Abortion

This is a sensitive subject and many people are polarised when it comes to discussing it - many people are either for it or against it. Sadly, it is not something that is as black and white as we'd like it to be and it is important that all aspects are covered because it is potentially a life-changing decision to have an abortion.

First let us be clear about what abortion is because medical professionals use this term to cover anything that causes the unborn baby to leave the womb prematurely without the ability to survive outside of the mother's body. When a woman miscarries, for example, it can often be a shock for her to hear the term "spontaneous abortion" or "missed abortion" - but that is what the word means - termination of pregnancy and expulsion of an embryo or of a foetus that is incapable of survival. When it comes to abortion as many understand it to be, it is referred to as an induced abortion; one that is the product of medical intervention to remove the embryo/foetus from the womb. An abortion is not a method of contraception - it should also not be used as an alternative to the morning-after pill. To avoid the trauma of multiple abortions, please ensure you use adequate contraception when embarking on a new relationship or engaging in casual sex - don't forget that many forms of contraception are free on the NHS, so make full use of them.

The decision to have an abortion is not one to be taken lightly - even if it does seem like the "easy" way to fix a seemingly impossible problem. There is not just the emotional aspect to go through but also the rigmarole of getting accepted for the procedure within the time limit - a real consideration for those who don't find out for a number of weeks that they are actually pregnant. I'll cover the process and procedures a bit later on, but right now I want to focus on the emotional aspects of choosing an abortion.

Is abortion the right choice for me?

To be perfectly honest with you, no one can answer that question and anyone who attempts to is a bit of an idiot, I'm afraid. Many people will give you their (somewhat heated) opinions but no one can actually make the decision for you. The trick here is to make sure that if you do ask others for their opinion, you don't ask too many. I'd recommend a maximum of three people you can trust, preferably older and wiser and at least one ought to be a counsellor specialising in abortion and post-abortion counselling. Whilst there are many organisations that claim to offer such a service as well as an abortion clinic, they are privately run and a few of them just want your money - harsh, but true. Or you can find yourself in the office of a counsellor affiliated with a pro-life organisation who will try to sway you towards their point of view - this is part of their job, but what you need is someone completely impartial, honest and armed with all the info you need to make this choice - because regardless of how hopeless you may be feeling, it is still a choice which you have control over.

One such organisation dedicated to helping women make the right choice for them - be it abortion, adoption, fostering or continuing the pregnancy - is a specialist crisis pregnancy service called Care Confidential. Whilst you may notice that they are part of a larger Christian caring network, they are unbiased towards all women regardless of religion or sexual orientation. They do not impose their values on others and undergo rigorous counselling training with refresher courses on a regular basis to ensure they are within the appropriate counselling guidelines. Of course, if you are a Christian, they will be more than happy to discuss the more spiritual aspect of your decision but without judgement. I really recommend these guys because many of them are people who have been through an abortion or unplanned pregnancy themselves, so they have a real heart of compassion for other people in the same situation.

Abortion is not an easy decision for many women - and for their partners and families too. Often it is chosen as the only option to what is regarded as a disastrous situation. Maybe you're single and don't have the means nor inclination to raise a child? Maybe you already have children and the thought of another adding to an already expanded family is too much to bear? Perhaps this pregnancy is the result of an affair and you need to remove all evidence if you have any hope of restoring a previous relationship? Or you could be one of the many women who are faced with the prospect of a severely disabled baby or are at risk of dying yourself if you continue with the pregnancy? What if you are still at school or you are just about to get that job/course/promotion and a baby will destroy your chances of a future? Whatever your reasons - it is not easy and it is not something you should have to go through alone. If you take the time to speak to the right kind of people, you may find that the decision won't be as frightening or as lonely as it may seem right now.

But I'm sure already - I don't want a baby right now

And that is perfectly fine - I'm just saying be sure. Once this pregnancy is over, it really is final - no going back and unfortunately you may feel differently afterwards. That is not always the case, of course, but it is something to seriously consider. Also, please don't forget that there are others involved here who may wish to have their views considered as well - I realise this is not a popular notion because, after all, it is your body and you are the one physically going through the trauma, but if there is a partner in your life he may well want to express his feelings too. As hard as it may be, please try to allow your partner at least the opportunity to talk it through with you, although I appreciate that this may be incredibly difficult, if not near-impossible.

