortion, others may be undecided. If you are feeling unsure, or need to discuss your situation further, we can arrange a counselling appointment for you.

Counselling is a talking therapy that will help you discuss your feelings and situation in a confidential, safe environment. MSI Reproductive Choices counsellors are highly trained and qualified to help you explore and manage your thoughts, feelings and issues. They offer caring, non-judgemental support.

Counselling is optional as part of our abortion care for most clients, and all NHS clients are entitled to free counselling sessions before, or any time after, treatment.

You can also pay for stand-alone counselling if you wish – take a look at our fees.

Counselling appointments are available over the phone, or face-to-face. If you need to talk, you can call us any time on 0345 300 8090 to arrange an appointment.

Find out more about counselling

Question 11

Can I bring a friend or partner to my abortion?

Accepted Answer

Yes, you can attend your appointment with one person: however they will need to wait in the waiting area during your appointment.

Arranging childcare: unfortunately, you won’t be able bring any children into the centre with you. This is to be as sensitive as possible to others who may be in the waiting areas. Because of this policy we do not have facilities for children in our centres. Please make sure you arrange childcare. (Please note that as some of our centres may be within a GP practice there may be babies/children in shared waiting rooms.)

Question 12

How confidential are MSI Reproductive Choices abortion services?

Accepted Answer

We’re committed to protecting your privacy. If you want to call us for advice you do not have to tell us who you are, and we will not call you back unless you want us to.

All contact and treatment information is confidential. We are not required to tell your GP. The decision you make about your abortion care will just be between you and our teams.

If you give us information over the phone or online, which suggests that you or someone else is at serious risk of immediate harm, we will ask to put you in touch with services that can help. There are some things that we think are too important to keep between just you and us, and we will talk to you about whether other people need to know what’s happening.

We have a duty of care to do this if we feel there is any risk of harm - but we will tell you if we need to do this and why.

Data protection

We are committed to protecting your privacy. We are legally responsible for making sure that all personal, sensitive, and confidential information we hold and use is done so lawfully. This covers information we collect directly from you, or information we may receive from other individuals or organisations.

MSI Reproductive Choices’s booking and advice line does not use caller display and calls are not traced. Calls to our advice line may be recorded for training purposes, and calls are played back in instances of a complaint.

Read more on our Privacy Policy page. You can also read our Privacy Notice explainer leaflet: you can pick it up in any of our clinics or read and download here.

Question 13

Can I have other tests on the day of my abortion?

Accepted Answer

If you are having an NHS-funded abortion, we may offer you some tests for sexually transmitted infections (STIs). We will talk you through these tests, how you will get your results, and answer any questions you may have.

You may be offered tests for:

Chlamydia
Gonorrhoea
HIV
Syphilis

If we offer you these tests, we strongly advise that you have them as a precaution. Chlamydia, in particular, is the most common STI in the UK and often has no symptoms. More information on chlamydia and other STIs will also be available in our clinics or centres.

We will also carry out blood tests and check your pulse rate during the health assessment part of your treatment.

Read more about what to expect during your appointment

Question 14

What do I do if my religion or family forbids abortion?

Accepted Answer

The decision about whether to continue or end the pregnancy is yours to make. This might not be the same decision your partner, friends or family would make.

We believe that no one should be judged for having an abortion, though we understand that there may still be some stigma attached to abortion within religious communities, or from peers or family who have religious views.

However, there are many religious pro-choice organisations who disagree with stigma, and explain that shaming people for accessing treatment is not in line with their overarching religious values. These organisations believe that abortion can be a moral option. Catholics for Choice; Christians for Choice; Muslims 4 Choice; and Religious Coalition for Reproductive Choice are just some of the organisations who promote being part of a faith community and being pro-choice.

If you feel unable to talk to friends or family about your decision, you can speak to a MSI Reproductive Choices counsellor, to your GP, or to a contraception and sexual health clinic. If you don't want to talk to your GP, that's ok too. You can call us any time on 0345 300 8090 to talk through your options.

Question 15

I'm being pressured into having an abortion - what should I do?

Accepted Answer

The decision about whether to continue or end the pregnancy is yours to make. This might not be the same decision your partner, friends or family would make.

If you feel that you're being pressured into having an abortion, please let us know. We will not provide treatment unless you are certain of your decision. As part of an abortion appointment you would have a private consultation before treatment, away from any person who has accompanied you to the clinic. You can talk to our team in private and let them know what you are experiencing.

You might feel unable to talk to those closest to you, or worry that you won't get impartial support from them. This is where counselling can really help. Our counsellors are highly trained and qualified, they offer caring, non-judgemental support. If you'd like to arrange counselling, you can call us on 0345 300 8090 to book an appointment.

Question 16

Will having an abortion increase my risk of developing breast cancer?

Accepted Answer

No, having an abortion will not increase your risk of developing breast cancer. The World Health Organisation^* has published data showing there is no link between abortion and breast cancer, and no increased risk.

In the UK, one in three women will have one or more abortion in their lifetime. Yet, this aspect of women’s healthcare is not often talked about in every day conversation. Abortion stigma can make some people feel like their decision must be kept secret and silent, leading to a lack of access to relevant and accurate information on the matter. Read our blog on Abortion Myths to find out more.

^{*World Health Organisation (2012), Safe Abortion: Technical and Policy Guidance for Health Systems (second edition), p.49. Available at: http://apps.who.int/iris/bitstream/10665/70914/1/9789241548434_eng.pdf}

Question 17

Will having an abortion make it difficult for me to get pregnant in the future?

Accepted Answer

Some women worry that having an abortion will affect their future fertility. This is not true, there is no link between abortion and infertility. In fact, following an abortion your fertility will return almost immediately.

It will be possible to become pregnant again almost immediately after an abortion. If you do not wish to become pregnant, it’s important to start using contraception immediately to be protected. We can give you information and advice about contraception options, and can provide your chosen method during your appointment.

In the UK, one in three women will have one or more abortion in their lifetime. Yet, this aspect of women’s healthcare is not often talked about in every day conversation. Abortion stigma can make some people feel like their decision must be kept secret and silent, leading to a lack of access to relevant and accurate information on the matter. Read our blog on Abortion Myths to find out more.

Question 18

Does an embryo or foetus feel pain during an abortion?

Accepted Answer

Medical evidence suggests that the foetus cannot feel pain before 24 weeks gestation, as the nervous system is not yet fully developed^*.

^{*Royal College of Obstetricians and Gynaecologists (2010), Foetal Awareness: Review of Research and Recommendations for Practice. Available at: https://www.rcog.org.uk/globalassets/documents/guidelines/rcogfetalawarenesswpr0610.pdf}

Question 19

Can I keep the abortion a secret from my family and partner?

Accepted Answer

The decision about whether to continue or end the pregnancy is yours to make. This might not be the same decision your partner, friends or family would make.

Many people accessing abortion care do not wish for their families or friends to know they have done so. This can be for many reasons such as domestic abuse, sexual assault, honour-based violence, sexual exploitation and gang involvement. Some people accessing abortion care simply wish to keep the matter private, and that is their choice too.

