Abortion Counselling Care and Support Service (ACCESS)

How to contact the ACCESS team

An unplanned pregnancy can be emotionally difficult and stressful. Some people will choose to continue the pregnancy but others will choose to have an abortion.

In Grampian people wanting to discuss unplanned pregnancy contact the ACCESS team based in Aberdeen.

You do not have to be certain that you want an abortion before you get in touch.

You can make your own appointment by calling 01224 655535 Mon- Fri 0900-1400.

We use Language Line professional translation service when needed.

What happens next?

You will have a telephone consultation to discuss:

• how far on the pregnancy is
• details of any medical problems / previous pregnancies / medicines / allergies
• your individual circumstances and reasons for considering termination
• the methods of abortion you could choose
• contraception for the future
• tests for sexually transmitted infections.

If you agree we will send you a clinical questionnaire to complete on your mobile phone before the consultation.

Most people will need to come to clinic and have an ultrasound scan. One reason for a scan is to be sure how far on the pregnancy is. This affects the type of abortion you could have.

This is usually an internal (vaginal) scan so you do not need to have a full bladder. You can choose whether or not to see the scan picture.

Some people will be able to collect abortion medication without having a scan.

We advise everyone to have a vaginal swab to check for infections which could cause complications if untreated.

You will be able to ask any further questions and then make arrangements for abortion - if this is what you choose. You may need more time to decide what to do or may decide to continue the pregnancy.

It may be possible to start the abortion process on the day you come to the clinic and we aim to offer abortion in hospital within 7 working days of your clinic visit.

Some people will need a blood test before the abortion.

Please let staff know if you find vaginal examination or blood tests difficult.

Safe Access Zones are in place around all premises in Scotland which provide abortion care. It is illegal to influence, harass or prevent anyone from accessing or providing abortion services within this 200m zone.

Please phone 01224 655535 to book, cancel or rearrange your appointment or if you have questions about what will happen at your appointment.

Different Methods of Abortion

Abortion can be done using medical (tablet) or surgical (operation) treatment.

Each method has advantages and disadvantages. You will be able to discuss the methods suitable for you in detail during the consultation and will be offered written information. The following is a brief summary.

Medical Abortion

This involves taking two different types of tablet two days apart.

The medical abortion is started by swallowing a tablet called mifepristone. This makes the second part of the procedure more likely to work. You can expect to carry on with your normal activities after this tablet. Some people have light vaginal bleeding and cramps but less than 1 in 100 people pass the pregnancy at this stage.

The abortion is completed 36 to 48 hours later with a medicine called misoprostol which makes the uterus contract and pass the pregnancy. The misoprostol tablets can be placed in the vagina or under the tongue. Further doses are taken every 3-4 hours until the pregnancy comes away.

Most people start to have cramps within 30 minutes. They will come and go until the pregnancy comes away. Most people say the cramps are stronger than their usual period pain. There will be heavy bleeding with clots that settles down after the pregnancy comes away. Some women feel sick, have diarrhoea or feel shivery during the abortion.

We would supply antisickness medicines and pain killers.

The abortion process usually takes 4-6 hours but may be quicker or slower. It tends to take longer if the pregnancy is further on.

Many people prefer to complete the abortion procedure at home. This can be an option in earlier pregnancy. We strongly advise that you have an adult with you on the day. You would not be able to work and must not be responsible for children that day. We provide a 24 hr Grampian phone number to call for advice or if there were problems during the procedure.

Some people will need to come in to hospital to complete the procedure. This may be because the pregnancy is further on or they may have medical problems or not have adult support. Some people prefer to be in hospital.

People coming in to hospital for medical abortion will have a single room in the gynaecology ward at ARI. A friend or relative can stay but there are no facilities for small children on the ward. Most people are able to leave hospital by the evening but we advise that you make arrangements in case you need an overnight stay.

There is a small risk, less than 1 in 100, that the tablets will not end the pregnancy. If this happened you would be offered a surgical abortion or another course of tablets, depending on how far on the pregnancy is. We advise people having a home abortion about what to expect and when to get in touch and supply a special pregnancy test to do after 2 weeks to rule out an ongoing pregnancy.

There is a risk that not all the pregnancy tissue comes away. This happens in around 1 in 100 medical abortions under 9 weeks, 4 in 100 between 9 and 12 weeks and 8 in 100 over 12 weeks. This may be treated with another course of tablets or may mean coming in to hospital for surgery to remove the tissue.

In pregnancies over 12 weeks there is a very small risk that the uterus could be damaged by the contractions caused by the medicines (less than 1 in 1000 women over 12 weeks). This would need emergency surgery through an abdominal incision.

Surgical abortion

Surgical abortion is an option in Grampian for pregnancies under 12 weeks. The operations are done on set days at hospital.

