7.4 Termination of Pregnancy

Question 1

What acts govern abortion laws?

Answer 1

1967 Abortion Act

1990 Human Fertility and Emryology Act

Question 2

What is the latest gestational age that an abortion is legal?

Answer 2

24 weeks (1990 HFEA Act)

Question 3

When can an abortion be done up to 24 weeks?

Answer 3

If continuing would involve great risk to physical or mental health of:

• mother
• existing children

Question 4

Under what conditions can an abortion be performed at any time?

Answer 4

Anytime if:

• continuing likely risks the life of the woman
• terminating will prevent “grave permanent injury” to physical or mental health of woman
• “substantial risk” that child would suffer physical or mental abnormalities and be seriously handicapped

Question 5

What are two legal requirements for UK abortions?

Answer 5

• two registered medical practitioners must sign to agree abortion is indicated
• must happen in NHS or approved premise by a registered medical practitioner

Question 6

How can someone access abortion services?

Answer 6

self referral to GP, GUM or family planning clinic.

Marie Stopes is a charity, do remote consultation if under 11 weeks

Question 7

What drugs are used when for a medical abortion?

Answer 7

MiFepristone First
MiSoprostol Second (1-2 days after)

Question 8

What is the MOA of mifepristone?

Answer 8

Mifepristone is an anti-progestogen that blocks progesterone, halting pregnancy and dilating the cervix.

Question 9

What is the MOA of misoprostol?

Answer 9

Misoprostol is a prostaglandin analogue.

Prostaglandins soften the cervix and stimulate uterine contractions.

Question 10

How much misoprostol is needed after 10 weeks?

Answer 10

Need to repeat misoprostol every 3 hours until expulsion.

Question 11

At what point in abortion care do you need to give anti-D prophylaxis?

Answer 11

If rhesus negative woman and if abortion is greater than 10 weeks
(consider it in <10weeks)

Question 12

What methods are used for surgical abortion and at what dates?

Answer 12

Cervical dilatation and suction (up to 14 weeks)

Cervical dilatation and evacuation using forceps (14-24 weeks)

Question 13

What can women expect after an abortion?

Answer 13

• bleeding and cramps intermittent for up to 2 weeks
• pregnancy test at 3 weeks
• discuss and start contraception where apropriate
• support and counselling offered