There is lots of support available if you are struggling, frightened or need some advice. Organisations such as:

Modern Slavery Helpline (Provides a fully-trained Helpline of Advisors to eradicate modern slavery)
St Mungo’s (Offers services such as hostels and housing to fight homelessness)
NSPCC (Offers support to children and their families to prevent child abuse)
Victim Support (Offers support to victims of crime and traumatic incidents).

If you feel unable to talk to friends or family about your decision, you can speak to a MSI Reproductive Choices counsellor, to your GP, or to a contraception and sexual health clinic. If you don't want to talk to your GP, that's ok too. You can call us any time on 0345 300 8090 to talk through your options: we will work with you to provide care in the safest way in line with your choices.

Question 20

What is medical abortion?

Accepted Answer

Medical abortion (or the abortion pill, as it's sometimes called) involves taking two types of medication at different times, to end a pregnancy.

The first, mifepristone, stops the pregnancy from growing by blocking the hormone progesterone, and causes separation of the pregnancy from the wall of the womb. The second medication, misoprostol, causes the softening and opening of the cervix (neck of the womb) and contractions of the womb so that the pregnancy passes through the vagina. You will experience cramping and bleeding, for which we can give you pain relief.

The first medication, mifepristone, is swallowed with water in the clinic.

The second medication is taken in the clinic. In some of our centres, the second medication can be given to you to take at home, depending on whether you are eligible. Not all of our centres and clinics are currently providing this service.

At MSI Reproductive Choices, medical abortion is available up to 9 weeks + 6 days of pregnancy.

Read about medical abortion in more detail

Question 21

Am I eligible for a medical abortion?

Accepted Answer

At MSI Reproductive Choices, medical abortion is available up to 9 weeks + 6 days of pregnancy.

For the majority of people who have a medical abortion, it is a very safe procedure. However, not everyone is suitable for a medical abortion, and may be offered a surgical abortion.

We will calculate your gestation (how many weeks pregnant you are) and take a full medical history from you during your consultation, and we may carry out some tests to ensure your safety.

Question 22

Is medical abortion the same as the ‘morning after pill’?

Accepted Answer

No, medical abortion (or the 'abortion pill' as it's sometimes called) is not the same as the ‘morning after pill’.

The ‘morning after pill’ is an emergency contraceptive that can be taken up to 96 hours (5 days) after unprotected sex to prevent a pregnancy. It is a progesterone-only hormone pill and works by delaying the release of an egg from an ovary, therefore preventing pregnancy. There is just one pill to take.

A medical abortion involves taking two different types of medicine - mifepristone and misoprostol - at different times, to end an existing pregnancy. At MSI Reproductive Choices you can use this method of abortion up to 9 weeks + 6 days of pregnancy.

Find out more about the medical abortion

Find out more about emergency contraception

Question 23

Does medical abortion have any side effects?

Accepted Answer

After a medical abortion it is completely normal to experience some cramping and bleeding. Some women may also experience:

Nausea or vomiting
Headaches
Diarrhoea
Fever/chills, temporary flushes, or sweats

If you are sick within one hour of taking the first pill, you will need to take another for it to be effective. You should let us know as soon as possible if you have been sick after taking the tablet.

The onset of these symptoms can happen fairly soon after taking the medication but most women recover quickly, usually within 1-2 days. Please plan your journey home from our clinic or centre in advance, especially if you are travelling long distances. We strongly recommend that you do not use public transport, and have someone travelling with you.

Question 24

Can I buy abortion pills online and take them at home?

Accepted Answer

The Abortion Act 1967 states that an abortion must be authorised by two doctors, so it is illegal in the UK to buy abortion pills online.

Depending on where they come from the pills may also be ineffective or poor quality and come with little or no information on how to administer the drugs, and no contact number for aftercare if needed.

You should only take medical abortion medication if it has been prescribed to you by a qualified health professional. Please do not purchase abortion pills online - they may not be suitable, you may be risking your health, and ... you don’t need to!

Please remember that in the vast majority of times, if you are from the UK, you can receive safe, confidential and NHS-funded abortion treatment at one of our MSI Reproductive Choices clinics.

If you have already ordered pills online we would advise that you call us before taking them – you can reach us on 0345 300 8090.

Find an abortion clinic near you

If you live abroad or do not qualify for NHS-funded treatment, you can also access our services privately.

Question 25

How will I take the medical abortion pills?

Accepted Answer

Medical abortion treatment consists of taking two different types of medicines.

The first medication is the mifepristone pill and this is swallowed with water. Most people are able to continue their daily routine as normal after taking mifepristone, although you may experience some bleeding and pain similar to starting your period. Do what you feel is comfortable at this time, and if you are in discomfort you can take paracetamol and ibuprofen.

You may feel sick and occasionally some people vomit. If you are sick within 1 hour of taking the first pill, you will need to take another mifepristone tablet for it to be effective. Please let us know as soon as possible if you have been sick soon after taking the tablet. We have nurses available to speak to you over the phone 24 hours a day – just call our aftercare line on 0345 122 1441.

It is unlikely that the abortion will begin after taking mifepristone only, but if you believe you have miscarried between appointments please let us know. It’s important that you still attend your second appointment.

If you are taking the second medication (misoprostol) at home, and believe you have miscarried before taking it, please call our aftercare line on 0345 122 1441.

The second medication is misoprostol. There are three different ways to take misoprostol; this depends on the amount of time between taking the mifepristone and misoprostol medication.

At the clinic - Misoprostol taken at the same time as mifepristone: You will be asked to insert 4 misoprostol pills into your vagina. You will also be given some pain medication and an anti-sickness tablet. You may also be given some antibiotics to prevent infection. All of these can be swallowed with water. If the tablets come out before you start to bleed you can reinsert them or call our aftercare line on 0345 122 1441 for instructions on what to do. The tablets might fall out of the vagina when you start to bleed. If the tablets fall out at this point, don’t worry. In most cases, enough of the medication will have been absorbed.

At the clinic - Misoprostol taken 24, 48, or 72 hours after mifepristone: When you return to the clinic you will be given 4 misoprostol tablets. There are two ways to use misoprostol medication. The first way is dissolving the tablets in your mouth between your cheek and gums. The second way is inserting the tablets into your vagina. You may be given some antibiotics to prevent infection, and some pain medication to take.

At home - Misoprostol taken 24 - 48 hours after taking mifepristone: If you are eligible for home use of misoprostol, you will take the misoprostol tablets home with you. You may also be given some antibiotics to prevent infection which can be swallowed with water. You can choose how you would like to use the misoprostol tablets at home. You can either dissolve the tablets in your mouth between your cheek and gums or insert the tablets into your vagina. The misoprostol tablets should be taken between 24 - 48 hours after taking mifepristone at the clinic. Don't worry if you take them a few hours before or after this window, the tablets are still likely to work. If more than 72 hours pass and you still haven't taken the misoprostol tablets, please ring our aftercare line on 0345 122 1441 as you may need to repeat the treatment.