My husband/partner/family are insisting I abort but I'm not so sure

Again, it must be emphasised that this is your choice even though I highly recommend bearing the views of your partner in mind when making this decision. If you are not sure, be aware that the longer you take to decide, the more difficult and traumatic the method of abortion because as the foetus grows larger, a quick tablet won't be enough to remove the contents of the womb. Too often the decision to abort is made without telling a single soul in order for it to all be over quickly - a decision made in haste and repented at leisure as you should have at least one person you can confide in to support you. Again, this won't necessarily be easy but it is better than keeping it to yourself and bottling up all the emotions that go with it. Get in the know - find out as much as you can about your various options besides abortion and arm yourself with that knowledge for when you start to voice your uncertainty. It is very likely others will simply not understand your reasons for wanting to take more time or perhaps not have an abortion after all when it all seems clean-cut and efficient to them for you to terminate asap. Be ready for this and be informed so that it will show them a practical way of dealing with the situation - if you feel more in control, it may very well calm some of their fears too. Above all, when it comes to the crunch it is you who has to go to the hospital/clinic; you who has to have medications or an operation; you who has to cope with the aftermath and any possible side effects. Be assertive, even if it is difficult - the last thing you want is to end up resenting those closest to you for pushing you in a direction you were never completely sure about in the first place.

I've had an abortion because it was the best choice for me - so why am I so upset?

Truth is, many women end up feeling a combination of emotions - usually starting with relief that it is all over and then in time becoming depressed, agitated and even suicidal. The realisation that a potential life has been ended can hit some women very hard indeed - even if they spent time getting the necessary information and counselling prior to the termination. Some women will feel sad, some guilty and some will be inconsolable at times - there are no hard and fast rules concerning your feelings after abortion.

Some people may say to you that you have no right to be so upset but you do - you have every right and it is far more harmful to keep a lid on such powerful emotions than it is to talk it over with someone. You may find you have no regrets, no emotions and nothing but relief and happiness afterwards and that is ok too - just be aware that there could come a time when you aren't so chirpy and in those instances you must allow yourself to be upset in order to stay emotionally and mentally healthy.

You may find yourself worrying that you may never be able to conceive again or if you do become pregnant and the baby has a health problem, you may blame yourself because of your previous abortion. Please be assured that this is not the case and sadly these things do happen - talk to someone if you feel overwhelmed by these fears so that they don't become something bigger than they are.

If the abortion was a decision made for you by a doctor (you may have not known you were pregnant and when a routine operation revealed the pregnancy, it may have been necessary to remove the embryo/foetus to avoid risk to your life) or had to be made as a result of a life-threatening condition or foetal defect then a sense of loss is perfectly understandable. You have been faced with an awful choice/situation and no one should begrudge you the decision to terminate. In the case of an embryo/foetus being removed in order to preserve your life, please understand that no doctor makes that decision lightly and please do not blame your partner or next of kin if they had to make that decision in your place - try to see how traumatic it must have been for them too, knowing how you are going to feel once you wake up from surgery. They did the best they could with what they had - under immense pressure and a time limit of perhaps only a few minutes too.

In whichever case - and those scenarios I have not covered - mourn the loss if you feel that is what you need to do. Go with your feelings and keep the lines of communication open with whoever you feel comfortable talking to. Resentment can build up if you don't stay honest and your partner/family must also be able to voice their feelings too - it won't be easy, but it is essential for your (and their) emotional wellbeing.

My partner is considering an abortion - what about my feelings?

It's a tough thing to go through when you are faced with the prospect of an unwanted pregnancy or you have been told that an abortion is the only route to save her life, for example. You may feel marginalised during the whole process and that your opinions don't count - you may have so many conflicting emotions that you don't know where to start. Plus, everyone seems to be fussing over the woman and expecting you to just fit in no matter what - even though you may have a completely different viewpoint to those around you. You may think that all you should do is support your partner's decision, but she will want your input too - many is the occasion whereby the man has kept his feelings to himself only to find out that he feels resentful and his partner feels like he didn't care enough to give his opinion. An excellent site dedicated to supporting men dealing with abortion is Men and Abortion - it provides articles, information and the opportunity to discuss your own story. It is an American site, for those of you outside of the US, so not all the relevant links and contact details will be applicable to you but it is an excellent source nonetheless. You may also find chatting to other guys over at C.A.L.M could help - it's a site and helpline dedicated to letting men talk about anything concerning them and has loads of useful links for those of us in the UK. Whilst not specific to abortion, it really is guy-friendly and puts emphasis on you rather than the women in your life. Makes a nice change, huh?

Abortion is my final choice - how do I go about this?