The procedure involves removing the pregnancy through the cervix using a suction technique. The operation itself usually takes less than 10 minutes. The operation is made safer by softening the cervix with a medicine called misoprostol. The tablets are taken when you arrive at hospital. They are placed under the tongue and need 1-3 hours to be effective. They may cause cramps, bleeding, nausea and shivers. You would be offered antisickness medicines and painkillers.

You should not eat or drink for a short time before the abortion. We will give you details about this.

Surgical abortion can be done with local anaesthetic (awake) or general anaesthetic (asleep).

General anaesthetic (asleep) is given through a drip in the back of your hand. You are asleep for the whole procedure. You would need to stay in hospital for 2-3 hours after the operation and need an adult to collect you and be with you for 24 hours. You should not drive or do anything needing quick reactions for 24 hours.

Local anaesthetic (awake) is given as an injection to numb the cervix. Most people say that they feel strong cramps during the procedure which ease off within 15 minutes or so. The theatre team are there to support you. You can usually leave hospital about an hour after the procedure and can drive yourself home if you feel able.

We do an ultrasound scan at the end of the procedure to confirm the pregnancy has been removed.

If you choose an IUD (coil) for ongoing contraception we could fit it at the end of the procedure.

Surgical abortion has a small risk of damaging the uterus (less than 1 in every 1000 abortions in Grampian) or the cervix (less than 1 in 1000 abortions in Grampian). If the uterus is damaged, you would need further surgery which may be laparoscopic (keyhole) or open to repair any injury.

There is less than a 1 in 500 chance in Grampian that you would need to come back into hospital for more treatment because the pregnancy was continuing.

There is less than a 1 in 500 chance in Grampian that you would need to come back to hospital for more treatment because not all the pregnancy tissue had come away.

How Safe Is An Abortion?

Abortion in Scotland is a very safe procedure. None of the abortion methods are ‘easy’ but there are fewer health risks from abortion than there are from continuing a pregnancy.

There are some risks from having any type of abortion:

Less than 1 in every 10 people having an abortion may develop an infection. We advise everyone to have a swab test to rule out certain infections before abortion. Some people will be offered preventive antibiotics. We will advise you what to look out for and how to get in contact if you think you may have an infection.

Around 1 in every 1000 people having an abortion may have heavy bleeding and need a blood transfusion. Heavy bleeding is more likely if the pregnancy is further on. Please let the clinic doctor know if you have concerns about blood transfusion.

If the abortion is uncomplicated, it should not have any direct effect on the chance of getting pregnant in the future. There may be a small increased risk of slightly early labour in a future pregnancy. No other long term health issues have been linked with abortion.

How you feel emotionally will depend on your individual circumstances, why you are having the abortion and how comfortable you feel about the decision. You may feel relieved or sad or a mixture of both. Most people have a range of emotions around the time of abortion. Only a small number have long term feelings of sadness, guilt or regret after an abortion.

Problems after either ending or continuing an unplanned pregnancy may be more likely if you have had emotional or mental health problems in the past. Please get in touch with the ACCESS team or your GP if you would like more support.

What Should I Expect After An Abortion?

After any type of abortion you may have cramps like period pain for 2 to 3 days. It is quite usual to need a heat pad or painkillers such as paracetamol or ibuprofen.

You can expect to have bleeding like a moderate/heavy period for 7-10 days and you may pass some clots. There may be another 1-2 weeks of lighter bleeding.

We advise you to wait for the bleeding to settle before having sex.

Your first period is likely to come 4-6 weeks after the abortion and may be heavier than usual.

If you had a medical abortion or surgical abortion with local anaesthetic you could expect to return to work/childcare within a day or two. If you had a surgical abortion with general anaesthetic you should not drive or do anything needing quick reactions for 24 hours.

Further Information

Further information is available from the NHS inform website www.nhsinform.scot

Abortion talk provide a telephone counselling service www.abortiontalk.com Tel: 03330 909 266 7pm-10pm Mon, Tue, Wed, Thur

Research Studies

You may be asked if you would consider helping with research studies. This is always your choice and will not affect the care you receive. All research studies are approved by the Grampian Research and Ethics Committee and full patient information leaflets are provided.

Health Records

Details of your care from the ACCESS service will be recorded in your hospital medical files and on the NHS Grampian secure computer system and on the secure NASH Scottish Sexual Health System.

We will ask you whether we can directly contact your GP about the procedure.

Some information must be recorded to meet the requirements of the Abortion Act 1967 and Abortion (Scotland) Regulations 1991. Data is provided in strictest confidence to the Information Services Division of NHS National Services Scotland.

All data is processed and stored securely in accordance with General Data Protection Regulation.

 

Published: 24/01/2025 11:46