Please note that not all of our centres and clinics are currently offering home use of misoprostol.

Please make sure that you have some pain relief medication (paracetamol, ibuprofen, or codeine) at home before using the misporostol. We recommend taking some pain relief tablets 10 minutes before taking the misoprostol tablets. some people should avoid using ibuprofen, and others should use it with caution.

Please do not take aspirin as it can increase bleeding.

Read our medical abortion page for more detail about the procedure.

Question 26

Does medical abortion hurt?

Accepted Answer

For a few hours after your abortion you may experience strong cramping and heavy bleeding, usually stronger and heavier than a period. If you are used to heavy periods and strong period cramps, the abortion may feel just a bit heavier than usual. However, every person is different and will experience different levels of pain and bleeding throughout the abortion process.

At your appointment, we’ll give you advice you on what pain relief to take at your appointment. Paracetamol, codeine, or ibuprofen are all pain medications that will not interfere with the abortion medication.

Question 27

How long will it take to recover from a medical abortion?

Accepted Answer

Recovery times after an abortion will be different for everyone, and will depend on how many weeks pregnant you are when the abortion occurs.

Most women will recover quickly, but we would recommend you delay returning to work until after the abortion is complete as you may have cramping and heavy bleeding. This is usually within 1-2 days after taking the second set of tablets, but occasionally can take up to 2 weeks.

Read more about abortion aftercare and recovery

Question 28

What are the possible complications and risks of medical abortion?

Accepted Answer

Medical abortion is a very safe option for termination of early pregnancy. However, as with any medical treatment, it is not free from possible complications or risks, and there is a small chance of experiencing the following:

Incomplete abortion – uncommon (affects 3 in 100 people)

This means that the pregnancy is no longer developing, but some of the tissue is left in the womb. This can cause pain and bleeding, and may lead to infection. If incomplete abortion is diagnosed, further treatment will usually be recommended. The treatment offered may be medical (such as taking misoprostol tablets and antibiotics) or a minor surgical procedure to remove the pregnancy tissue from the womb.

If medical abortion tablets are given at the same time, the risk increases slightly to 5 in 100 people.

Treatment failure (continuing pregnancy) – uncommon (affects 1 in 100 people)

This means that the pregnancy continues to develop, even after taking both sets of tablets. In the event of continuing pregnancy further treatment, such as medical (misoprostol) or surgical treatment, will be discussed. Depending on how many weeks pregnant you are the options would include repeating the medical abortion or offering a surgical abortion. Very occasionally you may need to be referred to another NHS service.

We recommend doing a pregnancy test 3 weeks after treatment (any earlier test will not be reliable).

If medical abortion tablets are given at the same time, the risk increases slightly to 2 in 100 people.

Infection – uncommon (affects less than 1 in 100 people)

This can be reduced by following our aftercare advice. If an infection is not treated it can lead to further serious problems and future infertility. If you have symptoms of pelvic inflammatory disease (PID), such as unusual vaginal discharge, fever, or pain and discomfort in the lower abdomen you must seek urgent medical attention. See your GP or visit your local A&E department.

Haemorrhage – very rare for a medical abortion (affects less than 1 in 1000)

If you experience bleeding that is soaking through more than 2 sanitary pads an hour you should seek urgent medical advice.

Serious complications have warning signs. If you experience any of the symptoms below, call us straight away:

Very heavy bleeding that soaks through more than 2 sanitary pads (suitable for a heavy flow) an hour.
Abdominal pain or discomfort that is not helped by pain relief medication, or by heat pad.
Vaginal discharge that smells unpleasant.
Fever lasting more than 24 hours.

Sepsis can be caused by an infection in any part of the body. Sepsis after an abortion is rare, but very serious. Symptoms of sepsis can be like having the flu at first. If you develop any of the signs below it is important to seek urgent medical advice:

Feeling dizzy or faint
Confusion
Slurred speech
Extreme shivering
Severe muscle pain
Being unable to urinate
Severe breathlessness
Loss of consciousness
Cold, clammy and pale or blotchy skin

Please keep in mind that not everyone will be suitable for medical abortion treatment. However, you may still be suitable for a surgical abortion. During your consultation we will discuss your medical history to make sure the option is safe for you.

If you have any questions about treatment suitability, you can call us any time on 0345 300 8090.

Question 29

Does the abortion pill show up in blood tests?

Accepted Answer

No, there is no blood test to show if you have had a medical abortion with pills.

A medical abortion is like a miscarriage. The risk of not passing all of the pregnancy tissue happens in both medical abortion and miscarriage and is treated the same. If you think that your medical abortion at MSI Reproductive Choices has not worked then you should contact us.

Question 30

What is surgical abortion?

Accepted Answer

A surgical abortion involves the pregnancy being removed through the vagina by an experienced doctor using a procedure called vacuum aspiration (a suction method) or dilatation and evacuation (D&E).

The procedure for a surgical abortion is different at different gestations (how many weeks you have been pregnant). We can offer the procedure with or without an anaesthetic, and your choice will be discussed during your consultation.

Instruments used may be plastic or metal with rounded edges. You may be given antibiotics to decrease risk of infection.

At MSI Reproductive Choices, surgical abortion is available up to 23 weeks + 6 days of pregnancy.

Read our surgical abortion page for more detail on the procedure.

Question 31

What will happen to me during a surgical abortion?

Accepted Answer

The procedure for a surgical abortion can differ depending on how many weeks you have been pregnant. However, no matter what stage your pregnancy is at, surgical abortion is a very safe and quick procedure.

Before your treatment our receptionist will check your notes to ensure all details are complete. If you've not yet had an ultrasound scan or blood test, this will be completed before your admission for treatment if applicable.

Most people who have an abortion with MSI Reproductive Choices will be able to receive NHS-funded treatment, however if you’re not eligible for this we’ll take payment for your treatment before your admission. Unfortunately, we will not be able to proceed with treatment without payment - please read our fees page so you can see the cost for each procedure and the payment types we accept.

Our doctors will review your notes and ensure you're medically fit for the procedure, and then once everything is ready for you, you will be shown through to the pre-treatment waiting area. Should you have any questions or require any information about what happens to your pregnancy following abortion, one of our nurses will be on hand to answer them for you.

Depending on how many weeks pregnant you are, you will receive one of the following types of procedure. This will be explained to you during your appointment, where you’ll have the opportunity to ask any further questions you may have:

Before 12 weeks of pregnancy

The pregnancy is removed from the uterus by vacuum aspiration (this involves a suction method), which is used to remove the pregnancy through the cervix (neck of womb) and vagina.

This is a very quick and simple 5 – 10 minute procedure.

If you are under 10 weeks pregnant you may choose not to have any anaesthetic. A general anaesthetic is not necessary before 12 weeks of pregnancy but we can offer sedation.