Okey dokey - here's what you need to know:

• Abortion is only legal in the UK up to 24 weeks - only in exceptional circumstances may a woman be permitted an abortion beyond this period as by 24 weeks the baby is considered viable - capable of surviving outside of the womb. Needless to say, an abortion after this time is intensely traumatic and rarely offered.
• The earlier you can identify the pregnancy, the better - to have an abortion on the NHS can be free but there is a waiting list of anything between 2-4 weeks, so ideally it is best to determine whether you are pregnant before 8 weeks. You can opt for a private abortion, but it will cost you upwards of £450 on average and then get even more expensive if you are nearer to the 24 week mark.
• In order to qualify for an abortion you need the agreement of two doctors - they have the right to object on moral grounds but they ought to refer you to someone else and explain this to you. Often the referring doctor may advise you seek counselling beforehand - some private clinics offer this in-house, but an impartial service is recommended to avoid any possible bias one way or the other. You will also be required to tell your doctor your reasons for wanting an abortion, so be prepared to answer a few questions about your decision.
• The abortion may be performed if the doctors can agree that the baby will harm the mental or physical wellbeing of the mother or that it will affect the mental or physical wellbeing of any children the woman already has. If it is after 24 weeks, an abortion may be performed if the baby is going to be seriously disabled in some way or if the mother's life is in danger. It is also considered if there is a risk of serious permanent harm to the mother's mental and/or physical wellbeing.
• If you are under 16 and wish to have an abortion, it is possible but there are special rules to follow in this instance. Be aware that your parents cannot force you to have an abortion - it is still your choice, although speaking to them about it would be preferable. You do not need parental consent if the doctor decides that it is in your best interests and that you are well informed enough to make such a decision. However, it is best to seek further advice and support from somewhere like a Brook Advisory Clinic as they have plenty of experience in dealing with an underage pregnancy and will be able to advise you best.
• There are two main methods of abortion for embryos/foetuses up to 24 weeks - early medical abortion and vacuum aspiration. The early medical abortion is only available up to 9 weeks and only in certain areas on the NHS so please check with your doctor whether this is available in your area or not. There is no surgery involved - you are given a pill called mifepristone and then 36 to 48 hours later, a tablet called prostaglandin is placed in your vagina. This method ends most early pregnancies within the following four hours and it feels like having a heavy and rather painful period, so stock up on sanitary towels (not tampons) and take painkillers if you need them - Feminax is a good choice as it specifically targets period pain (obviously check any painkillers you take against other regular medications to ensure you don't take something you shouldn't). Vacuum aspiration is used up to the 13th week of pregnancy and is more invasive - you are given either a local or general anaesthetic before your cervix is gently stretched open to allow the doctor to insert a tube into the womb which then sucks out the contents in less than a minute. Afterwards, a healthy woman only needs about an hour to recover before being allowed to go home the same day. There are no stitches or scars left behind, so don't worry about anything like that although there will be some bleeding and pain for a few days after the abortion which can be managed with over-the-counter painkillers. You will be advised by a nurse/doctor as to any specific after-care following the procedure and if you should experience any unusual vaginal discharge/heavy bleeding/severe pain/high temperature you must go back and see a doctor in case you have an infection.
• It is possible to become pregnant again as soon as 7 days after the abortion so please use contraception as soon as possible if you do not wish to repeat the experience - don't forget that some areas will refuse to do second abortions, so be aware of your area's policy regarding multiple terminations. You will also need to keep a follow-up appointment with your doctor to ensure that everything is still ok.
• If your pregnancy has exceeded 13 weeks, be prepared for something a little more traumatic - it will depend on your doctor and facilities available as to which method will be used and it will also depend on how advanced the pregnancy is which is why it is recommended that you get a positive pregnancy test as early as possible. You may be offered a pill and pessary combination similar to the early medical abortion, but the bleeding and pain will be more severe and may take slightly longer. Something called a surgical dilatation and evacuation (D&E) may be another option whereby you will be put to sleep and the cervix will be opened to allow for a suction tube and forceps to remove the foetus in parts. If you are quite advanced in your pregnancy (over 20 weeks) and your doctors are willing to still carry out the procedure, you may require a short stay in hospital in order to have one of two operations:
• Surgical 2-stage abortion - under general anaesthetic the umbilical cord will be cut and then in a second operation, the contents of the womb will be removed.
• Medical induction - the foetal heart will be stopped and then you will be given medication to induce premature labour - make no mistake about it, this will be intense and shocking and you must be so certain that this is the decision you wish to make. It is a huge trauma to go through and it is no wonder many doctors refuse to carry out the procedure unless there is a very good reason.

More to it than you thought? Maybe - which is why I keep stressing the point that you must speak to someone if possible before making this decision. Be prepared for your doctor to possibly ask that you wait for a while before referring you for an abortion - he/she is doing this to ensure you are fully ready, but if you are not happy to wait, you can always contact a clinic for further advice and a shorter delay. After an abortion, there is very little chance of your fertility being impaired - it is so rare as procedures are far more refined these days and the risk of serious injury is pretty remote. You may need antibiotics if you contract an infection following the procedure, but again this should not affect your ability to have children in the future.

All in all, it will be a difficult decision but you are not alone. There are many people out there who can help you before and after an abortion - you can also come and discuss it in our Abortion Forum or if you prefer a more private discussion, feel free to contact us here at Mystopgap.com.