12 - 18 weeks + 6 days of pregnancy

At this gestation range we may need to dilate (gently open) the cervix. Medication is placed in your mouth between your cheek and gums or placed in your vagina to dissolve. This causes the cervix to dilate (gently open) over a few hours. You will wait in the centre during this time.

Between 12 - 14 weeks gestation a suction method is used to remove the pregnancy through the cervix and vagina. This procedure is done under short-acting sedation.

Between 14 - 18 weeks gestation slender specialised instruments will then be used to dilate (gently open) the cervix and remove the pregnancy. This procedure is called dilatation and evacuation (D&E). It is done under general anaesthetic. The procedure takes 10 - 15 minutes, but you will be in the centre for half a day.

In very rare cases, the medications used for cervical preparation can cause the pregnancy to be expelled. If at any point you start to experience very strong cramps, heavy bleeding, or an urge to push, please let one of our team members know right away.

19 - 23 weeks + 6 days of pregnancy

At this gestation range the treatment is performed in two separate stages. You will be asked to arrive at the centre early in the morning for the first stage, which involves preparation of the cervix (neck of the womb). Medication is placed in your cervix at the top of your vagina to cause the cervix to dilate (gently open) over 4 - 6 hours. You will wait in the centre during this time.

To complete the procedure, the second stage will take place later that day. You will be given a general anaesthetic. The cervix is further opened and the pregnancy is removed through the cervix and vagina using slender specialised instruments and suction. This procedure is called dilatation and evacuation (D&E).

The procedure takes about 10 - 20 minutes, but you will be in the centre all day.

In very rare cases, the medications used for cervical preparation can cause the pregnancy to be expelled. If at any point you start to experience very strong cramps, heavy bleeding, or an urge to push, please let one of our team members know right away.

If you have made an appointment to have a surgical abortion, read ‘How should I prepare for my abortion’ for more information.

Question 32

How long will it take to recover from a surgical abortion?

Accepted Answer

Most women will recover from a surgical abortion very quickly, and can return to work within a few days. After surgical abortion treatment, it is normal to experience:

Bleeding - this can start immediately or up to 72 hours following the procedure. Bleeding can be heavier than a normal period, with small clots, but it is not a period. It can last up to 1-2 weeks.
Pain - cramping pain is normal following the procedure as the uterus contracts to its normal size. Cramps can be constant or intermittent, and it’s not unusual to continue to get cramping on and off in the first 2 weeks after treatment.

If you have had a procedure where cervical preparation medication is used, you may experience side effects such as:

Nausea
Diarrhoea
Chills or light fever
Cramping pain
Bleeding - if you start to bleed after cervical preparation, please let one of our nurses know right away, so we can assess you.

We’ll give you advice on pain relief, such as paracetamol or codeine. These pain medications will not interfere with any abortion medication, however please do not take aspirin as it can increase bleeding. Do not take ibuprofen until 12 - 18 hours after your procedure.

If you have any worries about any pain or symptoms you experience following your abortion, you can call our aftercare line on 0345 122 1441 any time, day or night, to speak to a nurse.

For advice on recovery after an abortion, read our page about abortion aftercare.

Question 33

Will surgical abortion hurt?

Accepted Answer

We will make every effort to make sure you are comfortable before, during, and after your procedure.

If you're having a general anaesthetic, you'll feel no pain during the surgical part of the procedure as you'll be completely asleep. If you're more than 14 weeks pregnant, you may be given some medication to help dilate the cervix and this can cause some cramping pain.

If you're having sedation, you can feel some discomfort and pain in the lower abdomen as the uterus (womb) contracts at the end of the procedure. If you're having sedation, a painkiller will also be given to you.

If you're not having any anaesthetic, it's likely you'll experience some pain, but will not have the side effects of the drugs used for sedation. If you're not having sedation or a general anaesthetic, you can take 400mg of ibuprofen and/or 1 gram of paracetamol an hour before your appointment. Please inform the nurse on arrival of any medication you have taken. Please do not take aspirin as this can increase bleeding.

For 2 weeks after the procedure you may experience constant or intermittent cramping-type pain in your abdomen as the uterus contracts and returns to its normal size. We’ll give you advice on pain relief, such as paracetamol, codeine, or ibuprofen. These pain medications will not interfere with any abortion medication.

If you're concerned about the level of pain you're experiencing, or if your pain is not being controlled by taking painkillers, please call our 24-hour aftercare line on 0345 122 1441, attend an A&E department, or see your GP.

Question 34

Do I need an anaesthetic with a surgical abortion?

Accepted Answer

We offer three options of anaesthesia during the surgical abortion procedure. During your consultation we can discuss which option would be recommended, given your unique circumstances and medical history.

No anaesthesia

This is suitable for clients less than 10 weeks pregnant, especially if you have given birth vaginally before. You can take ibuprofen and paracetamol before the procedure. Some people should avoid using ibuprophen, and others should use it with caution. Please do not take aspirin as it can increase bleeding. You will be in the treatment room for about 10 minutes. The procedure is uncomfortable, but usually only lasts a short time. You will feel severe cramping pains which will pass when the procedure has finished. Our nurses will stay with you and keep you distracted. We will give you a heat pad and other pain relief afterwards.

The benefits of no anaesthesia include:

Avoiding the risks associated with anaesthesia.
Being able to eat and drink before the procedure.
Quicker recovery time.
Being able to drive yourself home.

Sedation anaesthesia or general anaesthesia

With both types of anaesthesia, you are not likely to remember the procedure. They both involve administering the same types of medications through a needle or cannula (small tube) in the vein, usually in the back of your hand. The amount of medication administered is unique to each person’s needs. Our anaesthetist will be with you at all times during this procedure.

If you are having an anaesthetic, you will need to fast before your appointment. This means not eating or drinking for some hours in preparation. Please read ‘How should I prepare for my abortion’ for details of when you must stop eating and what you are able to drink before your appointment.

Sedation anaesthesia (typically for under 14 weeks gestation): You are given a smaller dose of medication, resulting in heavy drowsiness or unconsciousness for the short duration of the procedure, and a quicker recovery. You will retain control over your breathing and reflexes, but are not likely to remember the procedure.

General anaesthesia (typically for under 23 weeks 6 days gestation): You are given a larger dose of the medication, resulting in a deeper unconsciousness for a longer duration. It will take you slightly longer to recover. You may not retain control over your breathing and reflexes, so we may administer oxygen and help you breathe through a mask or a plastic tube in your throat. The anaesthetic risks and complications (below) increase as the level of anaesthesia increases.

Side effects from the anaesthetic

Drowsiness - you should not drive, sign important documents (such as contracts), or operate heavy machinery for 24 hours following the procedure. Some car insurance specifies that you should not drive for 48 hours after a procedure with anaesthetic, so please check with your insurance provider.
Nausea and vomiting - please let the doctor or nurse know if you are feeling nauseous, as we can give medication to help.
Heightened emotions - for some clients, this means they may feel a range of emotions after treatment. A nurse will be on hand to help and this sensation normally passes after 10-20 minutes.
Bruising – you may develop some bruising and pain where the cannula has been inserted into the vein. Bruising usually settles within a week.
Pain - you may experience a cold sensation or pain in the vein during injection of the anaesthetic. This settles quickly and is not harmful. Sometimes you may feel soreness in the vein after the procedure, which settles after a few hours.

Possible complications and risks from anaesthetic

Adverse drug reaction - reactions to anaesthetic medications are rare and can range from mild (rash) to severe (anaphylaxis). The anaesthetist will assess and treat any adverse drug reactions.
Airway difficulty - spasm of the airway or vomiting during the procedure are rare complications. The anaesthetist will monitor you during the procedure and will deal with any complications if they occur. However, if the anaesthetist is concerned that vomit may have entered the lungs you will be transferred to an NHS hospital service.
Prolonged recovery - most clients feel fully awake, relatively comfortable, and nearly back to themselves within 30-60 minutes after waking up. On rare occasions - due to dehydration, recreational drug use, or other co-existing health problems - it may take longer for you to feel back to normal. We will not discharge you from our care until we’re confident that you’ve fully recovered, you can walk around independently, and your pain is well managed. If you do not start to feel like yourself within a normal timeframe, or if you have persistent pain, this may be a sign that you need further care to recover and we may transfer you to a more advanced healthcare setting such as a hospital.
Difficulty or failure gaining intravenous (IV) access - this is where the anaesthetist has difficulty inserting the needle/cannula into the vein. It can be affected by the size and depth of your veins or dehydration. This is rare, but if it happens, it may mean that your treatment cannot proceed today.

Please keep in mind that anaesthetic will not be suitable for everyone. During your consultation we will discuss your medical history to make sure the option is safe for you. We will take further advice as necessary to make sure the safest option is offered to you.

Question 35

What are the side effects of a surgical abortion?

Accepted Answer

Side effects of surgical abortion are common, but short-lasting. Any side effects that you experience will depend on your procedure and anaesthetic choice, and can include:

Bleeding - this can start immediately or up to 72 hours following the procedure. Bleeding can be heavier than a normal period, with small clots, but it is not a period. It can last up to 1-2 weeks.
Pain - cramping pain is normal following the procedure as the uterus contracts to its normal size.

Side-effects from cervical preparation medication (if required):

Nausea
Diarrhoea
Chills or light fever
Cramping pain
Bleeding - If you start to bleed after cervical preparation, please let one of our nurses know right away, so we can assess you.

If you have any worries about any pain or symptoms you experience following your abortion, you can call our aftercare line on 0345 122 1441 any time, day or night, to speak to a nurse.

Question 36

What are the possible complications and risks of surgical abortion?

Accepted Answer

Surgical abortion is a very safe procedure (many times safer than childbirth), but as with any medical procedure, it is not free from possible complication or risks:

Infection - uncommon (affects less than 1 in 100 people)

Can be reduced by following our aftercare advice. If an infection is not treated it can lead to further serious problems and infertility. If you have symptoms of pelvic inflammatory disease (PID), such as unusual vaginal discharge, fever, or pain and discomfort in the lower abdomen you must seek urgent medical attention. See your GP or visit your local A&E department.

Retained tissue (retained products of conception) – common (affects less than 5 in 100 people)

This is where part of the pregnancy is not removed from the uterus, or a blood clot forms in the uterus following the procedure. Retained tissue, products, or clots will sometimes pass spontaneously, or they may require further treatment (medication, or another surgical procedure similar to a surgical abortion).

Heavy bleeding (haemorrhage) – uncommon (affects 1 - 4 in 1000 people)

This can happen during the procedure, immediately afterwards, or up to 10 days after you’ve returned home. It can be associated with having had previous pregnancies, previous C-sections, and increased age.

Perforation of the uterus – uncommon (affects less than 5 in 1000 people)

This is the risk of instruments piercing or tearing the uterus, bladder, or bowel. The risk increases at higher gestations. If we become aware that this has occurred, we will transfer you to a hospital.

Cervical damage – uncommon (1 in 100 people)

This can happen during the surgical procedure. If this happens the surgeon will make a decision on whether to repair the damage or transfer you to an NHS hospital.

Treatment failure (continuing pregnancy) – uncommon (1 in 100 people)

This means that the pregnancy is continuing to develop, even after the procedure. Further treatment, such as medical (misoprostol) or surgical treatment, will be discussed. Transfer to another service can also be made in the event of continuing pregnancy. We recommend doing a pregnancy test 3 weeks after treatment (any earlier test is not reliable).

Thrombosis (clots in the legs or lungs)

This is a risk of being pregnant and a risk of any surgery. There is also a risk of thrombosis with air travel. The risk increases with a higher gestation.

Serious complications have warning signs. If you experience any of the symptoms below call us straight away:

Abdominal pain or discomfort that is not helped by pain relief medication, or by heat pad.
Vaginal discharge that smells unpleasant.
Feeling hot and shivery with a high temperature of 38°C or more.
Generally feeling unwell.
Very heavy bleeding that soaks through more than 2 sanitary pads (suitable for a heavy flow) an hour.
If you bleed heavily during or immediately following your treatment, we are often able to manage this on site, but may transfer you to a hospital.

Sepsis can be caused by an infection in any part of the body. Sepsis after an abortion is rare, but very serious. Symptoms of sepsis can be like having the flu at first. If you develop any of the signs below it is important to seek urgent medical advice:

Feeling dizzy or faint
Confusion
Slurred speech
Extreme shivering
Severe muscle pain
Being unable to urinate
Severe breathlessness
Loss of consciousness
Cold, clammy and pale or blotchy skin

If you have any worries about any pain or symptoms you experience following your abortion, you can call our aftercare line on 0345 122 1441 any time, day or night, to speak to a nurse.

Question 37

What will happen to the foetal tissue after a surgical abortion?

Accepted Answer

If you don’t have any special requests, we always make sure that all foetal tissue is managed and disposed of in a respectful and professional way. We also follow all relevant UK legislation, including The Human Tissue Act, which has a clinical framework for the storage and disposal of foetal tissue.

If you would like arrange burial or cremation, please let us know when you book your appointment. We can advise you on how to make preparations.

Question 38

I’m bleeding after my medical abortion, what should I do?

Accepted Answer

It is perfectly normal to bleed after you have had a medical abortion. Every person is different, and will experience different amounts of bleeding throughout the abortion process.

You may experience heavy bleeding for a few hours, and during this time it would be expected for you to pass the pregnancy tissue and blood clots that range in size from small (the size of a pound coin) to quite large (the size of a lemon). Many of our clients find it easier to have a private toilet nearby; often the pregnancy is passed in the toilet between 4 – 5 hours after taking the second set of medication.

Once the pregnancy has been passed, your bleeding will usually lessen and become more like a heavy period. It may continue to be quite heavy for a day or two as the uterus needs to contract and return to its normal size.

It's very important to use sanitary pads and not tampons or menstrual cups to avoid infection, and to keep track of your bleeding. It is normal to have some bleeding or spotting for up to 4 weeks after your medical abortion. This bleeding may be unpredictable, irregular or prolonged. Please do not take aspirin during this time as it can increase your bleeding.

If you ever feel worried, you can call our aftercare nurses on 0345 122 1441 any time – lines are open 24 hours a day.

Find out more about medical abortion

Question 39

I’m bleeding after my surgical abortion, what should I do?

Accepted Answer

It’s perfectly normal to experience some bleeding after having a surgical abortion. This can start immediately or up to 72 hours after your procedure, and can last up to 1-2 weeks.

Bleeding can be heavier than a normal period, with small clots, but it is not a period. Please do not take aspirin during this time as it can increase your bleeding. If you bleed heavily during or immediately following your treatment, we are often able to manage this on site, but may transfer you to a hospital.

Some women can haemorrhage – this is uncommon and affects around 1-4 in 1000 women - but it can happen during the procedure, immediately afterwards, or up to 10 days after you’ve returned home. It can be associated with having had previous pregnancies, previous C-sections, and increased age.

If you find that you’re experiencing very heavy bleeding that soaks through more than 2 sanitary pads (suitable for a heavy flow) an hour, please call us straight away. You can reach us on our dedicated aftercare line: 0345 122 1441 – open 24 hours a day.

Read more about surgical abortion

Question 42

If I am given antibiotics after my abortion, how should I take them?

Accepted Answer

After your abortion procedure, we may give you some antibiotics. The nurse will assess your need for extra protection against infection.

You may be given (sometimes we may give you different antibiotics, for example if you have allergies to the drugs we use):

Metronidazole - 2 tablets to take in the clinic; OR
Doxycyline – 1 tablet twice, daily for 3-7 days (not used if breastfeeding); OR
Azithromycin - 4 tablets taken together on day 1 and then 2 tablets day 2 and 2 tablets day 3 - 8 tablets in total.

How to take the antibiotic – Azithromycin

You have been given a 3-day course of the antibiotic called Azithromycin.

This 3-day course is in the two boxes of antibiotic you have been given. Both boxes contain 4 tablets of the same dose (250mg).

Please read the manufacturers leaflet before taking this antibiotic. This leaflet contains more information on this medication including possible side effects.

Azithromycin tablets can be taken before or after food. If the antibiotic upsets your tummy it is better to take after food.

If you think you are allergic to this medication, please do not take any tablets before checking with a doctor or nurse.

Please take Azithromycin as follows:

Day 1: Take 4 tablets (250mg tablets x 4) as a single dose
Day 2: Take 2 tablets (250mg tablets x 2) as a single dose
Day 3: Take 2 tablets (250mg tablets x 2) as a single dose

For more information check Patient UK website on https://patient.info/ and search for Azithromycin.

Here are some common questions and answers about antibiotics:

What does a ‘single dose’ mean?

A single dose means that you need to take the tablets one after the other with a glass of water. You don’t need to put all the tablets in your mouth at the same time.

What do you do if you forget to take your dose of antibiotic?

Remember it is important to finish the course of tablets. If you have forgotten to take your antibiotic dose, take it as soon as you remember (for example the next morning or within 24 hours), but do not take two doses at the same time. Leave 24 hrs between doses.

I have been sick after taking the antibiotics; will I need to take them again?

If you are sick within one hour of taking the tablets you will need get more tablets, otherwise you don’t need to worry.

If you've tested positive for chlamydia, you’ll need to see your GP as soon as possible for more antibiotics. You should also take care to follow the aftercare advice regarding how to minimise the risk of infection.

Can I breastfeed whilst taking the antibiotics which were prescribed to me?

Small traces of the antibiotics will be present in breast milk, but it’s fine to continue breastfeeding (if you’re breastfeeding you wouldn’t have been given Doxycyline).

If you’re able to, we recommend expressing some milk before attending the clinic to see you through until you can breastfeed again.

Read NHS guidance on expressing and storing breast milk

Can I drink alcohol while taking the antibiotics?

You should not drink alcohol while taking your antibiotics or for 48 hours after finishing your course.

I have diarrhoea and stomach cramps after taking the antibiotics, is this normal?

Diarrhoea is a common side-effect of the Azithromycin antibiotics and may last a couple of days.

The antibiotics aren’t relieving my pain

The antibiotics will not relieve any pain you may be experiencing - you'll need to take painkillers for this. You can take painkillers and antibiotics at the same time, and we can advise you on painkillers that won’t interfere with any abortion medication.

If you have any more questions about antibiotics, or aftercare following your abortion, please call us on 0345 122 1441. Our lines are open 24 hours a day, 365 days a year.

Question 43

Do I have an infection after my abortion?

Accepted Answer

It's fairly uncommon to get an infection following an abortion; only around 1 in 100 women will get one. You can reduce the risk further by following our aftercare advice. After your abortion procedure, we may prescribe antibiotics for you to help minimise the risk of getting an infection.

Read more about taking antibiotics after an abortion

If you think you have an infection, it’s important you seek urgent medical attention as soon as possible by contacting your GP or visiting your local A&E department. If an infection is not treated it can lead to further serious problems.

The symptoms of an infection include:

Abdominal pain or discomfort that is not helped by pain relief medication, or by heat pad.
Vaginal discharge that smells unpleasant.
Feeling hot and shivery with a high temperature of 38°C or more.
Generally feeling unwell.

If you have any concerns at all, or you need help taking your antibiotics (if you have been given them), please call our dedicated aftercare line on 0345 122 1441. Lines are open 24 hours a day.

Question 44

Should I do a pregnancy test after my abortion?

Accepted Answer

Following a medical abortion, we'll give you a pregnancy test to take home with you to confirm that the pregnancy has passed. We ask that you wait for 3 weeks after your abortion before taking the pregnancy test. This is because some pregnancy hormones can be present for up to 3 weeks following abortion, which can give a false-positive result.

If the pregnancy test is positive, please call our aftercare line on 0345 122 1441 immediately. Our advisors can help you to book an appointment for another ultrasound, and further treatment if needed.

It is uncommon for women to remain pregnant following a surgical abortion - treatment failure only affects around 1 in 100 women. However, if you’re concerned you may still be pregnant, we also recommend doing a pregnancy test 3 weeks after treatment and contacting us if you get a positive result.

Question 45

What contraception can I use after an abortion?

Accepted Answer

It’s possible to get pregnant almost immediately following an abortion, and as part of your abortion aftercare you should avoid sex for two weeks following treatment.

If you do not want to become pregnant, we recommend that you have contraception ready for after your treatment. We can help you find a method that suits your body and lifestyle - you can talk to us about contraception either on the phone, or at a face-to-face consultation during your appointment.

Contact us on 0345 300 8090 to arrange a contraception consultation.

Types of contraception

Contraception methods can be short-acting, long-acting, or permanent. They all have their different advantages and disadvantages, and not every method will suit everybody. They also each have different levels of effectiveness. We can talk you through any of these methods if you would like to explore them further, and can give you more information.

Many methods of contraception can be started on the same day following your abortion. This means you can leave your appointment knowing that you are protected right away. If you’re not sure of which method you would like to use long term, we can provide you with a short-term method. You can then make an appointment with your GP or local family planning service when you are ready for further contraceptive services.

Short-acting contraception includes:

External (male) condoms
Internal (female) condoms
Combined pill
Progestogen-only pill (POP or 'mini pill')
Vaginal ring
Diaphragm or cervical cap
Contraceptive patch

Long-acting reversible contraception (LARC) includes:

Contraceptive implant
Intrauterine system (IUS) – also known as the coil
Intrauterine device (IUD) – also known as the copper coil
Contraceptive injection

Permanent contraception includes:

Vasectomy – also known as male sterilisation
Female sterilisation (not offered by MSI Reproductive Choices)

Visit our contraception page to read about each of these methods in more detail.

Question 46

When will I get my period after an abortion?

Accepted Answer

Your first period will usually return between 4 to 8 weeks following a successful abortion. Remember to do your pregnancy test 3 weeks after the abortion to confirm it was successful. It is not uncommon for your first few periods to be heavier and last longer than usual. It is also normal to pass more clots than usual. Some hormonal contraception can stop or change your periods, therefore if you started contraception around the time of your abortion, this may explain why your period has not returned. If you had unprotected sex after your abortion, you may be at risk of a new pregnancy.

Question 47

I've had unprotected sex, am I pregnant?

Accepted Answer

If you’ve had sex without using contraception, or your contraception has failed, you could be at risk of becoming pregnant. It's possible to get pregnant at any time of your monthly cycle and, although highly unlikely, you can even get pregnant when you're on your period. That's why it's important to have regular contraception sorted - this reduces the risk of an unplanned pregnancy. Using condoms also reduces the chances of you getting a sexually transmitted infection (STI).

At this page "I've had unrpotected sex. Am I pregnant?" you will find answers to the following questions:

What is emergency contraception and when can I take it?
What are the signs of pregnancy?
When is it best to take a pregnancy test?
Where can I get a pregnancy test?
What can I do if I find out I’m pregnant and I don’t want to be?
How to find out how many weeks pregnant I am?

If you're pregnant and are unsure what to do next, we can talk you through your options.

Read more about different types of contraception.

Question 48

How can I prevent a pregnancy?

Accepted Answer

Using contraception when having sex is always the best way to prevent a pregnancy – you can choose from a range of long term and short term methods. If you've had unprotected sex or your contraception has failed (eg. you've missed taking a contraceptive pill or the condom split), emergency contraception can also prevent a pregnancy.

Emergency contraception is often referred to as the ‘morning-after pill’ when it can actually be used within five days of having unprotected sex.

Read more about the different types of contraception

Read more about the difference between the "morning after pill" and the "abortion pill"

Question 49

Where can I get emergency contraception?

Accepted Answer

You can get emergency contraception for free from:

GPs
NHS walk-in centres
Sexual health clinics
Pharmacies
Some Hospital A&E Departments
Brook services (for under 25s)

Brook provides free, confidential relationships and sexual health services for young people including contraception, STI testing and treatment, pregnancy testing and choices, counselling and online help and advice. For more information and to find your local service visit Brook's website.

Question 50

What are the signs of pregnancy?

Accepted Answer

If you've had unprotected sex or your contraception has failed, you could be pregnant. Signs and symptoms of pregnancy vary and can include the following:

Late or missed period.
Swelling or tenderness of the breasts.
More frequent trips to the toilet.
Nausea or vomiting (‘morning sickness’ can in fact happen at any time of the day).
Change in appetite.
Tiredness

If you've had unprotected sex within the last five days and don't want to be pregnant, you can use emergency contraception such as "the morning after pill" or IUD to ensure any pregnancy doesn't continue.

It's important to know the difference between the "morning after pill" and the "abortion pill": read more at this link.

If you've had unprotected sex more than five days ago, it’s important to take a pregnancy test after about three weeks, if your period is late, or if you have abnormal bleeding. Different home pregnancy tests can have different sensitivities, so if you have any doubt that you're pregnant –even when the test is negative – you should repeat the test a week later, or make an appointment with your GP or MSI Reproductive Choices.

If you’d like to know more, please call our advice line on 0345 300 8090.

Question 51

What is an ectopic pregnancy?

Accepted Answer

An ectopic pregnancy is a pregnancy that develops in the wrong place. A normal pregnancy implants inside the uterus (also known as the womb) but an ectopic pregnancy implants somewhere else, most commonly within the fallopian tubes. Ectopic pregnancy is estimated to occur in 11 of every 1,000 pregnancies.

If you have had a scan that confirms the pregnancy is developing normally, your risk of ectopic pregnancy is extremely low. If you have not had a scan or the scan did not show the pregnancy because it was too early, the risk of ectopic pregnancy is still very small, but it is important to know the following.

As ectopic pregnancies do not develop properly, the abortion medication is not effective to treat them. Therefore, if we suspect you may have an ectopic pregnancy, we will refer you to hospital for treatment.

Although not everybody with an ectopic pregnancy will have symptoms, the following things are important to look out for:

Sharp, stabbing pains in the lower abdomen
Pain in the shoulder tip area
Weakness, dizziness and fainting
Vaginal bleeding
Gastrointestinal symptoms (vomiting and/or diarrhoea).

If you have any of these symptoms, please give our nurses a call on our 24-hour aftercare line: 0345 122 1441

If you are experiencing severe pain, or feel very faint or dizzy, please call 999 or attend A&E as soon as possible.

You can read more about ectopic leaflet at this link.

Question 52

How many weeks pregnant am I?

Accepted Answer

If you've had a positive pregnancy test, we can help you find out how many weeks pregnant you may be (your gestation). Just call us on 0345 300 8090 and tell us the first day of your last period.

If you've had a positive pregnancy test and are thinking about having an abortion, it's important to know how many weeks pregnant you are as this can affect your options. Medical abortion (the abortion pill), for example, is only available at MSI Reproductive Choices up to 9 weeks and 3 days gestation.

If you’ve had a positive pregnancy result and it was unplanned, read more about your options.

Remember, our friendly team are here for you – just call us to speak with one of our advisors.

Question 53

How can I test whether I'm pregnant?

Accepted Answer

Home pregnancy testing kits are available in pharmacies and supermarkets. Your local GP, family planning clinic, specialist young people’s clinics like Brook, and some pharmacies can also provide free pregnancy testing.

After a positive pregnancy test result you can find out your gestation (how many weeks pregnant you are) by visiting a GP or sexual health clinic. If you know the date of the first day of your last menstrual period, we can help you to work out your gestation.

If you have irregular periods, no periods, or if the stage of the pregnancy is unclear, gestation can be checked with an ultrasound scan.

How many weeks you have been pregnant can affect what abortion options are available to you, so it’s important to find this out

Question 54

What is the “morning after pill”?

Accepted Answer

Using contraception when having sex is always the best way to prevent a pregnancy – you can choose from a range of long term and short term methods. If you've had unprotected sex or your contraception has failed (eg. you've missed taking a contraceptive pill or the condom split), emergency contraception can also prevent a pregnancy.

Emergency contraception is often referred to as the ‘morning-after pill’ but in fact it can be used within five days of having unprotected sex, and it works by preventing or delaying ovulation.

It is important to know that if the morning after pill is taken after ovulation it is unlikely to be effective.

Read more about emergency contraception.

Question 55

What is the most effective form of emergency contraception method?

Accepted Answer

There are 3 types of emergency contraception:

the emergency contraceptive pill Levonorgestrel (LNG), also known as Levonelle: it can be taken within 96 hours (four days) of unprotected sex, however it is most effective within the first 72 hours (three days).
the emergency contraceptive pill Ulipristal Acetate (UPA) also known as Ellaone: this can be taken within 120 hours (five days) of unprotected sex.
the intrauterine device (IUD or coil): this is the most effective emergency contraception and can be fitted up to 120 hours or 5 days after unprotected sex. A copper coil is a small, T-shaped copper device that is placed in a woman's womb and can provide contraceptive protection for up to ten years. One of the benefits of using the IUD is that, once fitted, you can then choose to continue to use it as your on-going form of contraception. Long-acting reversible contraceptive (LARC) methods offer excellent protection against pregnancy, ranging from three months up to ten years. They're ideal if you know that you do not want to have children for a while.

Because the morning after pill is unlikely to be effective when taken after ovulation, the most effective form of emergency contraception is the intrauterine device (IUD), also known as the coil.

The IUD can be inserted up to 5 days after unprotected sex, or up to 5 days after the earliest time you could have ovulated (released an egg), to prevent pregnancy.

Read more about emergency contraception methods.

Question 56

How does the IUD work as emergency contraception?

Accepted Answer

The intrauterine device (IUD) is a small, T-shaped plastic and copper device that's put into your womb (uterus) by a doctor or nurse. It releases copper to stop the egg implanting in your womb or being fertilised.

The IUD can be inserted up to 5 days after unprotected sex, or up to 5 days after the earliest time you could have ovulated (released an egg), to prevent pregnancy.

You can also choose to have the IUD left in as an ongoing method of contraception. The emergency IUD is the most effective method of emergency contraception – less than 1% of women who use the IUD get pregnant.

Read more about the IUD as emergency contraception.

Question 57

Which emergency contraception method should I use?

Accepted Answer

The type of emergency contraception you use will depend on your preference and the risk of falling pregnant. You can assess your risk of falling pregnant by using a simple calculator.

When did you have unprotected sex? Use this useful calculator.

Read more about emergency contraception methods.

Question 58

Do I have to pay for the morning after pill?

Accepted Answer

If you're aged 16 or over, you can buy the emergency contraceptive pill from most pharmacies, in person or online. You need to be at least 16 years old to buy the morning after pill online. The cost varies, but it will be around £25 to £35. You will have to pay for the morning after pill if you choose to purchase online.

We recommend to being assess by a health professional before using emergency contraception.

If you want the morning after pill for future use

Some organisations may allow you to buy the morning after pill for future use. Check your options with your provider.

Read more about emergency contraception.

Question 59

What is vasectomy?

Accepted Answer

Vasectomy is the common name for male sterilisation. It is a minor outpatient procedure which takes about 15 minutes and seals the tube (vas deferens) which carries sperm. This will prevent sperm entering your semen, which is the fluid ejaculated during sex.

Without the sperm in the semen, a woman's egg cannot be fertilised and she cannot become pregnant.

Read our vasectomy page for more detail on the procedure.

Question 60

Does vasectomy work straight away?

Accepted Answer

No - there will be some sperm left in your tubes after your procedure, so you will need to use another method of contraception until we have confirmed the success of your vasectomy in writing.

We will test your semen at 12 weeks after the procedure. When you have given your sample, we will write to let you know that your vasectomy has been successful and that you can stop using contraception. In some cases this can take several tests.

Please note, if you had your vasectomy prior to the 21st of November 2019, you will need to follow the process of providing two samples at 16 and 18 weeks after your procedure.

Find out more about semen-testing

Question 61

Will a vasectomy  affect my sex life?

Accepted Answer

Having a vasectomy will not affect your sex life.

After a vasectomy, the testicles will still produce the hormone testosterone, which is the male sex hormone. Many couples say that they enjoy sex more after a vasectomy. This is because they can choose to have sex more spontaneously, without worrying about an unintended pregnancy.

Question 62

Will I still be able to ejaculate after a vasectomy?

Accepted Answer

Yes. Vasectomy does not affect orgasm or the appearance of your semen.

Question 63

How should I prepare for my vasectomy?

Accepted Answer

Once you have booked an appointment for your vasectomy procedure, you can begin to prepare so that it goes as smoothly as possible.

1. Arranging travel

We will send you a map showing you how to reach the centre. If you are unsure about directions, have any queries, or think you are going to be late for your appointment, please call us on 0345 300 0212.

Find a clinic near you

It is important to arrange your return travel before you come to your appointment. You must not drive yourself home after your procedure, or drive for 48 hours afterwards. We recommend that you do not use public transport, but you can use a taxi service. If you need to use public transport, we strongly recommend that someone is with you when you travel in case you begin to feel unwell.

2. What to wear

It is important to wear tight-fitting cotton underwear on the day of your appointment, and for a minimum of seven days afterwards – the tighter the better. This is to support your scrotum, make you more comfortable, and speed up the healing process. We recommend getting some which are 1 or 2 sizes smaller than normal, and enough fresh pairs for your recovery. Close fitting underwear:

provides support to the testicles
helps reduce any pain
is more comfortable
will aid recovery
reduces swelling to the testicles

3. Pain relief

You can take pain relief before your appointment to help manage any pain or discomfort. We recommend that you take pain relief before your procedure - we suggest taking paracetamol (2 x 500mg).

Do not take aspirin as this can increase the risk of bleeding. If you take aspirin for medical reasons, please let us know so we can discuss this further with you.

4. Drug use

You should not have used any recreational drugs for at least 24 hours before your appointment. If you have taken recreational drugs, please tell us. This could affect your treatment and ability to consent.

5. Drinking alcohol

We recommend that you don’t drink alcohol 24 hours before your appointment. Alcohol can cause your blood vessels to dilate which may result in increased bleeding.

7. Bathing

It’s a good idea to have a bath or shower before leaving home on the day of your appointment. Please do not shave or trim the hair around the testicles.

Question 64

How should I care for the wound after a vasectomy?

Accepted Answer

As we only need to make a small puncture hole in the skin of the scrotum, your wound will be covered using just a simple dressing. The dressing should be kept dry and held in place for at least 48 hours by wearing tight-fitting, supportive underwear during the day and at night. This provides more support, can reduce pain and swelling, and will be more comfortable.

Please avoid taking a bath or shower during this period. You will be given aftercare information at your appointment with more detail.

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